Vulnerability
Doctors, as a group, are conscientious to the point of self-effacement and have a tendency to blame themselves for perceived inadequacies (18). We can be perfectionistic and conscientious, putting our own needs aside to provide good patient care. When the workload becomes overwhelming, we try to increase our own work capacity. These qualities can be strengths, but the diminished ability for self-care creates a vulnerability that can increase the risk of mental health problems. The consequences can be serious if our identity is rooted in mastery and control. Guilt and shame for not measuring up add an extra burden. The perception of doctors as superhuman is likely something we as a group have inadvertently cultivated. Disdain for our own weakness and fear of showing vulnerability can also affect the way we interact with patients (19).
Villa Sana is a high-quality resource. Its content is well tested and is beneficial for weary doctors. Knowledge from the professional community around Villa Sana should be utilised more extensively for prevention and to enable medical students and doctors to recognise the mechanisms of burnout and increase their knowledge of self-care.
Social support acts as a buffer against the strain of high demands and little control. The #legermåleve stories unfortunately suggest that not everyone receives this support from their colleagues and managers. The doctor culture has major potential for improvement, providing an opportunity to reflect on our own practices.
The Health Personnel Commission states in its report that 'a manageable workload, well-being, motivation and professional development are important for recruiting and retaining employees' (20). This is an essential realisation that must be taken seriously. Well-being is about how we get on with each other, how we communicate and how we support each other. Strong relationships require work.
Doctors are particularly vulnerable in the early stages of their career. Throughout history, junior doctors have been told that 'things were worse back in the day'. In many hospitals, it is still socially accepted that junior doctors are reprimanded in front of other people. In some places, junior doctors are even afraid to contact the doctor on call, which compromises patient safety. Insecurity creates a poor learning environment (21).
Doctor colleagues should aim to be a resource for each other and share their experiences. Everyone has a responsibility to look out for colleagues and help create a culture of effective communication; however, older doctors should feel a special responsibility. Junior doctors need care, a safe environment, adequate training and professional support.