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 Researchers surveyed 299 residents at 20 teaching hospitals in New
England about their physical and mental health. Participants were 31
years old, on average, and 35% reported having no routine place for
medical care, the study found.
Among these young doctors who lacked a place for regular checkups,
38% were taking daily prescriptions for chronic health problems.
"This is a much higher proportion than that of the general
population, in which 22% of individuals aged 25 to 44 lack a routine
place for medical care, leading to concern for reduced resident
health and untreated medical or mental disease," lead study author
Dr. Erika Rangel, of Brigham and Women's Hospital and Harvard
Medical School in Boston, and her colleagues write in the Journal of
the American College of Surgeons.
"Despite efforts to establish resident wellness programs, the
proportion of trainees in this study who do not have a routine place
for medical care has not improved over the past 20 years, suggesting
further work must be done to reduce barriers to care," Rangel and
colleagues write.
While the study wasn't designed to examine whether or how training
to become a doctor might deter people from seeking care, it's
possible that erratic working hours, time constraints, easy access
to informal health consultations, and a culture of self-reliance may
contribute to this problem, the study team writes.
Most of the study participants were in their first or second year of
residency programs and 78% of them reported being in a relationship
- often with other doctors or residents.
Residents without a routine place for medical care were less likely
to get preventive health services like skin exams, blood pressure
screenings, or cholesterol checks than their counterparts who did
have a regular medical home.
More than half of residents said they had not seen a primary care
provider in the past year and one in four of them had not seen a
mental health provider.
Residents who reported they had not seen a mental health provider
within the past year were more likely than those who had to describe
depression symptoms: 81% compared with 62%. Half of residents who
didn't see a mental health provider reported burnout, compared with
36% of people who did get mental health care.
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People with children were more than twice as likely to report
burnout as residents without kids, the study also found.
Residents who were in romantic relationships with other residents
were 49% less likely to report symptoms of depression.
Residents who took prescribed medications, however, were more than
twice as likely to report depression or burnout than their peers who
didn't have daily prescriptions.
Compared with survey participants in family medicine, those in
surgery, internal medicine, radiology, anesthesia, obstetrics and
gynecology, and pediatrics were roughly four to eight times more
likely to lack a routine place for medical care.
The likelihood of depression or burnout didn't appear to vary based
on medical specialty.
Beyond its small size, another limitation of the study is that
researchers relied on participant recall. Because the main focus of
the study was self-care habits specific to depression, people
without symptoms of depression may have been less likely to
participate, skewing the results, the study team also notes.
Even so, the results highlight a potential need to improve access to
care and utilization of health services among residents, they write.
"Resident health is vital to the mission of physician well-being and
mitigating the escalating problem of burnout," the researchers point
out.
"Barriers to self-care and help-seeking behavior should be evaluated
to promote sustainable behavior that will encourage a long
professional career," the study team concludes.
SOURCE: https://bit.ly/2Lsp41j Journal of the American College of
Surgeons, online November 22, 2019.
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