Paediatricians
Paediatricians have represented around 5% of referrals to our service over the past 10 years. 79% of patients have been working at presentation. Paediatricians presenting to the service are more likely to be female (76%) than male and in training (70%), meaning the cohort is quite young. As with the O&G specialty, the vast majority of these patients present to the service with mental health issues rather than addictions. Paediatricians in fact have the lowest percentage of addiction problems across all specialties that have presented the Practitioner Health. This specialty if also the lowest out of all groups in terms of involvement with the regulator. Theories as to why this may be include the possibility that paediatricians have better systems in place to identify poor performance or in particular identifying where an impact on performance starts to affect someone’s work. Another idea could be that those who choose to specialise into paediatrics are more willing to follow rules, guidelines and policies than other professional groups.
Neonatologists and intensive care specialists in particular forma significant subgroup of the paediatrician patients attending Practitioner Health.
When considering why paediatricians are developing more mental health problems, there are a number of potential theories. Paediatricians can be subject to negative exposure when high profile cases face media attention. For example court cases regarding negligence in cases such as Baby P or Dr Bawa-Garba show how paediatric departments can be scrutinised in the public eye, leaving the staff to feel even more under pressure. Cases also such as Charlie Gard and Alfie Evans, where parents’ appeals go against doctors’ treatment plans being shown in the media and taken to High Court allow members of the public to give their opinion from afar, criticising care that these patients receive from paediatricians and other healthcare teams. This leads to a further decrease in morale amongst doctors who are trying their best. Self-doubt and anxiety about their abilities can result, as well as practitioners experiencing lower moods which on an ongoing basis can develop into depression. These factors, in combination with increasing rota gaps and workforce pressures has had a negative impact on recruitment and morale within the profession. Practitioner Health sees the impact of this as the numbers of paediatricians presenting to the service has increased in recent years and is an over-representation in comparison to other specialties of similar size.
Although paediatrics has always been a tough specialty, the rewarding aspects of the job include seeing children recover on the wards and in the community. However this aspect of the job is now not as prominent, as wards tend to be filled with more long-stay patients with acute and chronic illnesses. Complex illness in patients who aren’t improving, combined with parents who are tired and stressed makes for a challenging combination.