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Do overworked Doctors need Appraisal the most?

Dr Sue Warren

It has been shown that doctors have a higher rate of burnout and increased suicide rate than the general population. Doctors today face much stress, regulation, and a culture of complaints. They are not staying in the profession, which is causing a countrywide shortage of GPs. Many doctors have little time and access to a reflective space in which to discuss their own situation with someone outside their own Practice and family. This is even more true in COVID times. This has important implications for the functioning of the NHS, exacerbated further by a high increase in workload and patient consultations which are up 13%. 

This study set out to discover whether a GP who is at risk of burnout could feel comfortable with discussing this issue at Appraisal, and whether they see Appraisal as a useful forum for discussion of issues that could affect their mental health and physical wellbeing.

The survey, comprising 11 questions, was sent out in October 2018 to 2,520 GPs in the Wessex region using an online data collection survey application. There was a 20% return rate, providing 503 responses. The key findings from the survey were:

  • 90% reported some level of burnout
  • 88% stated that their mental and physical health had been affected by their work
  • 42% considered the appraisal meeting to be useful personally
  • 30% reported that they had a poor work/life balance
  • 60% would discuss issues with burnout at the time of appraisal
  • 67% considered appraisal discussion as good use of their time

This study identified a very worrying level of burnout and distress among GPs in Wessex. The majority of GPs who responded found value in a supportive and formative Appraisal. The likelihood of realising this valuable aspect of the Appraisal discussion is dependent on the quality of the Appraiser. It is also important to minimise the burden of Appraisal.

The study showed that Appraisal can have a role in identifying GPs in difficulty and signpost them to appropriate help and support. Interventions, such as coaching, referral to other agencies such a Practitioner Health, or the BMA counselling service, may be appropriate.

Dr Warren is a former GP Partner, currently a Locum, Appraiser, and Clinician in Practitioner Health.