Don’t leave me this way: looking at the doctor exodus and underlying reasons

The morale of doctors is low and many are considering leaving the profession due to work pressures and stresses. A recent survey revealed that not only are half thinking of leaving the profession but that two out of three doctors would consider working abroad to improve their work-life balance. We take a look at the survey results and speak to Dr Richard Pullinger, consultant in emergency medicine, about the reality of the situation

The results of this survey are a reminder of a very real crisis in healthcare; we are experiencing rising public demand and diminished resources to answer this alongside a worrying shortage of doctors; this will likely get worse before it gets better.

The findings

Surveying 1,161 doctors, found that more than 50% of doctors don’t feel appreciated at work and are considering leaving the profession due to stress. It was also found that two out of three doctors would consider working overseas to improve their work-life balance.

The survey also showed that there were regional differences, with doctors in the North and South West highlighted as the most overworked and suffering from the highest levels of stress; Northern Ireland comes out on top as the best region to work.

The findings represent a snapshot of the sentiment of the medical community at a time of turbulence within UK healthcare – and makes for concerning reading, especially for the NHS.

Not to be ignored

The evident shortage of doctors in the UK has resulted in a recruitment drive to attract overseas’ doctors. However, rather than look beyond the UK and rely on international recruitment, the team at suggests that perhaps we first need to focus on addressing the problems at home.

“The decision to apply for medical training is never taken lightly and the prospect of hard work required for a medical career is balanced by the expected rewards of making the lives of the injured and unwell a little better.

“The imperfections of health services can weigh heavily upon the those involved. Recent doctors’ strikes in several countries reflect the tension between rising public demand for healthcare and limitations of available resource,” Dr Richard Pullinger, consultant in emergency medicine, says.

A general feeling

What, then, is the general feeling amongst the community? “UK doctors are aware of the decrease in health expenditure as a percentage of GDP since 2009 – despite increasing requirements for healthcare amongst a larger and more elderly population. They are aware that the UK public say that they would be happy to pay higher rates of tax to support improvements in the NHS. Whilst they know that systems and pathways need to continually adapt to rising demand the dominant concern among doctors is that UK health and social care need to be adequately funded,” Dr Pullinger says.

In late October, a letter, co-ordinated by the NHS Confederation, was sent to the treasury, calling for increased funds to tackle the health and social care crisis and support the precarious state of NHS healthcare. However, it remains to be seen whether the chancellor, Philip Hammond, will revisit spending plans for 2018-19 and 2019-20 and provide ring-fenced funding which would support the development of new, fit-for-purpose care models.

Problems in practice

What of general practice in all of this? The pinch of the ‘workforce crisis’ is being felt. A group of Bedfordshire-based GPs have raised concerns at their Local Medical Committee conference about increasing pressures on GPs at a time of constant workload increases and severe underfunding. The group is calling on the British Medical Association to, ‘urgently look at how these GPs can be supported to operate within a private, alternative model’.

In other areas doctors are warning that patient welfare and safety is being put at risk due to GP shortages. For example, in Folkstone, one GP has had to close due to a GP shortage, with the other seven practices in the local area saying that they are too full to take any additional patients.

As healthcare providers prepare for the winter influx, it seems unlikely that there will be any break in the pressures being borne by those in the business of providing care.

Your experiences

How are you and your practice team coping with and managing increased workloads and pressures? Have you encountered difficulties recruiting GPs, or do you have a GP who is leaving for pastures greener? We’d love to hear about your experiences and your opinions on this subject. Please get in touch my emailing Marie Cahalane.

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