Occupational health risks for doctors in contemporary public healthcare systems (review)

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UDC: 
316.334:614.253
DOI: 
10.21668/health.risk/2020.2.20.eng
Authors: 

I.L. Krom, M.V. Erugina, M.G. Eremina, E.P. Kovalev, E.M. Dolgova, G.N. Bochkareva, E.A. Grigor'eva

Organization: 

Saratov State Medical University named after V.I. Razumovsky, 112 Bol'shaya Kazach'ya Str., Saratov, 410012, Russian Federation

Abstract: 

Doctors’ health is seen as a sign that a public healthcare system is efficient. Authors of the present work aimed to review occupational health risks for doctors in contemporary public healthcare systems; to do that, they analyzed publications taken from both domestic and foreign databases. Multiple research works indicate that doctors’ health and their efficiency are closely connected with peculiarities of their working conditions. Literature contains convincing evidence that unfavorable working conditions exert their influence on doctors’ health; induce occupational diseases, occupational stress and burnout. Specific attention paid to occupational burnout is due to its high prevalence as well as impacts exerted by it on individual health and occupational efficiency of doctors.
The authors note that researchers’ interest to occupational stress occurs due to its negative effects on doctors’ health and occupational efficiency and clinical safety as well. Some research works dwell on clinical context of occupational stress that includes strict requirements to work and adverse conditions that stimulate burnout and can result in a threat to a patient’s safety. In researchers’ opinion, specific development of occupational stress syndromes is predetermined by essence and peculiarities of occupational activities performed by doctors with different specialties. Prevalence of occupational burnout among doctors is associated with dysfunctional practices adopted in national public healthcare systems, conditions for medical aid provision, medical specialty, age and gender characteristics, and a stage in career development.
It is noted here that doctors’ health is discussed in modern Russian research works not only within the context of unfavorable working conditions. An overall crisis and dysfunctional practices adopted in contemporary Russian public healthcare system have determined status inflation and marginalization of doctors’ occupational group; it influences their individual health directly via financial deprivation and relative deprivation such as stress related to social comparison. In the authors’ opinion, this stress ultimately results in occupational one.

Keywords: 
health risks for doctors, risk factors, doctors’ efficiency, occupational stress, unfavorable working conditions, burnout, status inflation, financial deprivation
Krom I.L., Erugina M.V., Eremina M.G., Kovalev E.P., Dolgova E.M., Bochkareva G.N., Grigor'eva E.A. Occupational health risks for doctors in contemporary public healthcare systems (review). Health Risk Analysis, 2020, no. 2, pp. 185–192. DOI: 10.21668/health.risk/2020.2.20.eng
References: 
  1. Lesser C.S., Lucey C.R., Egener B., Braddock C.H., Linas S.L., Levinson W. A behavioral and systems view of professionalism. JAMA, 2010, vol. 304, no. 24, pp. 2732–2737. DOI: 10.1001/jama.2010.1864
  2. Lemaire J.B., Wallace J.E. Burnout among doctors. BMJ, 2017, vol. 14, no. 358, pp. j3360. DOI: 10.1136/bmj.j3360
  3. Leont'eva E.Yu., Bykovskaya T.Yu., Ivanov A.S. Current state of working and health conditions of health workers of dental speciality. Glavnyi vrach Yuga Rossii, 2019, no. 3 (67), pp. 4–8 (in Russian).
  4. Krasovskii V.O., Karamova L.M., Basharova G.R. Professional risks to health of the personnel of service of the first help. Norwegian Journal of Development of the International Science, 2019, no. 26 (2), pp. 52–57 (in Russian).
  5. Weigl M., Hornung S., Angerer P., Siegrist J., Glaser J. The effects of improving hospital physicians working conditions on patient care: a prospective, controlled intervention study. BMC Health Serv Res, 2013, no. 13, pp. 1. DOI: 10.1186/1472-6963-13-401
  6. Kraatz S., Lang J., Kraus T., Münster E., Ochsmann E. The incremental effect of psychosocial workplace factors on the development of neck and shoulder disorders: a systematic review of longitudinal studies. Int Arch Occup Environ Health, 2013, no. 86, pp. 375–395. DOI: 10.1007/s0042 0-013-0848-y
  7. Ma T., Yang T., Guo Y., Wang Y., Deng J. Do challenge stress and hindrance stress affect quality of health care? Empirical evidence from China. International journal of environmental research and public health, 2018, vol. 15, no. 8, pp. 1628. DOI: 10.3390/ijerph15081628
  8. Msaouel P., Keramaris N.C., Apostolopoulos A.P., Syrmos N., Kappos T., Tasoulis A., Tripodaki E.-S., Kagiampaki E. [et al.]. The effort reward imbalance questionnaire in Greek: translation, validation and psychometric properties in health professionals. J Occup Health, 2012, no. 54, pp. 119–130. DOI: 10.1539/joh.11-0197-OA
  9. Loerbroks A., Weigl M., Li J., Angerer P. Effort–reward imbalance and perceived quality of patient care: a cross-sectional study among physicians in Germany. BMC Public Health, 2016, vol. 18, no. 16, pp. 342. DOI: 10.1186/s12889-016-3016-y
  10. Tsutsumi A., Kawanami S., Horie S. Effort–reward imbalance and depression among private practice physicians. Int Arch Occup Environ Health, 2012, no. 85, pp. 153–161. DOI: 10.1007/s0042 0-011-0656-1
  11. Vu-Eickmann P., Li J., Mueller A., Angerer P., Loerbroks A. Associations of psychosocial working conditions with health outcomes, quality of care and intentions to leave the profession: results from a cross-sectional study among physician assistants in Germany. International archives of occupational and environmental health, 2018, vol. 91, no. 5, pp. 643–654. DOI: 10.1007/s00420-018-1309-4
  12. Lee R.T., Seo B., Hladkyj S., Lovell B.L., Schwartzmann L. Correlates of physician burnout across regions and specialties: a meta-analysis. Hum Resour Health, 2013, no. 11, pp. 48. DOI: 10.1186/1478-4491-11-48
  13. Lepaev Yu.V. Clinical Sign of Emotional Stress in Neurologists. Vestnik Meditsinskogo stomatologicheskogo instituta, 2018, no. 2 (45), pp. 31–36 (in Russian).
  14. Nesyn V.V., Nesyna S.V. Burnout of health professionals. Zdorov'e i obrazovanie v XXI veke, 2019, vol. 21, no. 6, pp. 19–23 (in Russian).
  15. Siegrist J., Shackelton R., Link C., Marceau L., Vondem Knesebeck O., McKinlay J. Work stress of primary care physicians in the US, UK and German health care systems. Soc Sci Med, 2010, vol. 71, no. 2, pp. 298–304. DOI: 10.1016/j.socscimed.2010.03.043
  16. Nerush T.G. Main Stages of Studying the Burnout Phenomenon. Izvestiya Saratovskogo universiteta. Seriya: Filosofiya. Psikhologiya. Pedagogika, 2017, vol. 17, no. 4, pp. 454–459 (in Russian).
  17. West C.P., Dyrbye L.N., Erwin P.J., Shanafelt T.D. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet, 2016, vol. 388, no. 10057, pp. 2272–2281. DOI: 10.1016/S0140-6736(16)31279-X
  18. Maslach C., Leiter M.P. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry, 2016, vol. 15, no. 2, pp. 103–111. DOI: 10.1002/wps.20311
  19. Wurm W., Vogel K., Holl A., Ebner C., Bayer D., Mörkl S., Szilagyi I.-S., Hotter E. [et al.]. Depression-burnout overlap in physicians. Plos One, 2016, vol. 11, no. 3, pp. e0149913. DOI: 10.1371/journal.pone.0149913
  20. Linzer M., Poplau S., Babbott S., Collins T., Guzman-Corrales L., Menk J., Murphy M.L., Ovington K. Worklife and wellness in academic general internal medicine: results from a national survey. J Gen Intern Med, 2016, vol. 31, no. 9, pp. 1004–1010. DOI: 10. 1007/s11606-016-3720-4
  21. Sorokin G.A., Suslov V.L., Yakovlev E.V., Frolova N.M. Professional burnout in doctors: the value of the intensity and quality of the work. Gigiena i sanitariya, 2018, vol. 97, no. 12, pp. 1221–1225 (in Russian).
  22. Reshetnikov A.V. The social institution of medicine. Part II. Sotsiologiya meditsiny, 2018, vol. 17, no. 2, pp. 68–79 (in Russian). DOI: 10.18821/1728-2810-2018-17-2-68-79
  23. Kumar S. Burnout and doctors: prevalence, prevention and intervention. Healthcare (Basel), 2016, vol. 43, no. 4 (3), pp. 37. DOI: 10.3390/healthcare4030037
  24. Kobyakova O.S., Deev I.A., Kulikov E.S., Pimenov I.D., Khomyakov K.V. Burnout in doctors and medical errors. Is there a connection? Sotsial'nye aspekty zdorov'ya naseleniya, 2016, no. 1 (47), pp. 5 (in Russian).
  25. Netesin E.S., Gorbachev V.I., Nelyubin A.G., Mitkinov O.E. Burnout syndrome in anesthesiologists and intensive care physicians. Acta Biomedica Scientifica, 2017, vol. 2, no. 1 (113), pp. 74–78 (in Russian).
  26. Styazhkina S.N., Demina M.A., Chernysheva T.E., Belousova O.A., Shestakova A.P., Shirobokova A.P. Sindrom emotsional'nogo vygoraniya kak bar'er professional'noi samorealizatsii vrachei-khirurgov [Emotional burnout syndrome as a barrier to occupational self-realization of surgeons]. Tavricheskii nauchnyi obozrevatel', 2017, no. 4–1(21), pp. 100–101 (in Russian).
  27. Yuguero O., Forné C., Esquerda M., Pifarré J., Abadías M.J., Viñas J. Empathy and burnout of emergency professionals of a health region: across-sectional study. Medicine (Baltimore), 2017, vol. 96, no. 37, pp. e8030. DOI: 10.1097/MD.0000000000008030
  28. Vasil'eva I.V., Grigor'ev P.E. Features of emotional burnout of physicians depending on work experience. Tavricheskii zhurnal psikhiatrii, 2017, vol. 21, no. 1 (78), pp. 21–27 (in Russian).
  29. Lee R.T., Seo B., Hladkyj S., Lovell B.L., Schwartzmann L. Correlates of physician burnout across regions and specialties: a meta-analysis. Human Resources for Health, 2013, no. 11, pp. 48. DOI: 10.1186/1478-4491-11-48
  30. Rotenstein L.S., Matthew T., Marco M.A., Rosales R.S., Guille C., Sen S., Mata D.A. Prevalence of burnout among physicians: a systematic review. JAMA, 2018, vol. 320, no. 11, pp. 1131–1150. DOI: 10.1001/jama.2018.12777
  31. Panagioti M., Panagopoulou E., Bower P., Lewith G., Kontopantelis E., Chew-Graham C., Dawson S., Van Marwijk H. [et al.]. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA. Intern Med, 2017, vol. 177, no. 2, pp. 195–205. DOI: 10.1001/jamainternmed.2016.7674
  32. Dyrbye L., Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ, 2016, vol. 50, no. 1, pp. 132–149.DOI: 10.1111/medu.12927
  33. Semina T.V. Social conflict «doctor-patient» in modern Russian society: the objective reasons and subjective factors. Vestnik Moskovskogo universiteta. Seriya 18: sotsiologiya i politologiya, 2016, vol. 22, no. 1, pp. 84–106 (in Russian).
  34. Ivchenkova M.S. Modernization of Public Health Care in Russia and in the Region: Sociological Overview. Izvestiya Saratovskogo universiteta. Seriya: Sotsiologiya. Politologiya, 2013, vol. 13, no. 3, pp. 41–43 (in Russian).
  35. Freeland R.E., Hoey J. The Structure of deference: modeling occupational status using affect control theory. American Sociological Review, 2018, vol. 83, no. 2, pp. 243–277. DOI: 10.1177/0003122418761857
  36. Kleinjans K.J., Krasse, K.F., Dukes A. Occupational prestige and the gender wage gap. Kyklos, 2017, vol. 70, no. 4, pp. 565–593. DOI: 10.1111/kykl.12149
  37. Reshetnikov A.V. Sovremennye podkhody k otsenke vzaimootnoshenii mezhdu patsientom i vrachom, meditsinskoi organizatsiei, strakhovoi meditsinskoi organizatsiei [Contemporary approaches to assessing relations between a patient and a doctor, medical organizations, and medical insurance company]. Sotsial'naya rol' vracha v Rossiiskom obshchestve: materialy Vserossiiskoi nauchno-prakticheskoi konferentsii. Nizhnii Novgorod, 2018, pp. 1–3 (in Russian).
  38. Shchepin O.P., Korotkikh R.V. The perspectives of development of health care of the Russian Federation. Problemy sotsial'noi gigieny, zdravookhraneniya i istorii meditsiny, 2015, no. 23 (6), pp. 3–6 (in Russian).
  39. Popova I.P. Novye marginal'nye gruppy v rossiiskom obshchestve (teoreticheskie aspekty issledovaniya) [New marginal groups in the Russian society (theoretical aspects of the research)]. Sotsiologicheskie issledovaniya, 1999, no. 7, pp. 62–71 (in Russian).
  40. Gromova R.G. Sotsial'naya mobil'nost' v Rossii: 1985–1993 gody [Social mobility in Russia: 1985–1993]. Sotsiologicheskii zhurnal, 1998, no. 1–2, pp. 15–38 (in Russian).
  41. Razinskii G.V., Slyusaryanskii M.A. The groups of descending social mobility and the market: specificity of integration. Vestnik Permskogo natsional'nogo issledovatel'skogo politekhnicheskogo universiteta. Sotsial'no-ekonomicheskie nauki, 2011, no. 10, pp. 11–30 (in Russian).
  42. Krom I.L., Erugina M.V., Kovalev E.P., Eremina M.G., Vlasova M.V., Dolgova E.M., Bochkareva G.N. Marginalization of health institute professional groups: societal approach. Saratovskii nauchno-meditsinskii zhurnal, 2017, vol. 13, no. 4, pp. 854–856 (in Russian).
  43. Zang E., Bardo A.R. Оbjective and subjective socioeconomic status, their discrepancy, and health: evidence from East Asia. Social indicators research, 2019, vol. 143, no. 2, pp. 765–794. DOI: 10.1007/s11205-018-1991-3
  44. Nedospasova O.P., Shibalkov I.P. Socioeconomic status (ses) of a person as a health factor. Azimut nauchnykh issledovanii: ekonomika i upravlenie, 2017, vol. 6, no. 1 (18), pp. 140–144 (in Russian).
  45. Pastukhova E.Ya. Material welfare as a factor of influence on the population health in Russian regions. Obshchestvo: politika, ekonomika, pravo, 2017, no. 8, pp. 38–41 (in Russian).
  46. Wang J., Geng L. Effects of socioeconomic status on physical and psychological health: lifestyle as a mediator. International journal of environmental research and public health, 2019, vol. 16, no. 2, pp. 281. DOI: 10.3390/ijerph16020281
  47. Pastukhova E.Ya., Morozova E.A. Poverty as a risk factor for population health in the regions. Mezhdunarodnyi zhurnal prikladnykh i fundamental'nykh issledovanii, 2017, vol. 3, no. 2, pp. 253–257 (in Russian).
  48. Rusinova N.L., Safronov V.V. The issue of social inequality in terms of health: a comparative study of Russia within the European context. Vestnik Instituta sotsiologii, 2019, vol. 10, no. 1, pp. 139–161 (in Russian).
  49. Sedova N.N., Vargina S.A. Sotsial'nye riski rasprostraneniya «meditsinskogo imperializma» v postsovetskoi Rossii [Social risks of «medical imperialism» spread in post-Soviet Russia]. Izvestiya VolgGTU, 2010, vol. 7, no. 7, pp. 38–42 (in Russian).
  50. Reshetnikov A.V. Sotsiologiya meditsiny [Sociology of medicine]. Moscow, 2010, 864 p.
  51. Krom I.L., Erugina M.V., Kovalev E.P., Eremina M.G., Bochkareva G.N. The quality of life of physicians in the contest of financial deprivations. Sotsiologiya meditsiny, 2018, vol. 17, no. 2, pp. 80–82. DOI: 10.18821/1728-2810-2018-17-2-80-82
Received: 
05.12.2019
Accepted: 
03.06.2020
Published: 
30.06.2020

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