Speaking exclusively to GPonline, Chris Milligan called for measures to limit workload and protected time to allow GPs to 'decompress' following difficult cases or situations at work to protect doctors.
His comments come less than six months after his wife Dr Gail Milligan, a GP partner in Surrey, took her own life after the pressure of work became overwhelming.
Mr Milligan said pressure on partners in particular was unsafe. ‘The extra pressure from being a partner is relentless,’ he said. ‘I think it is a very dangerous profession to be involved in because you care so much.’
He called for more proactive intervention to identify and then support GPs who may be struggling, adding that this was particularly important for partners.
Mr Milligan said that in the year leading up to her death, Dr Milligan was working between 70 to 80 hours a week, sometimes more. The number of hours his wife worked began to spiral out of control when she was set up to work from home at the start of the pandemic.
‘When she could access the systems from home she lost her sanctuary,’ Mr Milligan told GPonline. ‘She said to her partners in previous years that she could switch off from work when she got home – and she lost that.
‘And then it just took over more and more of her time, to the point where she had no time to do anything else because her mind was constantly on work. And she felt guilty for stepping away. She never really turned off.’
Dr Milligan was eventually working a 12-hour day at home on her day off on Thursday, on top of 12- to 14-hour days in the surgery the rest of the week, and at least six or seven hours each Saturday and Sunday.
Negative media coverage
In the months leading up to her death Dr Milligan was also deeply affected by negative media coverage about the profession.
‘Gail struggled a lot with the really bad press that was coming out about doctors – GPs being lazy, and not working full time, and not seeing people face to face,’ Mr Milligan said. ‘But she was working herself to death.’
Mr Milligan said he believed GPs should be monitored on how much they are working. ‘There needs to be a cut-off point where the system goes “right you have spent far too long on this and you are now locked out until tomorrow morning”,’ he said.
‘There needs to be more monitoring of how hard they are actually working and how many hours they’re putting in, because I assumed what Gail was doing was normal and it was far from normal.’
He added that GPs also needed protected time to ‘decompress’ if they were involved in complex or emotionally difficult cases. After Dr Milligan died, her husband discovered that she had been involved with some ‘heartbreaking’ cases in the months before her death, as well as dealing with increased levels of abuse from patients.
‘She had all that going on inside her head on top of everything else. And [GPs] have no decompression time, no debriefing time, no time to share these stories with anybody else,’ he said.
Mr Milligan compared this to the police force where officers are actively supported after dealing with incidents that are disturbing, with time off and access to counselling.
More support for GPs
GPs who are struggling also need more proactive support, Mr Milligan said. He pointed out that doctors have to put themselves forward and ask for help, but said: ‘Gail would never have done that, so I think it needs to be a more proactive intervention.’
Last month GPonline revealed that dozens of GPs with suicidal thoughts are seeking help each month from NHS Practitioner Health, the NHS service that provides specialist mental health support to doctors. Service leaders have warned that this could be the ‘tip of the iceberg’ because the figures only include doctors who recognised they needed to seek help.
NHS Practitioner Health, the RCGP and Doctors in Distress, the charity that campaigns to end suicide in healthcare professionals, are planning a meeting next month involving doctors, stakeholders and family members of doctors who had taken their own lives to discuss action that could be taken to address suicide in the medical profession.
Mr Milligan said he was talking to GPonline about his wife’s death because he wanted people to understand how hard GPs were working and the impact it was having on their wellbeing – and in the hope that it could prevent other GPs from taking their own lives.
- Full details on all the support and resources available to doctors experiencing mental ill health are here
Mr Milligan would like to highlight Doctors In Distress, a charity dedicated to reducing suicide rates in healthcare professionals. You can donate to the charity here.