Crazy Socks 4 Docs: raising awareness for doctor burnout and mental health

IT HAS been estimated that 80% to 90% of doctors experience some form of burnout at some point in their careers. This can affect their ability to practise optimally and to connect with their patients with empathy and care. The consequences are serious, as burnout and depression are major risks for doctors, threatening both their wellbeing and the quality of care they provide.

On the first Friday in June each year, everyone is encouraged to wear colourful, mismatched or otherwise attention-grabbing socks to mark Crazy Socks 4 Docs, an international awareness movement aimed at increasing the visibility and support for mental health for medical professionals, who are at especially high risk for depression, burnout and suicide. 

It is deeply concerning that at least 50% to 60% of healthcare professionals will experience depression at some point during their working lives. Junior doctors are particularly vulnerable, and their risk for depression and burnout seems to be increasing.

One of the factors that contributes to burnout is work overload, as doctors are expected to do more and more within the same amount of time. Beyond patient consultations, they face a growing mountain of paperwork – from medical aid forms and insurance requirements to documentation and providing clinical feedback on patients with complex medical needs.

Often, there aren’t enough doctors to keep pace with healthcare needs, and not enough hours in the day. People may ask why doctors do not take on fewer patients – the need is simply too great and the resources too few. Even in the private sector, if you, as a doctor, decide to see fewer patients, this simply means longer and longer waiting times for people who need treatment from the few specialists in the field available in their city or province.

Very often, patients just cannot wait months for an appointment. As caring healthcare professionals, we often tend to squeeze more urgent patients into our days, often at the expense of a much needed break.

Doctors often find themselves in a situation where they are constantly putting their patients’ needs before their own basic needs. In the short term, a person may be able to handle this intense pressure, but in the long term, we know it’s not sustainable and will impact their physical and mental health sooner or later.

Some 20% to 40% of doctors’ time is spent on tasks they are not remunerated for, such as writing scripts, completing documents, making phone calls, following up and speaking with patients’ families. While we do this, and do it with caring, in the "always on" culture of social media and digital technology, healthcare professionals are expected to be available and responsive almost around the clock. Not only are these additional tasks very time consuming, but they are often expected outside of normal consulting hours. This can add to feelings of losing control, a major factor in burnout.  

While doctors are looked up to as healers, they themselves may experience "moral injury", which is one of the greatest contributors to burnout among healthcare professionals. This refers to a situation where you are forced into doing something that you may not entirely agree with, often made necessary because doctors are working within the parameters of funding constraints, managed care and patients’ medical scheme benefits. 

These limitations mean that we as doctors may not always be able to prescribe the ideal treatment that we feel would be most beneficial for our patients – simply because many of the drugs are grossly unaffordable. This places healthcare professionals who have their patients’ best interests at heart in the very difficult position of sometimes having to make compromises on the treatment they can prescribe. This is often experienced as a moral injury that can weigh down doctors, taking a toll on their mental health as a risk factor for burnout and depression. 

Doctors are sometimes mistakenly perceived to be omnipotent, and we are expected to never get ill ourselves, including both our physical and mental health. There is still a huge stigma associated with mental health among doctors. We are expected to keep going, no matter what. This means many doctors don’t seek mental healthcare when they need it, often because they are afraid this reflects negatively on their competence or ability to practice.

Tragically, doctors therefore often wait until they really can’t cope before seeking mental healthcare, and by then it becomes more difficult for us to help, where earlier intervention could have prevented such a serious decline that it may affect all areas of their lives. 

Another contributor to doctors’ burnout and depression is the worrying rise in anti-medicine culture globally, such as the anti-vaccine movement and anti-pharma beliefs. As doctors, we bear the brunt of this as individuals who take these beliefs to heart may need our help, but express such distrust, often founded on baseless online conspiracy theories that are counterproductive to their wellbeing. Healthcare professionals are placed in the invidious position where patients come to us and want us to help them, but they do not want the help that we are able to give. 

Very often, doctors and their receptionists are unfortunately also on the receiving end of verbal abuse. Even threats and physical violence against doctors are not uncommon, particularly in the public sector. 

Doctors, wanting to do their best for their patients, work in a highly stressful environment that has become even more pressured, litigious, and demanding than ever. As doctors, we need to acknowledge that we are only human and be aware of the additional risks our profession places on our mental health so that we can take better care of ourselves. This is the only way to continue doing our best for our patients with the means and time available.

Recognising the immense pressures doctors work under, shifting the narrative from silent endurance to proactive self-care is essential. Just like their patients, doctors must feel empowered to seek help early, whether through confidential counselling, peer support groups, or mental health resources tailored to healthcare professionals. Understanding that needing support is not a sign of weakness, but a vital part of sustaining their ability to care for others, can break down the stigma that so often holds doctors back. 

Public and private healthcare facilities and professional bodies also have a responsibility to create environments that encourage openness about mental health, provide accessible support systems, and actively reduce unnecessary administrative burdens. By fostering a culture where doctors can acknowledge their own needs without fear, we protect not only their health but the quality of care patients receive.

Ultimately, caring for ourselves is not a luxury – it is essential. When doctors prioritise their mental wellness, they can continue to serve with the empathy, skill, and dedication their patients deserve.

Dr Bavi Vythilingum – psychiatrist practising at Netcare Akeso Kenilworth

** The views expressed do not necessarily reflect the views of IOL or Independent Media. 

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