Work environment crucial to physician health
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* Rebecca Ghani

“Good work” is good for your health, Professor Dame Carol Black told delegates to the 2014 International Conference on Physician Health. What constitutes “good work”? According to Black, an expert advisor on health and work to the Department of Health in England, it is work that’s safe and stable. It is work that offers flexible arrangements, fair employment and opportunities for training. For physicians in particular, it is “hugely important” to have a sense of “individual control.”

“If we don’t have some sense of control in the environment we’re in, then that really makes it very difficult,” Black said during her keynote address to the audience of more than 300 representatives from 16 countries at the conference, held Sept. 15–17 in London, United Kingdom.

“We are all workers, and we’re terribly influenced by our environments, whether we work in a hospital or a clinic,” said Black. “Whatever our environments, they can influence our health enormously.”

Engaging a workforce is also crucial to its health and productivity, said Black. Referring to a National Health Service staff survey, she noted that “employee engagement is very clearly correlated to whether managers communicate well.”

The survey also linked higher levels of staff engagement to positive clinical outcomes, including lower patient mortality rates and fewer hospital-acquired infections. “So we have lots of reasons for wanting doctors to be in an environment which supports them, and enables them to be healthy,” said Black.

As an example of successful engagement in another safety-critical industry, Black pointed to the London Olympic Games, which had no construction worker deaths and an accident rate less than half the average in the construction industry. “And what the Olympic authority said was that they thought that part of that success was because they had engaged these workers and provided appropriate support and an environment in which they could thrive,” said Black.

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/186/15/E563/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/186/15/E563/F1)

Physician well-being is linked to factors in the work environment, whether it be a hospital, a clinic or some other setting.

Image courtesy of Pixland/Thinkstock

Good leadership is another environmental factor that affects workforce health, said Black. Traditionally, doctors may not have thought of themselves as being managed, but they are increasingly working in hierarchical environments, and many eventually become managers themselves.

“Many doctors do take on management roles,” she said. “Do we train them appropriately to be able to look to the needs and health of doctors as they go through their career?”

To highlight the importance of leadership, Black pointed to a research paper that found environmental and leadership factors to be major predictors of back pain severity in the workplace. Some of the most consistent predictors were shown to be control over decisions and leadership that was fair and empowering.

“So ordering physiotherapy would probably not bring about the result you desire,” said Black. “The leadership we are subjected to is really, crucially important.”

Occupational health representation at board level can also make a difference in improving staff health, said Black. Having a board member responsible for health and well-being has shown measurable results, she said, including reduced absences from sickness, less bullying and harassment, and increased take-up of development opportunities.

“The role of employers is crucial if we’re going to stay in work and feel well and engaged,” Black said in conclusion. “Being in good employment is protective of health, and unemployment contributes to poor health.”