Striving Through Adversities of Professional Life to Provide Better Care: A Content Analysis of News Articles and Online Blogs on Deteriorating Mental Health of Medicos

Abstract

Background:

One of the noblest professions is medicine, which comprises ancillary services, medical students, and other paramedics. The challenges faced by the medical fraternity are infinite and uncertain.

Aim:

This study aims to thoroughly understand the professional challenges faced by medical professionals that can lead to mental health issues.

Methods:

A content analysis of 64 news articles and online blogs was done. The articles and blogs that addressed mental health issues among medical professionals were shortlisted. The data retrieved was accessed digitally between 2016 and 2024. Frequency analysis was done using QDA Miner Lite (free version).

Results:

The findings were summarized into six themes and 17 sub-themes, showing a high frequency of rising mental health issues among medicos, lack of organizational support, poor work-life balance, violence, and sacrificed health, with other less frequent codes like toxic seniority, hostile work culture, negative consequences of reporting mental health problems and hiding vulnerability to protect self-efficacy.

Conclusion:

The data retrieved from various news articles and blogs presents the personal experiences and real-life struggles of medical professionals. The outcome of this study is to understand the key issues affecting medicos at personal, professional, social, emotional, and spiritual levels.

Keywords

Content analysis medical professionals mental health suicide news articles blogs

Key Message:

The study focuses on the leading causes of mental health concerns among medical professionals using a qualitative approach, “content analysis”

Burnout among medical professionals has led to a frequent and co-occurring phenomenon across the globe involving emotional fatigue, exhaustion, distorted work-life balance, and a depletion of work satisfaction.¹ According to a study, working with demanding patients can contribute to mental health challenges at the start of a medical career. Stress related to work-life balance is a persistent difficulty that arises in the medical profession.² A meta-analysis on physician burnout clarified that autonomy, positive work attitudes, culture of quality, and safety were all adversely correlated with emotional exhaustion among medicos.³ However, workload, restrictive organizational structure, misconduct, aggression, conflicts, insufficient safety measures, conflicts between work and personal lives, and factors that contribute to poor mental health were all strongly correlated.³ The lack of sufficient numbers of trained physicians and other healthcare workers in India is one of the prevailing narratives in the public health field in the context of the implementation of universal health coverage.⁴ The World Health Organization (WHO) has established a 1:1000 ideal doctor-to-population ratio, and more than 44% of WHO member states specified that there were fewer than one doctor for every 1000 people.⁴ According to the World Medical Association, frustration related to burnout has become a collective issue across various countries, which could be due to challenges by authorities, organizational pressure or responsibilities, limited or no resources, sensationalist media reports of medical errors, or unethical conduct.⁵ The previous literature has information available about the level of depression, anxiety, or other mental health disorders prevalent among doctors. This article delves into the resources (online news articles and blogs) that highlight the concerns related to the deteriorating mental health of medical professionals, the negative effects of poor work-life balance on doctors, the negative consequences of reporting mental health issues, treatment hesitation, and its causes, the perpetuating and causative factors associated with these phenomena.

Methods

Sampling

A Google search was done using “mental health of doctors-news articles,” “Suicide risk among doctors-news,” “mental health among doctors news-India,” and “stress among doctors in India-News” on 29.01.2024. All the articles and blogs related to mental health concerns and reported suicide cases among doctors were shortlisted. A total of 64 articles were selected based on the study’s objective, all of which were in English, except for two news articles, which were in Hindi (one of the languages of India). The data retrieved were accessed digitally, and the resources were particularly from the period between 2016 and 2024. Duplicate articles on different websites were removed at the time of the selection of articles and blogs.

Data Analysis

The data were then reviewed and reread step by step to reach a deeper understanding of the content, followed by making condensed meaning units, coding, and short-listing themes, respectively. Both explicit and latent analysis were adapted to derive codes and themes, though a latent pattern was included. Latent projective (author’s interpretation) was not used by the authors. The frequency analysis was done using QDA Miner Lite (free version).

Results

The 64 news articles and blogs included were from the WHO, Medscape, ETHeathworld, Hindustan Times, The Times of India, The Hindu, The Japan Times, NDTV, BBC News, Mint, The New Indian Express, CNN, Outlook, The Economic Times, India Today, The Financial Express, The Washington, and the World Economic Forum. The findings are summarized into six themes and 17 sub-themes in Table 1.

Table 1.

Showing Themes, Codes, Descriptions of Codes, and Frequency Data.

Themes	Codes	Description of Codes	Cases	% Cases
Mental health crisis	Risk of suicide	Doctors who have either attempted suicide due to workplace stress or had suicidal ideations	20	30.80%
Mental health crisis	Rising mental health issues among doctors	Doctors experiencing depression, stress, anxiety, suicidal ideation, and other mental health problems	31	47.70%
Toxic work culture	Toxic seniority and hostile work culture	Pressure, bullying, humiliation, biasness, harassment, disrespect, aggressive behavior, and non-supportive attitude of seniors in the workplace	10	15.40%
	Equal mental health treatment for doctors	Absence or lack of mental health treatment facilities and availability as non-medical patients	12	18.50%
	Lack of organizational support	Non-approval of leaves, pressure by management, infrastructural limitations, staff shortage, and lack of other legal difficulties faced by doctors	16	24.60%
Resistance to treatment	Negative consequences of reporting mental health issues	Fear of losing license or legal difficulties for getting mental health treatment, fear of being judged by colleagues	8	12.30%
	Social stigma of professional role	Pretending to appear healthy to prove to patients they can heal	11	16.90%
	Treatment hesitation	Miscellaneous factors	10	15.40%
Perpetuating factors of poor mental health among doctors	Gender differences	Gender differences in experiencing and responding to mental health challenges, workplace biases	6	9.20%
	Violence and lack of support	Aggressive outbursts, lack of support from others, hostile behaviors by patients and relatives toward doctors	9	13.80%
	Poor work-life balance	Incongruence between professional and personal commitments	15	23.10%
	Guilt on patient’s death	The persistent emotional turmoil and guilt of the patient’s death	6	9.20%
Causes of poor mental health among doctors	Work under pressure	Excessive working hours, pressure from organizations, working in critical environments, lack of supportive facilities	33	50.80%
Causes of poor mental health among doctors	Recurrent negative experiences	Breaking bad news, experiencing frequent negative responses from patients and relatives, working in critical conditions	8	12.30%
Negative effect of work life on doctors	Lack of empathy due to physical, social, and spiritual exhaustion	Lack of empathy as a coping strategy due to physical/social/spiritual exhaustion	4	6.20%
	Extreme emotional exhaustion	Compassion fatigue due to poor work-life balance	10	15.40%
	Sacrificing health	Unable to take time for one’s health and involved in positive health practices	10	15.40%

Theme 1: Mental Health Crisis

The frequency analysis showed that out of 64 articles and blogs, 51 resources reported mental health crises of doctors, under which there are two sub-themes: risk of suicide 30.80% and rising mental health issues among doctors 47.80%, with the highest frequency in comparison to the other themes and sub-themes of this study. Suicide is highly prevalent among doctors in comparison to the general population, and it is necessary to address their vulnerability, which can be identified at an early stage.^6,7,8

Excerpts (Risk of Suicide)

“Suicide has figured among causes leading to the premature death of doctors, though not to the extent posed by stress and cancer.”

“doctors are at a greater risk of dying by suicide compared to the general population.”

“She must have gone through a huge amount of bullying and stress; otherwise, she is not the girl who would have done this.”

“Doctors are prone to suicide owing to stress, high incidence of depression, and concomitant substance abuse. Doctors are one group of professionals who have easy access to addictive and habit-inducing drugs.”

“over the last four years, more than 250 young PG doctors in India had tragically died by suicide due to various reasons.”

Another sub-theme is “rising mental health issues among doctors,” which includes 31 news articles and a blog. Studies strongly suggest that depression, stress, and anxiety are highly prevalent among medicos.^9,10,11

Excerpts (Rising Mental Health Issues Among Doctors)

Extreme workload, less time to be involved in a positive routine to reduce stress, and mental health problems are often linked with substance abuse.^12,13

“30% of Indian doctors and physicians go through depression, while 17% have thought of ending their life. Physician suicide is a public health crisis, and about 4 doctors per 10,000 people commit suicide every year. The rate of suicidal depression is higher in male doctors than female physicians.”

“Physicians report hallucinations, life-threatening seizures, depression, and suicide due to sleep deprivation. Fatigued doctors have felt responsible for harming patients,”

“Dissatisfaction, depression, and burnout are common in physicians” and “Younger physicians (under 55) were more likely to experience stress, emotional distress or burnout.”

“The vast majority of them ignore their feelings and may fall into self-destructive behaviors.”

“Physicians may try to treat their mood disorder by prescribing medications before consulting from a psychiatrist, while others may indulge in alcohol or illicit drugs for elevating their mood.”

“Smoking is no less common amongst doctors than it is amongst the general population.”

Theme 2: Toxic Work Culture

A total of 38 resources reported a “toxic work culture,” in which “toxic seniority and hostile work culture” was reported in 10 articles. Pressure, bullying, humiliation, biases, harassment, disrespect, aggressive behavior, and non-supportive attitudes of seniors at the workplace were identified as a predominant concern among medicos.^14,15,16

Excerpts (Toxic Seniority and Hostile Work Culture)

“Seniors not only make juniors feel worthless but also make them do menial work—from getting their food to paying for their meals. Not everyone can handle such pressure.”

“Issues of bullying, casteism, favoritism, isolation, the relegation of passion, to name a few, lurk behind the dark screen of mental health issues.”

“In many institutes and multiple departments, resident doctors face humiliation, public embarrassment, and indignity from their seniors on a daily basis.”

Tolerating toxic behavior by seniors may perhaps be due to a fear of losing opportunities or being neglected in professional opportunities.

“We are forced to conform, or our senior doctors will not impart surgical skills and deny us opportunities to participate in a surgical procedure. We are not supposed to talk, give our opinions, or suggest anything.”

Excerpts (Equal Mental Health Treatment)

Sub-theme includes 12 news articles and blogs that report on the absence or lack of mental health treatment facilities and the availability of medicos. Mental health support was recognized as a priority to meet professional obligations.^17,18,19

“One of the reasons for our hectic lives is the danger associated with the unavailability of medical care when necessary.”

“There is no arrangement or program created till now for doctors to channel their mental health.”

“We are almost never offered counselling, and in the end, you get the jaded emergency doctor who struggles to care…”

The third sub-theme of toxic work culture is “Lack of Organizational Support.” Support and positive responses from the organization were found to be responsible for higher work commitment.^20,21

Excerpts (Lack of Organizational Support)

“Hospitals, especially those in the corporate sector that are run as modern ‘five-star hospitals,’ advertise and shout from the rooftops of high-end services being offered. This places doctors, who actually are responsible for delivering those services, under tremendous pressure,”

“The hapless doctor, already under considerable pressure and stress to restore health to the ailing under his/her care, is often pulled up by the management of these behemoths in the over-corporatized sector to meet targets, most of them financial. Plainly speaking, it is all about profit,”

The resources also state about inadequate infrastructural facilities, extra clerical work, and lack or absence of security of doctors within hospital set-up, because of which healthcare professionals have to face violence and hostile behavior by patient’s family members in case of any adversity.

“Doctors must be provided with personal security and an atmosphere of security, shielded from marauding members of the public,”

“Lack of infrastructure in government hospitals and business management graduates dictating terms in corporate hospitals, leaving doctors without a free hand to work, makes them depressed too.”

Theme 3: Resistance to Treatment

Twenty-nine news articles reported evident and concerning levels of treatment hesitation reported by the majority of the medical professionals because of factors like losing a license, fear of being judged for suffering from a mental health disorder, trouble in the renewal of license, lack of confidentiality, and denial of mental health issues to protect self-esteem. A few such circumstances have been addressed by the present resources, which are categorized as “negative consequences of reporting mental health issues.”

Excerpts (Negative Consequences of Reporting Mental Health Issues)

“Doctors face extra difficulty; they are reluctant to take help for depression due to the fear that their taking professional help may be revealed.”

“too many doctors suffered depression in silence, afraid to seek help because they feared penalties at work and in some cases being judged in their personal lives as well.”

Another sub-theme of resistance to treatment is the “Social Stigma of Professional Role,” which increases the chances of neglecting one’s mental health. Stigma among doctors is significantly higher than among the general population, leading to delayed help requests, self-medication without psychiatric advice, and deteriorated mental health conditions due to a lack of social acceptance.²²

Excerpts (Social Stigma of Professional Role)

“Doctors are trained early in their training to mask their pain, to maintain a stoic stance about illness, and this perpetuates the denial of their health vulnerabilities.”

“The pressure to perform can be psychologically debilitating, and doctors also fear that they will be seen as less competent than their peers should a mental health issue be disclosed.”

“The “positive” culture implicitly popularizes the practice of tamping down emotions and to “keep moving.”

“I am not supposed to be weak, and I am not supposed to cry, and I am not supposed to have all these emotions, because then patients will assume I am not good enough at my job.”

“Treatment hesitation” for miscellaneous reasons like self-diagnosis, neglect of mental health problems by colleagues, and unawareness of mental health issues in public by doctors had a frequency of 10 (15.40%).

Excerpts (Treatment Hesitation)

“Self-diagnosis and treatment are not advisable. When a doctor approaches a colleague for guidance with mental health, both might underestimate the severity of the issue.”

“Treating doctors might also underestimate the patient’s suicidal risk and not hospitalizing a physician-patient who faces the risk of self-harm.”

Theme 4: Perpetuating Factors of Poor Mental Health Among Doctors

Four sub-themes were identified, which can be considered factors maintaining deteriorated mental health among medicos. “Poor work-life balance” had the highest frequency (15) under this theme, focusing on poor dietary habits, mixed-up personal and professional obligations, disharmony in marriage, poor sleep hygiene, and limited or no interaction with social circles. Poor work-life conflict and lack of institutional support have often been linked.

Excerpts (Poor Work-life Balance)

“Too much paperwork, too many long shifts, too little time to sleep, exercise, or relax with family and friends.”

“They often have hectic work hours which leave them little time for self-care and rejuvenation.”

“Doctors have extremely disordered eating schedules, as also a higher-than-normal consumption of junk food.”

“Doctors are overworked, and a majority of them are cut off from society.”

Excerpts (Violence and Lack of Support)

Violence and lack of support from patients and their families were identified as a persistent fear among medical professionals with a nine frequency (13.80%), which could be due to limited search on keywords like “aggression towards doctors” and because the majority of the cases are unreported. However, in recent decades, there has been a significant increase in violent incidents against doctors in developing countries, making their safety a critical issue.²³

“…with depleted doctor-patient trust, being physically assaulted by patients’ relatives is a reality”

“62.8% of the doctors surveyed…are unable to see their patients without any fear of violence.”

“several attacks on doctors and nurses across the country have made them even more worried. It is difficult to understand why anybody would attack doctors. We are saving lives, risking our lives every day. We need love, not fear.”

“You have to be beaten up at least once to become a doctor.”

Excerpts (Gender Differences at Workplace)

The last two sub-themes, with equal frequencies of 6 (9.20%) are “gender differences at the workplace” (in response to mental health issues and workplace challenges and workplace biases) and “guilt on patient’s death,” which is defined as the persistent emotional turmoil. In terms of gender, women receiving specialized care have higher levels of reported stress and compassion fatigue than males, which was observed during the analysis also.²⁴

“Study of older women doctors found that age- and gender-based harassment, discrimination, and salary inequity persisted throughout their careers. While these problems diminished over time, the participants’ levels of seniority and professional experience did not put a stop to them.”

“Female physicians, in particular, report work-life balance as a significant concern, with the goal of achieving this balance often affecting their career choices.”

The guilt of a patient’s death leads to an unending emotional exhaustion, which leaves a scar on the mental health of medical professionals, particularly those who work in critical care departments or emergency services. Physicians often experience emotional distress when a patient dies; feeling inadequacy, helplessness, and fear of criticism is common, resulting in fatigue, impatience, and irritation.²⁵

Excerpts (Guilt on Patient’s Death)

“Secondary traumatic stress comes from within, such as beating yourself up when a patient dies. Alternatively, it can be a response to witnessing another’s grief or tragedy.”

“Every time a patient dies, there is a huge feeling of guilt. You keep wondering if there is anything else you could have done.”

“Patient deaths hurt doctors…doctors may never forgive themselves for losing a patient. Suicide is the ultimate self-punishment. In several cases, the death of a patient seemed to be the key factor in pushing them over the edge.”

Theme 5: Causes of Poor Mental Health Among Doctors

The perpetuating factors and causative factors overlap. However, the demarking aspect was the most identified sub-theme: “work under pressure,” which was linked as the leading cause of mental health issues among medical professionals, with 50.80% across 64 news articles and blogs. A few instances are prolonged working hours stretching up to 15–16 hours, muti-tasking (teaching, attending to patients, mentoring, research work), disproportionate doctor-patient ratio, lack of leaves, and constant on-call availability resulting in burnout and depression. Physicians in healthcare face numerous challenges, including time constraints, scheduling, workload control, hierarchies, conflicts, and patient-relative conflicts, which contribute to stress and burnout, further exacerbating the strain on their professional lives.²⁶

Excerpts (Work Under Pressure)

“Doctors are asked to work for long hours, often without adequate rest, sleep or relaxation, adding to the stress, burnout, and sleep deprivation, with their attendant ill effects.”

“I understand that we cannot get holidays, but we should at least be given days off once a month on a rotation basis. We are overworked and burnt out.”

“There is little to no flexibility in her professional life as phone calls never end, and consultations can go on forever.”

“Pressures on physicians to see more patients and to discharge them from the hospital quicker have created ‘fast medicine’. Like fast food, it is deadly. It drives burnout and compassion fatigue.”

Excerpts (Recurrent Negative Experiences)

A frequency of 12.30% (8) includes breaking bad news, experiencing frequent negative responses from patients or relatives, and working in critical conditions. Physicians often struggle to break bad news without sufficient preparation and continuity, causing emotional stress for both physicians and patients.²⁷ Doctors experience adversities regularly due to varying treatment outcomes, increasing professional uncertainties.²⁸

“Critical care doctors routinely work in a highly demanding technical environment, especially where dying and death are common events, and errors can be dangerous.”

“Doctors sometimes treat patients in excruciating pain, rush to heal bodies shredded by gunshots, and deliver the most heartbreaking news to patients’ relatives.”

“Doctors are surrounded day and night by disease, distress, dangerous infections, demands from patients, and death. This often leads to burnouts, depression, mental health challenges, and even suicides.”

Theme 6: Negative Effect of Work Life on Doctors

Most of the resources address the growing mental health issues among medical professionals. A few lesser discussed or reported negative effects of hectic work life on doctors are “lack of empathy due to social, physical, spiritual exhaustion,” “emotional exhaustion,” and “doctor’s sacrificing their health” or not being able to take positive steps for their well-being with a frequency of 4,10,10, respectively.

Excerpts (Social, Physical, Spiritual, Emotional Exhaustion)

“Compassion fatigue can be the result of physical, emotional, and spiritual exhaustion from the demands of being a physician.”

“treating people carrying the gravest of diseases to rushing bodies shredded by accidents, blasts and gunshots to the emergency rooms, healing those with excruciating pain to delivering heartbreaking news to families.”

“Compassion fatigue occurs when people in helping professions, such as doctors and nurses, are not just providing physical labor but also emotional labor by remaining empathetically present in many of people’s scariest moments.”

It is not uncommon for doctors to put their patients first and compromise on their health, which could be due to many reasons like the feeling of being judged, demands of daily work regime, and other obligations.⁵

Excerpts (Sacrificing Health)

“Doctors are as regarded as saviors, but their health is often neglected.”

“I sit in the OPD and tell my patients to eat a healthy diet, go for a walk every day, take breaks, set aside time for vacation, and spend time with their family. I never do it myself.”

“I know many doctors who have not had a health check-up in years.”

Discussion

The primary objective of the current study was to obtain a thorough understanding of the struggles and challenges experienced by doctors in their professional lives, which can significantly affect their mental health. The excerpts cited from numerous sources reflect unvarying challenges faced by doctors and consistently reported in news articles from 2016 onwards.^12,13 The findings suggest that their prolonged working hours, working under pressure (frequency of 50.80%),^29,30 disturbed sleep, and less time for recreational activities limit the scope of indulgence in positive health practices.²⁶ Further, the frequency mentioned in Table 1, these challenges have become an integral part of their work-life and require immediate attention. This vicious cycle results in deteriorating mental health (frequency of 47.70%), poor social life, marital disharmony, and compromised physical health among medicos. The alarming sub-theme was the elevated risk of suicide among healthcare professionals (frequency of 30.80%) due to continuous exposure to these adversities.⁷ Based on the resources (news articles and blogs), lack of organization support (frequency of 26.40%),²¹ with respect to providing mental health services to medicos also remains a challenge because of lack of confidentiality, difficulty in license renewal processes and fear of being judged by society and colleagues were found to be major reasons.²² The present qualitative analysis raises the immediate need to prevent medical professionals from physical, emotional, and spiritual exhaustion (frequency of 6.20%) and emotional exhaustion (frequency of 15.40%) and be able to find a balance between their professional and personal obligations.⁵ The articles selected were not limited to a particular region, though the results were consistent throughout. The short-listed resources did not include articles and blogs available in other languages. For an in-depth understanding of individual experiences and challenges faced by doctors, further investigations can be done through qualitative analysis to improve the work-life balance of medicos.

Conclusion

The study was based on content analysis of 64 newspaper articles between 2016 and 2024. The findings revealed majorly six themes and 17 sub-themes, which are mental health crisis, toxic work culture, perpetuating factors of poor mental health, causes of poor mental health among doctors, and negative effect of work life on doctors. In conclusion, the study emphasizes the ongoing crisis among medicos and an emerging need for sensitization about mental health concerns of medicos.

Supplemental Material

Supplemental material for this article is available online.

Footnotes

Acknowledgements

The authors express their gratitude to the online news articles and blogs that actively update readers about the current state of struggles faced by medical professionals. The authors also acknowledge the colleagues who supported them throughout the conduct of this study.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Declaration Regarding the use of Generative AI

I assume full responsibility for the entire content of the manuscript, and I have not generated any part of this study by the AI tool.

Funding

The authors received no financial support for the research, authorship and/or publication of this article.

Informed Consent

Not applicable.

ICMJE Statement

The manuscript complies with ICMJE guidelines.

Statement of Ethics

Not applicable.

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