This weekend, a little over dozen doctors will gather for an exclusive medical meeting in the tranquil hinterland behind Byron Bay.
Like most conferences, it’s accredited for CPD and is likely to be tax deductable for any doctor who attends.
But this is an educational event with a difference – the focus will be on healing the doctors themselves, who come from multiple specialties, ages and every career stage from junior doctor to senior consultant.
All are also in the grips of a crisis sweeping across the medical profession: the problem of burnout.
“We’re coming from the principle that regardless of who you are, whether you feel burnt out or not, you’re human and deserve care and nurturing,” says Dr Emily Amos, the founder of Whole Hearted Medicine and the force behind the event.
“As doctors, we’re high achieving people, but we sometimes neglect ourselves at the cost of that. This allows doctors to take a step back and focus on themselves.”
A GP and yoga teacher based in Melbourne, Dr Amos has been running wellbeing events for doctors since late 2020, each typically lasting for four days and three nights.
“We call them retreats, but education is a really key component and they do share a lot of similarities with other educational conferences,” she says.
“The difference is we’re intentionally picking out venues that allow us to eat together as a group, which is really important for connecting with each other and having authentic discussions about work and how we cope with the demands of our really quite demanding jobs.”
The educational program is centred on three pillars of self-compassion, self-care and self-awareness, areas that “can get a bit neglected in medicine”, in Dr Amos’ view.
That means daily guided mindfulness classes, talks on topics like “holding space & vulnerability”, “ego work”, yoga, and screenings of a documentary called “My year of living mindfully”.
For the Byron hinterland event, time is also set aside for spa treatments, walks through the venue’s macadamia grove or surrounding vineyards and swimming in its two heated pools.
All this might sound a bit like a luxury hippy holiday, but with self-reflection becoming a mandatory element of the Medical Board of Australia’s CPD requirements, it’s not dissimilar to what all doctors will need to start doing from next year as a condition of registration.
“Self-reflection is at the forefront of the new CPD guidelines but it isn’t something that comes naturally, we can be quite hard on ourselves,” Dr Amos says.
“So I think self-reflection needs to be supported for some people and come side by side with self-compassion, which again doesn’t always come naturally.”
With the pandemic now in its third year, it’s beginning to feel like the perfect moment to offer events to address burnout. Just last month, then-RACP president Professor John Wilson publicly announced he was quitting Victoria’s public hospital system in protest at mounting staff burnout and deteriorating conditions.
A survey of RACP members run by the college last year found 87% were concerned about the issue, while almost two thirds said they were worried about their own health as a result of COVID-19.
Those figures have been reflected internationally, with a 2020 survey finding 41% of UK doctors were experiencing depression, anxiety, stress, burnout, emotional distress or another mental health condition relating to or made worse by their work. Some 29% said this had got worse during the pandemic.
But for Dr Amos, who says she became so burnt out she had to stop working in clinical general practice in June 2019, the issue is far more personal.
She says that while the signs were obvious in hindsight, it was many months before she realised she was burning out.
“I started having panic attacks, which was something I had never had any issues with previously, and looking back I was practising defensive medicine, getting really exhausted, and I couldn’t sleep properly for months and months,” she recalls.
“At the time, I was just telling myself I was stressed. I thought everyone around me was stressed so it was OK, it was normal. But it wasn’t stress, it was a body and a mind that was struggling to stay afloat.”
She says she realised she needed to quit after a panic attack one morning, when she collapsed at the front door of her house as she was about to take her children to school.
“I just dropped to the ground in tears, completely fell apart because the idea of actually stepping outside and going in to work just seemed too overwhelming,” Dr Amos says.
The experience prompted her to start blogging about her experiences, eventually becoming the catalyst for her to start the conference company which she called Whole Hearted Medicine.
“And what was interesting was that it had been almost unmentionable, but once I started talking about it, so many other doctors began saying ‘me too’,” she says.
“Everyone said they were stressed but it was treated as like a badge of honour, not that we were actually all really struggling.”
In fact, demand for the retreats has been huge. This weekend’s event has been sold out for months, while others in NSW, Queensland and Victoria are fully booked until early 2023.
Nevertheless, Dr Amos stresses the aim is not to “fix burnt out doctors”, adding there are legitimate criticisms of the typical “resilience and free donuts at lunchtime sessions” held in many hospitals to address the issue.
“As has been said over and over, they simply don’t work,” she says.
“But does that mean that teaching mindfulness is pointless? I say no, because it does actually benefit us in other ways that are perhaps a bit more intangible.”
“A guiding principle of mindfulness is that the process is the point and the outcome is secondary. We’re not being mindful to fix burnout, we’re doing it to be mindful.”
“And if there are flow on effects of being calmer, having a longer fuse and sleeping better, they are a downstream effect of being more mindful, and obviously a welcome side effect, but not the main aim of practising mindfulness.”
“So we’re not doing this to fix burnout, we’re doing it because doctors deserve it.”