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Good work – good health

Academy of Medical Royal Colleges

Carrie MacEwen

Monday, 17 June 2019

AdobeStock_206093179_good_work_blog.jpgWe are commonly told that we will not say ‘I wish I had spent more time at the office’ on our deathbeds as we finally draw our last breaths. This is usually intimated by our nearest and dearest when we have been putting in extra hours at work and not spending sufficient time with them. However, contrary to this paradigm, spending time at work is actually good for our health and provides, not only, the income which allows us to enjoy non-work activities but it also provides focus, status, constructive activity and varied personal interaction. Work, however, is only good for us if it is ‘good work’ – meaning work in which we feel valued, have some degree of control and takes place in an enabling environment.

Stopping work when unwell is essential in order to make a recovery but returning to work at the correct time is also key so that ‘normality’ and the benefits of work can be resumed. In some instances this return to work may need to be supported with suitable adjustments made to the workplace, activities or hours worked – sometimes on a temporary basis. This assistance becomes increasingly important the longer someone is off work – 50% of people who are off work for six months due to sickness do not return and this increases to 95% once they have been off for one year. However, the value of work as part of a patient’s rehabilitation programme is not, in general, well recognised and managed – waiting for a full recovery and not considering possible adjustments to enable the process are more common options.

While work is good for us, long term lack of work is associated with overall poor health. This reflects a complex interplay between income, sense of purpose and culture – and more worryingly, this may go on to affect subsequent generations within a family. Encouraging and enabling work can help to break this cycle.

The connections between health and work were recently the focus of a conference led by the Academy and the Faculty of Occupational Health on behalf of Public Health England, the Department of Health and Social Care and the Department of Work and Pensions to identify ways to help clinicians have constructive conversations with their patients about the role of work in their recovery from illness and the benefits of work for their general health. In the words of one of the speakers – ‘work prevents ill health, promotes good health and is important in rehabilitation following illness or injury’.

The Colleges and Academy are acutely aware of the need to support the medical workforce – the RCOG and RCS(Ed) have together developed resources that are relevant to all working in healthcare to tackle work related bullying and harassment. In addition, there are several initiatives to improve and enhance the lives of junior doctors – carried out in association with the local post-graduate education and training systems.

So, we may need to change the narrative should we have the opportunity to share our dying thoughts. We may even delay the date of death if we work in the appropriate environment and are supported back to the workplace if we are unlucky enough to suffer illness or injury during our working lives. As healthcare professionals we need to recognise and emphasise the importance of good work for good health for our patients and to discuss this more openly. In addition, owe it to ourselves and our colleagues to ensure we work in an enabling and positive atmosphere.


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Carrie MacEwen

Professor Caroline (Carrie) MacEwen is Chair of the Academy of Medical Royal Colleges (2017–2020) and a Consultant Ophthalmologist at Ninewells Hospital, Dundee. She holds a Honorary Chair as Head of the Department of Ophthalmology at the University of Dundee, is Ophthalmology Specialty Adviser to the Scottish Government, and is leading the National Ophthalmology Workstream in Scotland. She has published more than 150 papers and written and contributed to several textbooks for both undergraduate students and qualified doctors. Her blogs can be found on the Academy of Medical Royal Colleges website.
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