Rate of sedentary doctors is almost double that of the general population, research shows

More than a quarter of doctors in São Paulo do not adopt healthy lifestyle habits that they usually recommend to patients, such as the regular practice of physical exercises.

An unprecedented survey by the APM (Associação Paulista de Medicina), carried out with 778 doctors working in the state of São Paulo, shows that 27% are sedentary.

The rate is almost double that recorded among adults in 26 Brazilian capitals plus the Federal District (15%), according to data from Vigitel 2021, a telephone survey by the Ministry of Health that surveys risk factors for chronic diseases.

Among those who practice some physical activity regularly, 15% do it five or more times a week; 13.75%, four times; 23.52%, three; 15.94%, two; and 4.7%, only one. Most (68%) do not dedicate more than 30 minutes to exercises.

The WHO (World Health Organization) recommendation is to practice 150 to 300 minutes of physical activity per week.

The APM survey was carried out through an online questionnaire and does not have a methodological design to represent the entire São Paulo category. More than half (53%) are doctors in the capital; 39%, from the interior; and 8% from other states. Most (54%) are up to 50 years old.

“The objective was to understand which habits are more or less healthy among colleagues to think about campaigns and other prevention strategies”, says anesthesiologist and intensivist José Luiz Gomes do Amaral, president of APM.

According to the survey, more than half of doctors use some medicine (54%). Tranquilizers, anxiolytics and antidepressants are the most consumed (30%), followed by drugs to control hypertension (24%), cholesterol levels (19.8%) and diabetes (11.5%).

Among the health problems they have or have had in the last year, the most cited are: sleep disorders (44%), headache (30%), psychological disorders (22%) and sexual dysfunctions (11%).

The mental health of those who take care of us also inspires care: 72% report discouragement and impatience; 21.5%, depression; 26%, memory changes; and 31%, lack of attention and concentration. According to the survey, a quarter of respondents (24.94%) say they do not take a vacation.

Another survey released in September by a medical platform, with professionals from across the country, shows that a third of them had symptoms of depression in the last 12 months. A similar percentage says they have symptoms of anxiety disorders and burnout. However, most declare that they did not seek specialized help to deal with these problems.

The factor most associated with “burnout” was the excessive number of working hours, followed by insufficient wages and lack of professional fulfillment.

Physician Ana Amorim, director of professional practice at the Paulista Association of Family and Community Medicine, says that there is a noticeable increase in problems related to the mental health of doctors who are at the edge of the public health system, in primary care, and that also work on shifts in hospital emergency rooms.

“These problems are very much related to professional burnout, but they do not come alone. It is often associated with the entire work team. One of the situations identified as motivating is, without a doubt, the pandemic, which led to an increase in the workload without additional human resources .”

In the survey, only half of the doctors declare that they work eight hours a day and 44 hours a week, established in the Constitution. The other part of the category adopts working hours of up to 50 hours (25%) or up to 60 hours or more (24.3%).

Amaral, from APM, says that more studies will be needed to assess how much of this mental suffering is a result of the pandemic, lack of physical activity, excess and working conditions. “There is a clear process of pejotization of doctors, with very precarious employment relationships. This all affects mental health”, she comments.

According to doctor Ana Amorim, this precariousness of employment contracts, with many self-employed professionals being hired as legal entities through social health organizations (OSS), has had negative impacts on doctors and the care offered to the population.

“Professionals feel less tied to services. They are charged much more for quantitative than qualitative numbers. In practice, this impacts care. Professionals who do not feel covered, who are sick and who reach their limit, end up abandoning their positions of work.”

The recent cuts in federal government resources in important programs such as Farmácia Popular and HIV-Aids, which can lead to a shortage of medicines, in addition to changes in strategies in PHC (primary health care), without consulting the health professionals who are at the end, they are also factors of mental suffering, according to Amorim.

APM research shows that the impact of Covid has been great among doctors and continues to have negative effects. About 68% say they have been infected one or more times, 28% say they have not contracted the disease, the rest said they do not know.

Among those who complain about the effects of long-term Covid, 32% report fatigue; 16%, memory loss; 15%, hair loss; 14%, muscle pain; 11.7%, persistent cough; and 10.4%, loss of smell or taste.

Nine out of ten doctors say they have had at least one dose of the Covid-19 vaccine. More than half (58.6%) are immunized with the four doses; 33%, with three; 6.2%, with two; 0.4%, with one. Only 1.41% of respondents say they have not taken any dose. “The vast majority of doctors are in favor of the vaccine, of science”, says Amaral.

According to him, the research brings another good news in relation to smoking: only 5% of doctors declare themselves to be smokers, against 9% of the Brazilian population in general, according to Vigitel. The vast majority (77.7%) say they have never smoked and 16% say they have abandoned the habit.

“When I started to practice medicine, in the 1970s, 1980s, there was a very high percentage of doctors who smoked. This change is very important. It is not enough to prescribe smoking cessation, you have to set an example.”