In my work as an online doctor, I have been struck by the high number of shift workers using our service. There are some obvious practical reasons for this- when a person works unsociable hours, it is always going to be difficult to access a GP during the “normal” working day.

Availability of an online route to obtain a medical certificate or a repeat prescription can be enormously helpful and convenient. A tough shift schedule also means that rest periods are all the more precious so if access to an online doctor can save a person a few hours in a waiting room, that is going to be quite an attractive option.

However, there is also growing evidence that shift work may actually pose a risk to health, in a variety of ways (though further research is needed in a lot of these areas before we can be 100% certain).

Injuries and accidents seem to occur more frequently amongst shift workers- with an estimated increase of 15% on evening shifts and 28% on night shifts.

In 2007 the World Health Organisation classified shift work as a “possible carcinogen” or cancer-causing agent. It appears there may be a link between shift work and an increased risk of breast cancer and there is some evidence of links with other cancers, such as colon cancer. It seems that there may also be a higher risk of heart disease, obesity, raised blood pressure, and type 2 diabetes. Some research indicates an increased risk of preterm delivery, gastrointestinal symptoms, and mental health problems.

So, it may be prudent for a shift worker to see their GP more frequently for checkups than they might otherwise do- to ensure that issues such as high blood pressure or high blood sugar are picked up early, and appropriate steps are taken. And as a doctor online whether  or based in a clinic, it is certainly worth clarifying whether the patient sitting before us is a shift worker or not, as this knowledge may prompt us to more thoroughly explore issues relating to physical and mental health.

For many people, shift work is just a phase, on the way to the next step of their lives. For countless others, it is simply a reality of their career in the longer term. For these people, an online doctor may be of real benefit- to prevent disease through education and lifestyle changes, to diagnose problems early before they become severe, and perhaps most importantly of all- to provide all this in a way that acknowledges the reality of shift work- ensuring that the care accessible to regular 9-5 workers is just as accessible to shift workers, albeit in an online form. In many cases, those who perform shift work are running services without which society would not function- from healthcare to travel and transport, energy provision and law enforcement. As a society, it makes absolute sense to support these people in their vital work, in whatever ways we can.

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