Working in a medical defence organisation we have always been aware of the stresses doctors deal with day to day. While working in medicine is rewarding, the challenges are many and it is important that as doctors we acknowledge sometimes these can take a significant personal, physical and psychological toll. The pressures can be exacerbated when a doctor receives a medico-legal claim or complaint. Whether it is the slow burnout, or the specific trigger of a complaint or claim, at Avant we see daily how doctors’ professional and personal life and mental health can suffer. This can be a vicious cycle, as research supports the view that there is a relationship between poor practitioner mental health and increased medico-legal risk1. Impaired mental health can lead to performance issues and increase the likelihood of complaints, disciplinary proceedings and civil matters2.
We understand the importance of the role our staff members play as a friendly ear, advisor, or sounding board. Part of our role is often to encourage members to seek help. We know that doctors are not good at seeking help. They often do not have a treating practitioner and may find it hard to get the support they need.
It is common when in distress to feel isolated, and as if you are the only one going through this experience. That first step in reaching out for help can seem insurmountable. It is important that our staff have the tools and strategies to assist members experiencing distress and connect them with appropriate resources to ensure ongoing assistance.
Doctors’ Health Advisory Services perform an important support role for the profession in Australia. We recently welcomed Professor Garry Walter, psychiatrist and Medical Director and Sarah Foster medical social worker of the NSW Doctors’ Health Advisory Service (DHAS NSW) to share their experiences and discuss ways in which our organisations can better work together to support doctors.
It soon became obvious that between everyone in the room, there was very little we hadn’t seen in many years of supporting colleagues in the medical profession with issues such as work-related stress or burnout, alcohol or substance abuse problems, relationship issues, psychological disorders, physical impairment or stress around a medico-legal claim. There are some concerning changes though, as increasingly younger members of the profession are contacting DHAS NSW in distress over workplace pressures and job security. We need to keep working on ways of supporting junior colleagues and students.
It was also reassuring to hear the number of times a phone call really can make the difference, sometimes with quite simple, practical suggestions that only someone outside the issue can see.
The DHAS presentation was an invaluable opportunity to hear from Garry and Sarah about the important service that DHAS offer and the assistance it can offer our members. The session reinforced for me the importance of supporting each other and reassured me how many people are willing and able to assist those who do seek help.
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Supporting your colleagues and raising awareness
In 2017 the issue of doctors’ wellbeing received much coverage following the tragic suicides of a number of doctors. After many years of advocacy on issues such a mandatory reporting laws, governments have started to take some notice.
Social media is also playing a role, as movements such as #CrazySocks4Docs connect individuals across the profession and around the world. We will be breaking out our most outrageous socks on 1 June this year as a reminder that we need to be able to talk about it when we are struggling, and we need to encourage each other to have those conversations. You can find out more about this initiative at the website: crazysocks4docs.com.au
1 Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings. 2017;92(1):129-146
1 See for example Avant. Position paper on the impact of claims and complaints on doctors’ mental health. 2015.
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