In the last few years, concern over the wellbeing of doctors has come to the fore.
A number of tragic deaths have been the tip of an iceberg that we all knew was there. Everyday we come across patients who are having their own challenges. Dutifully and caringly we try our best to help them overcome something that lurks in our own profession. We dispense advice that we cannot hope to follow ourselves. Less work. More time with those that you care about. Worry less. I have even been told by my seniors that my ability to worry will help me to be a better clinician.
Especially concerning is that we don’t often seek the help of others.
A culture exists where self diagnosis and treatment is common. Some of this is practicality and perhaps some of this is ego. It is hard for doctors to allow themselves to be vulnerable in front of others and more so in the presence of a colleague. For many, self worth is intricately linked with academic performance and clinical excellence. The admission that we may falter is a dent in our armour that we cannot easily accept. The other side of the coin is that we are not assured of the clinical acumen of others. Like a chef going to a restaurant, the trust that comes with mystery is lost.
Being a doctor for a patient who is a doctor is also a significant challenge.
Our self doubt and concern that we may be exposed as imposters can augment the therapeutic relationship. Often the doctor-patient is given much more control of their care. In excess however, this can erode the trust and respect needed for an effective relationship. There are a number of clinicians however who rise to the challenge. If you haven’t already, I’d recommend you have a look at the Doctors’ Health Advisory Services to find a growing list of doctors who care for doctors (in WA www.dhaswa.com.au).
There is no easy solution to this problem. Thankfully however, increased awareness of the issue has led to more action. Both the AMA and the RACGP have made this a priority as well as many other health organisations. Identifying and analysing the problem to seek out root causes has been our first step. More time and effort is required to address the issues identified and make the cultural changes that will be the vehicle to our recovery.