Reading the signs
Asking a colleague if they are OK can be difficult and the most likely answer will be, “sure, I’m fine”. But mentioning that they are looking tired, putting on weight, not keeping up with their paperwork, arriving late for work, irritable with the staff etc and that this is not what tare usually like, can help someone open up about what is worrying them.
What you can do to help
Assisting other doctors to look after themselves before they start to make mistakes means that they will not need to come to the attention of the Medical Board, which is only interested in unsafe doctors who are putting the public at risk.
Listening and supporting can make an enormous difference.
Acknowledging that as doctors we are used to trying to solve everyone else’s problems – but that this is actually is an impossible task. Acknowledging that we too are human, have human needs and human failings, and that medicine is extremely complex and often unsupportive.
Stress, the feeling that the outside circumstances are too overwhelming for our personal resources, is often an everyday occurrence and if this is going on day after day, health will suffer.
If our colleague needs to work through how they can increase their resources or change the outside circumstances, we can help them find appropriate people to talk this through. Remember that we are not the doctor or counsellor for our distressed colleagues, we are their friend and should encourage them to see appropriate assistance.
The Medical Board of Australia has recently clarified the mandatory reporting provisions by saying that they are ‘only interested in hearing about practitioners if they have an impairment likely to affect their practice and pose a substantial risk to the public. A doctor who is managing a health condition by seeking help, or who takes some time off to get well, is very unlikely to meet the threshold and should not be reported. On the other hand, a surgeon with untreated hand tremor who continues to practise unsafely should be reported to protect his or her patients. Or a doctor with an untreated psychotic condition, or Alzheimer’s disease, who cannot think clearly and continues to practise, would also meet the threshold. These situations are rare.’
Practitioners in Western Australia are not required to make a mandatory notification when their reasonable belief about misconduct or impairment is formed in the course of providing health services to a health practitioner or student
Having a doctor as a patient
There is a temptation when treating another doctor to spend more time socializing, to blur the boundaries, to discuss health outside the consulting room, to feel embarrassed asking difficult questions and not to do preventive healthcare or ask about personal and social risk factors. A good doctor for another doctor or medical student is one who:
– Maintains professional boundaries and establishes rules for engagement
– Is prepared to make longer appointments and creates an unhurried environment
– Builds trust and shows empathy
– Reaffirms the importance of confidentiality
– Establishes the usual billing arrangements
– Shares the decision-making and follow-up arrangements and discusses blended care
– Does not take shortcuts in practising evidence-based best practice and does not avoid uncomfortable discussions
More training can be found on the modules in this website.