With the continuing pressures of general practice and the added uncertainty related to the Health Bill, it is no surprise to learn that GPs are reporting more signs and symptoms of stress than ever.
Doctors remain one of the hardest to reach groups of professionals, fearing that asking for support might be perceived as weakness or a sign of failure, alongside the practical issues of accessing appropriate and confidential healthcare in a system where you are well known as a doctor.
GPs, like their patients, become ill. Poor health in a doctor can adversely affect the care of patients, healthcare costs, the lives of the doctor's colleagues, family and friends, and the doctors themselves.
As the Boorman review of NHS health and wellbeing put it: 'Healthier staff, teams that are not disrupted by sickness, or where staff are not under undue stress... all contribute both to the quality of care given to patients and to patient satisfaction.
'By contrast, where staff are unhappy and unhealthy, where there are high sickness rates, high turnover and high levels of stress, there are likely to be poorer outcomes and poorer patient experience.'
Many doctors tend not to consult with their own GP and may have 'corridor consultations' with colleagues, often finding innovative ways of obtaining healthcare, running the risk of inappropriately self-diagnosing, self-prescribing and even self-referring.
One of the first things GPs can do to get access to the right kind of help is to acknowledge that they have a problem and accept themselves as a patient.
Admitting to a need for help is not the death knell summoning the end of the GP's career as they know it. In fact, it may be quite the opposite. Ignoring any warning signs of stress or ill health can, and will, lead to one's problems growing.
If a patient presented at your surgery with obvious signs of a serious medical condition, would you advise them to ignore these symptoms and try not to think of them? These same rules apply to mental health or addiction problems.
For the vast majority of mental health and creeping addiction problems, simple changes to one's life and behaviour can avoid these problems becoming harder to manage. Many of these initial modifications can be done using self-help strategies, without the need for professional help.
When these problems are more serious or self-help techniques have failed, getting the right professional help in a timely manner can pay dividends in the future.
|Resources and support|
Becoming a patient
The GMC Good Medical Practice Guidance suggests that all doctors should be registered with a GP who can provide independent and objective care. You as a GP have exactly the same rights as the patients you treat, including confidentiality, but concerns about access to confidential services, where they will not be recognised by colleagues or patients, highlight the need for more specialist services addressing some aspects of the health of doctors.
The Practitioner Health Programme (PHP) is one such service. PHP provides a free, confidential service for doctors and dentists who have mental or physical health concerns and/or addiction problems. Doctors or dentists in the London area can self-refer; other areas of the country can access care via a referral from their own GP.
The service comprises GPs, psychiatrists, specialist addiction nurses, psychodynamic psychotherapists and cognitive behavioural therapists. At the three-year evaluation point of the PHP service, about one-third of all practitioner patients in PHP were GPs. You can contact the service via the website www.php.nhs.uk or by calling 020 3049 4505.
The need for similar services and levels of self-referral access outside London is beginning to be recognised. Until this happens, there are a number of excellent support mechanisms for GPs around the country, offering all kinds of support and guidance, including support with addictions, financial difficulties and health concerns.
Two good examples of 24-hour helplines are the BMA Counselling Service and Doctors Advisory Service, and the Sick Doctors Trust.
Good outcomes for GPs
When GPs do access the right services they show good outcomes. The PHP service alone has helped more than 700 practitioner patients through addiction and mental health problems.
A snapshot of PHP's caseload in October 2011 showed that approximately 77% of the practitioner patients were either working or returning to work, with overall abstinence rates from drugs and alcohol of 79%.
If you are currently experiencing any illness related to stress that could affect your work, it might just be worth seeing if any of these services could help you.
- This article was written by Jane Haywood, addictions nurse, Dr Ahern, GPSI, and Richard Jones, specialist nurse, at the PHP, with input from a GP patient. PHP is a free, confidential service for doctors and dentists.