How can I look after myself better?

Since I recently commented on my own experience of burnout, I have been contacted by multiple colleagues thanking me for the article and detailing their own adverse experiences.
 
I have to say that one of the overwhelming aspects of the replies, and my own experience, is that as GPs we repeatedly, and usually to our detriment, put our own needs second.
 
The fact that it has been among the most read articles on newsGP since it was published also speaks volumes.
 
I guess this is patient-centred care. As GPs, this is what we do. We do not have layers to support us in our work; we really are on the frontline in a way that doctors from other specialities are not.
 
We come to the profession with an altruistic desire to assist our fellow human beings. We want to give quality care and we want our patients to have the best life they can. We rejoice when they do well and we grieve for them when they don’t.
 
We are aware of the complexities of life’s opportunities and how they are affected by background, experiences, economic status, family and community.
 
We want and endeavour to provide all of our patients with a certain quality of care. But I wonder, how can we continue to give quality care and also save ourselves?
 
Having read a bit about resilience, I have to say it usually makes me mad.
 
The cry of let’s build resilience so young doctors don’t kill themselves or GPs don’t burn out frustrates me terribly. The despair and burnout come as a result of an imperfect system. Something we feel powerless to change.
 
I am sure everyone reading this will immediately think of examples. As I write this, the ones that come to mind for me are mandatory bulk billing during COVID only for GPs, mental health intake lines, Centrelink and Disability Support Services (DSP) not accepting that severe addiction is a medical condition, and the cornucopia of black holes that is the National Disability Insurance Scheme (NDIS).
 
Don’t get me wrong, I know there are wonderful people doing their best trying to work in these systems, but that doesn’t help to ease my frustration. The system may change, and I remind myself that I may have some (limited) agency. So I try to make the best of it; I take a deep breath and let my frustration go. This is what GPs do.
 
Clinical work is inherently risky and, at the same time, we must somehow be perfect. Adverse outcomes happen all the time; we can’t always control them and sometimes, even with the best intentions, we contribute to them.
 
The need to be perfect is a constant stress. And it’s impossible. All of us are very likely to have at least one complaint against us through our working lives.
 
I know of colleagues who have walked away from clinical medicine after a complaint process through the Australian Health Practitioner Regulation Agency (AHPRA) or the Health Care Complaints Commission (HCCC). They become the ‘second victim’ of the incident.
 
These are not bad doctors and we as a community lose something without them. I support the need to have a process to ensure high-quality practice – ideally a non-punitive process that diagnoses doctors’ medical conditions when needed and is educative and supportive, seeking to allow practitioners to learn and adapt.
 
And so I come back to a basic question: how I can look after myself better?
 
I manage work hours better, I revel in the time I spend with my family, I exercise, eat well and love my sleep. I slow down, I think, I offer patients their own power, I set boundaries based on risk. I take a day off when I’m unwell.
 
Most importantly, I forgive myself.
 
I am a failing human who doesn’t always get things right and I do my best. It’s okay not to know the answer. I can’t always do everything I would like for my patients and most of it is up to them. I let go of the illusion of control and I ask for support when I need it – and that happens often.
 
I am reminded of the physician’s pledge from the World Medical Association 2017:
 
As a member of the medical profession, I will attend to my own health, wellbeing and abilities in order to provide care of the highest standard.
 
And to that I will add:
 
And live a balanced professional and personal life that speaks to my values.
 
Help is available
Make sure you have a GP, one who isn’t a mate of a colleague in your practice if you can. The RACGP has a support service, there are a number of websites, including DRS4DRS, and Black Dog has some really useful information.
 
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