A GP for every doctor

Naomi Johnson

12/09/2019 11:51:06 AM

A GP19 Convocation item brings the important topic of doctors’ wellbeing into focus.

Dr Rebekah Hoffman
Dr Hoffman says that a number of things on different levels have led to low rates of doctors seeing a regular GP.

‘Everyone thought that it was really important to have your own GP, but none of them did. They were all aware that it was really important for self-care, but no one wanted to contact and have a GP.
‘I thought that was quite interesting.’
That is general practice registrar Dr Rebekah Hoffman reflecting on findings from her 2017 research project on junior doctors and burnout, which sparked her interest in doctors’ health. This interest has since led Dr Hoffman to submit the GP19 Convocation item ‘A GP for every doctor’.
Seconded by Dr Paula Conroy, Deputy Chair of RACGP Queensland, ‘A GP for every doctor’ asks the RACGP to endorse and support every doctor in visiting a regular GP.
‘We believe that it is vital that the RACGP promote a culture that recognises the importance of doctors’ health and wellbeing and that the college is well placed to help all doctors have their own GP,’ the item states.
Fewer than 40% of doctors in Australia have their own GP, according to the Doctors Health Advisory Service (DHAS). 
‘It really comes down to a number of things, at a systems level and at a fear-of-being-reported-to-AHPRA level,’ Dr Hoffman told newsGP.
‘[At a] systems level, doctors are all time-poor and it’s easier to self-prescribe the things you think aren’t a problem.
‘At a mandatory reporting level, I think there is still quite a lot of fear amongst the wider medical community that GPs have to report anyone even with a minor mental illness.’
Dr Hoffman hopes the Convocation item will lead to more free and online education around mandatory reporting.
‘The information needs to be at your forefront, and you need to know exactly what it is, the same as you would if you had to pick up adrenaline for a child in anaphylaxis,’ she said.
‘I think [it] needs to be known to the wider doctor community [that] if you have a mental health illness, or essentially any illness, get a GP. Have a GP, don’t treat yourself.’
Doctors are subject to increased rates of psychological distress and experiences of suicidal thoughts compared to other Australian professionals and the broader population.
‘I work at a university and I gave a lecture with a scientist last week and she [asked], “When do you learn what to do when a patient comes in and tells you deeply personal things that are really difficult and heartbreaking? How do you learn to manage that?”
‘I don’t think we really learn what to do with all of those big feelings and big emotions that come with being a GP, because in the room it’s just you and your patient.
‘Quite often we bundle it up and pop it in a box. [We] either don’t deal with it or deal with it in negative ways.’
Dr Hoffman would like to see more training within regional training organisations (RTOs) about self-care, and about having your own psychologist, Balint group, or support network.
The Convocation item comes at the same time as R U OK? Day, a reminder of the value in holding conversations with people as a means of support.  
Dr Hoffman sees Convocation as an avenue to discuss doctors’ health more widely in the GP community, with the hope that discussion continues beyond.
‘I can talk … within the network of the people I know, but Convocation just opens that up – different people that I can have the conversation with,’ she said.
‘I’d love to see GPs going to every intern orientation week saying, “We’re here, we’re your friends; where are local GPs who are happy to see interns? Come and see us.”’
The ‘A GP for every doctor’ Convocation item asks that ‘the RACGP empower the GP community by supporting our members who treat doctors as patients’.
‘I treat quite a few medical specialists and their families,’ Dr Hoffman said.
‘I think having a doctor is like any type of relationship; you’ll go along to the first date and they may not be the right person for you … it might take two or three doctors until you find someone who is going to be your “forever doctor”.’
Dr Hoffman acknowledged the difficulties in finding a ‘forever doctor’ in rural areas, where GPs and clinics may be limited.
‘There are telehealth services that are able to provide a rural doctors service, and DHAS are able to provide that service for doctors when they’re in need, especially from a mental health perspective, so I guess it’s just knowing about those services,’ she said.
DHAS also reported that, of the doctors who have an identifiable GP, many consult a practice partner or spouse.
‘I personally think [that’s] such a bad idea. I don’t know how I could be objective managing my partner’s medical conditions,’ Dr Hoffman said.
The RACGP’s Self-care and mental health resources for general practitioners outlines the college’s strong recommendation that GPs seek out their own regular GP.
The RACGP’s response to ‘A GP for every doctor’ will be addressed at GP19 Convocation on Thursday 24 October.

burnout convocation doctor health GP19 mandatory reporting mental health R U OK?Day

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Louise Stone   13/09/2019 8:08:22 AM

Hi Rebekah. Thank you for raising this and for all the work you do. I am interested in this of course and I’m wondering whether we also need some research about what works for doctors in terms of talk therapy. I am realising more and more that standard talk therapy needs to be adapted for doctors because of the unusual environment in which they work. It’s not normal to deal with suffering the way we do on a daily basis.