‘Everyone can benefit from having a GP in their lives’

Morgan Liotta

31/10/2019 3:36:37 PM

Recent research has seen doctor self-care under the spotlight.

Stressed GP
Eighty-four per cent of GPs report having difficulty finding time to seek care for themselves.

Earlier this year, the World Health Organization (WHO) identified burnout as a medical condition for the first time.
Doctors are disproportionately likely to be affected by the condition, which is characterised by energy depletion or exhaustion, increased mental distance or feelings of negativism or cynicism related to one’s job, and reduced professional efficacy, according to the WHO.
The 2019 beyondblue National mental health survey of doctors and medical students report also found doctors had ‘substantially higher rates of psychological distress and suicidal thoughts compared to both the Australian population and other Australian professionals’.
A key part of the problem is that GPs are often too busy to seek care. The General Practice: Health of the Nation 2019 report reveals that 84% of GPs report having difficulty finding time to seek care for themselves, and four out of 10 GPs report delaying treatment of care in the past two years.
The report also found almost half – 45% – of GPs had a diagnosed medical condition.
A recent RACGP survey of more than 2400 GPs echoed these findings, with 43% of respondents citing time pressure as a major barrier to accessing wellbeing support.
The survey found perceptions of wellbeing versus mental health was important to GPs and occur as a continuum, with wellbeing at one end and mental health concerns at the other.
Other common responses – also reported in Health of the Nation – included social stigma (10%), privacy concerns (8%), fear of being reported to regulatory authorities (5%) and fear of impact on career (5%).
Dr Michael Wright, Chair of the RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), acknowledges the significance mandatory reporting can have on GPs’ wellbeing.
‘Mandatory reporting legislation where GPs may need to report other GPs with severe impairments has certainly had an impact on GPs’ confidence in disclosing health conditions,’ he told newsGP
Dr Caroline Johnson is a GP and senior lecturer in general practice at the University of Melbourne who discusses GP wellbeing in a recent RACGP video.
She agrees that stigma associated with mental health issues and current mandatory reporting laws are ‘big issues’ for doctors.
‘While stigma includes self-stigma, it is often informed by the way doctors notice their colleagues responding when a peer has health issues,’ she told newsGP.
‘Fears about mandatory reporting are [also] a big concern for the profession, because although the bar for reporting a colleague is quite high, there is unfortunately a lot of ambiguity around what happens next.
‘There is certainly a lack of clarity around how it can help rather than harm the doctor needing assistance, and the ongoing concern that if doctors don’t seek help, the risk to the public will be even greater in the long term.’
Dr Johnson believes that even though GPs are time poor, that doesn’t mean they won’t set aside time for self-care.
‘There is no perfect strategy to ensure this happens,’ she said.
‘It usually isn’t about simply trying to manage time better, other than to accept that self-care needs to be high on the list of priorities if you are going to be a safe and effective practitioner.
‘Learning to be comfortable about saying no and managing expectations of others is a key part of that challenge.’
The RACGP’s GP19 conference featured wellbeing as a key theme, with presentations including ‘Preventing burnout in general practice’ and ‘Looking after myself and my patients’.
GP conference delegates took to Twitter to express the significance of self-care as a doctor, to not only benefit themselves, but their patients.
‘What is the cost to our patients when we become burnt out?’ Dr Phoebe Holdenson Kimura tweeted.

While Health of the Nation and the wellbeing survey have given further prominence to ‘the health of the profession’, Dr Johnson says it has always been an important area.
‘[But] there does seem to have been more attention to this topic lately, perhaps due to the ongoing challenges related to how to support under-performing doctors properly, while still protecting the public from harm.’
Dr Wright says that making GP wellbeing a focus is a good idea.
‘We are becoming aware that all people need access to general practices services – and that includes GPs,’ he said.
‘We have increasing awareness about the negative effects of difficult work environments, the benefits of exercise and non-work activities, and the importance of a work–life balance. 
‘GPs and all other doctors should have a GP. Everyone can benefit from having a GP in their lives’.
The RACGP offers a suite of GP wellbeing resources, including Dr Johnson’s video.
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A.Prof Christopher David Hogan   1/11/2019 10:17:34 AM

"You cannot look after others if you do not look after yourself first"
As I said at GP19, I am one of the RACGP historians & part of our role is to collect GP eulogies as a way of recognising GP lives & contributions. Not all eulogies are bright, positive & life affirming- some are incredibly sad. Not all stories are formally presented at funerals.
To my colleagues who feel alone- you are not.
To those who despair- there is hope & help available.
You offer it to others, why not take it yourself?
To those who feel that they must shoulder this burden alone- you do not
To those who feel the world is better off without you – it is not
To those who feel that they will be soon forgotten & that the pain their needless passing causes will ease- sorry, you are wrong
To those who think I have not been touched by this sorrow- wrong again