Interview

Q&A: Building a better workplace for registrars


Doug Hendrie


14/05/2019 1:17:29 PM

What can be done to help create a positive environment for general practice registrars? An expert shares his thoughts.

Happy workplace
According to Dr Roger Sexton, the link between wellbeing and productivity is clear. ‘Wellbeing also reduces clinical errors and complaints, and boosts efficiency,’ he said.

Dr Roger Sexton, Medical Director of Doctors’ Health SA, answers questions on how practices can create better workplace conditions for general practice registrars.
 
What have you been doing to improve workplace conditions for general practice registrars?
We have been promoting the value of healthy workplaces to GPs and practice managers for some time now across South Australia and the Northern Territory.
 
The aim of a healthy workplace is to create an environment in which GPs can excel and remain sustainable and productive. This involves work practices – rosters, booking systems and so on – as well as well-designed and inspiring work places, taking into account things like interior design, quiet places, and even treadmills.
 
We use team dynamics to support everyone during busy times. An example would be a young registrar who has difficulty saying ‘no’ to demanding patients who may flock to him or her and overburden them with complex requests for help and demands for opiates, etc.
 
This sort of situation must be discussed at a practice level to prepare a whole-of-practice response, which assists in spreading that sort of workload around and offers consistency in the way all doctors manage such difficult patients.
 
How do you encourage different practices to focus on the needs of general practice registrars?
Simple. We ask, ‘What are some examples of the ways your practice supports the health and wellbeing of your registrars?’ 
 
Responses might include rostering, flexible work, practice clinical meetings to discuss difficult consultations, a culture of taking appropriate sick leave when unwell, everyone having their own GP, valuing the availability of food and water in the practice, and avoiding double booking and working through lunch.
 
There are lots of good ideas out there that need to be shared.
 
The link between wellbeing and productivity is clear. Wellbeing also reduces clinical errors and complaints, and boosts efficiency.
 
What sorts of issues do you encounter? What can go wrong?
These might include such things as booking appointments and clinic times that flog the doctor, deny them catch-up time and even a lunch break, and ignore the unpaid clerical time spent after work phoning patients and completing case-notes.
 
There can also be practices without a team culture, where the front desk staff offload patient appointments onto doctors without regard for their working conditions, or where things are driven by the bottom line and GPs are pressured to bill item numbers. 
 
How can GPs help general practice registrars integrate?
Mentoring is very important. There are skills in general practice that can only be passed on face to face, such as learning to say no, managing complex or demanding patients, managing time and paperwork, building rapport and working in a way that suits your personality type.
 
Practice meetings with doctors are important to discuss difficulties and solutions, and to find ways to manage the workload and work–life balance. Good practices make time for this and close the doors to allow it to happen.
 
Caring for colleagues is another way to assist. It’s important to have a practice culture where GPs take time off where needed, have their own GP, and plan ahead for a workforce crisis or illness.
Practices need realistic rostering, which helps to avoid fatigue. 
 
What else should GPs know?
Working the way that suits your personality is so important. I have two examples.
 
Consider the busy ‘obsessional’ GP who writes reams of case notes and finds themselves logging in from home at night to tidy up their case notes and to double-check test results. This GP probably needs to work differently. Perhaps seeing one fewer patient per hour may be all that is required.
 
The second example is the unassertive doctor who finds it hard to say ‘no’ to patient requests. He or she could discuss this with colleagues and ask how they manage this challenge. 

Building wellbeing measures into the workplace and work practices will show support for your staff, and make it more likely to be able to recruit and retain GPs in the practice.



doctors health GP health registrar workplace conditions


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