Research reveals value of GP self-care

An increasingly complex workload, financial pressures, long hours, isolation and lack of support, work–life balance, vicarious trauma, the impacts of mandatory reporting and vexatious complaints.
 
With these just some of the issues contributing to burnout and mental health challenges among the healthcare workforce, experts are calling for GPs’ health and wellbeing to be a national priority.
 
The November issue of the Australian Journal of General Practice (AJGP) is spotlighting GP wellbeing, with research showing it is fundamental for a healthier system for all.
 
‘GPs’ wellbeing is inherently important,’ lead author Dr Shaun Prentice writes.
 
‘Doctors have struggled to practise effective self-care for a long time. This has been reinforced by attitudes of self-sacrifice embedded within medical culture.
 
‘Messages encouraging self-care practices can be met with scepticism and go unimplemented.’
 
For Dr Prentice, a psychologist with a long history of GP wellbeing research with the RACGP, burnout is an area he has been active in for the best part of a decade.
 
‘I have investigated burnout in both trainees and doctors and what the factors are associated with it, and increasingly identified the important role that health and wellbeing have on the quality of healthcare and on their own personal lives,’ he told newsGP.

Dr Prentice added that future research into workforce sustainability is needed to ensure that GPs can continue to ‘live and work in a sustainable fashion’.
 
From transitions in general practice training, the impact of medical culture, to risk factors for burnout among general practice registrars and self-care for GPs, Dr Prentice’s AJGP series draws from his background in registrar wellbeing and how GPs can practise self-care along their career.
 
This includes an examination of the ‘longstanding issue’ of why doctors struggle to practise effective self-care, and new guidance from the RACGP to support them.
 
‘Just as for your patients, your wellbeing is inherently important,’ he writes. ‘You hold a professional duty to monitor your wellbeing and practise effective self-care.’
 
His work outlines the importance of GPs practising self-care, and guides them to develop a personalised plan as part of their professional responsibility to support and maintain their own wellbeing alongside that of their patients.
 
‘I’m hoping the piece, in the context of the broader series, is going to help spark more conversations and reflections among GPs and doctors more broadly about their own wellbeing and that of their colleagues,’ Dr Prentice said.
 
‘As well as identifying that organisations such as the college are very supportive of GPs and doctors taking care of themselves – because if they don’t the consequences we see can be quite problematic.’
 
RACGP President Dr Michael Wright said reform is needed to alter the culture around self-care, as well as highlighting the necessary reforms to improve GPs seeking the care they need.
 
‘Although every GP is ultimately responsible for our own self-care and wellbeing, the systems around us must actively support our efforts,’ he said. 
 
‘[For example,] the college is engaging with the Australian Health Practitioner Regulation Agency and making inroads in achieving a different approach.
 
‘The regulatory body has committed to strengthening its procedures for identifying vexatious complaints to protect GPs from groundless notifications that take up time and energy and impact mental health.’
 
Dr Wright added that mandatory notification laws, which require doctors to report a fellow GP if they have a ‘reasonable belief’ that they are practising with an impairment, must be changed, saying they are deterring GPs from seeking help.
 
He also said regulatory and compliance investigations must be ‘carefully managed’ due to the serious impact these processes can have on practitioners. 
 
A two-way street, Dr Prentice says GPs’ own wellbeing directly impacts the health and safety of care that they deliver to their patients.
 
‘The goal is to try and ensure that doctors are remembering to take care of themselves as much as they’re taking care of their patients,’ he said.
 
To support this, the RACGP has developed a new CPD-recognised package to arm GPs with confidence in assessing their wellbeing and preparing a 12-month self-care plan.
 
Dr Wright says GPs can often de-prioritise self-care, with cultural attitudes within medicine still discouraging doctors from seeking support.
 
‘That has to change,’ he said.
 
‘GPs are patients too – we must look after ourselves. I encourage all GPs to take full advantage of the RACGP’s resources on self-care and mental health.’
 
Dr Prentice’s articles are the start of a longitudinal series in AJGP, with more to be published in the coming months on other topics relevant to doctors’ health.
 
From November, AJGP has launched a new digital journal and mobile-friendly app, debuting at GP25. 
 
The digital journal complements the print and online versions – giving members flexible new ways to read, listen to and share peer-reviewed research. It works on any device – mobile, tablet or desktop – and features text-to-speech so GPs can listen anywhere. 
 
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Australian Journal of General Practice burnout doctors’ mental health general practice registrars GP wellbeing self-care