Features: Your health matters
02 June 2010
Dr Clare Gerada, who leads the Practitioner Health Programme, reminds doctors that their own health and well-being is just as important as that of their patients
In 2008, Professor Louis Appleby produced the a report on Mental Health and Ill Health in Doctors which highlighted the difficulty in finding and accessing support often faced by doctors. Although only a very small number of doctors are referred to the GMC each year because of issues relating to their own health, we know that in reality there are many more in need of support.
The GMC has produced a leaflet called Your health matters with information on how to find advice and support on health problems, which we are sending to every doctor on the register. We hope that this will remind every doctor that their health matters too.
Another initiative taking place in greater London is the Practitioner Health Programme, set up specifically to help doctors with a health problem affecting their work. Dr Clare Gerada, who leads the programme, shares her experiences of this programme and why she believes it is so important.
Dr Clare Gerada
Doctors are too busy to be sick! Well at least that is my experience from running the Practitioner Health Programme, a service for doctors (and dentists) living or working in greater London who have a mental health, addiction or physical health problem affecting their work.
At the 12 month mark, over 180 health professionals had referred themselves to the service, this figure far exceeding predictions. Around two thirds of all referrals had a mental health problem (for example, depression, anxiety, obsessive compulsive disorder, anorexia nervosa), one third an addiction problem (alcohol dependence accounting for around two thirds of those with addiction). A very small number came with physical health problems or difficulty accessing NHS care, sometimes because they were not registered with a GP.
A common feature of the patients presenting for care is that many presented late, often in crisis following a problem at work such as a complaint or after being caught drink driving. Doctors are reluctant to seek help, feeling ashamed that admitting to having a health problem somehow equates to being weak or failing in their duty as a doctor.
Alcohol plays a big part in the life of a doctor, with regular and heavy drinking often starting at medical school. Doctors can delude themselves that ‘I can’t possibly be addicted as I don’t drink when on call/every day when doing shift work...’ and so on, forgetting that part of the dependence profile is rapid reinstatement after a period of abstinence and intermittent and heavy (or binge) drinking is just as detrimental to health as daily regular use.
How then can we health professionals look after each other and look after ourselves? Doctors should care for each other. They should support each other in times of crisis, point out when alcohol use appears excessive and give each other permission to take time out when unwell.
Doctors too, need to be aware of worrying signs. Persistent insomnia, feelings of dread, anxiety, drinking alcohol to aid sleep, looking forward to the gin and tonic at the end of the day, self prescribing of any centrally acting medicines, poor concentration, constant irritability and rowing with colleagues and family should be considered as signs and symptoms suggestive of mental health or addiction problems and help sought.
Colleagues, do not suffer in silence. Do not be too busy to be ill. Professional help is always at hand if you look for it.
You can download the Your Health Matters leaflet from the GMC website.
More details about the Practitioner Health Programme can be found at http://www.php.nhs.uk/