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Doctors neglect their own health say experts

Studies link poor doctor health to poor performance and patient care

OnMedica Staff

Friday, 13 November 2009

Doctors are lousy at monitoring their own health putting both themselves and their patients at risk.

A Review in this week’s edition of The Lancet looked at the possible link between poor doctor health and poor patient care. The review written by Profesors Jean E Wallace, Jane B Lemaire, and William A Ghali, of the University of Calgary, Canada, found evidence to support this link and proposed that healthcare systems should routinely measure physican wellness as an indicator of health-system quality.

Results of emerging research showed that doctors’ stress, fatigue, burnout, depression, or general psychological distress negatively affects health-care systems and patient care, claimed the authors.

They proposed that because wellness may not only benefit the individual doctor but also be vital to the delivery of quality health care, physician wellness should be included as an indicator of health-system quality.

Traditionally, health-care organisations assess their performance using patient-based indicators such as patient survival rates after major surgery. Doctor wellness as an indicator of the quality of the health-system would acknowledge the growing recognition that doctors who are unwell  negatively affect how the health system performs, said the authors.

Research suggests that many doctors are not very good at tending to their own health or seeking help from others.The authors explored a range of studies and found that doctors neglect to have physical examinations and procrastinate when seeking medical treatment.

For example, in one study, of 18% of Canadian doctors who were identified as depressed, only 25% considered getting help and only 2% actually did. Many doctors do not have family doctors as reported in another study where only 42% of Australian doctors studied had a general practitioner, and most had self-prescribed drugs.

“Physicians often rely on denial and avoidance as coping strategies, which are not very effective; the problem is exacerbated by the medical profession’s poor record for giving mutual support and feedback... doctors might feel uncomfortable in the role of patient, and fear that others will interpret their need for help as an indicator of their inability to cope," said the authors.

They added: "Findings show, however, that doctors who receive support from their colleagues or spouse are more successful in achieving wellness”.

They also discuss a study that says general practitioners feel pressure from both their patients and colleagues to appear physically well, even when they are sick, because they believe their health is interpreted as an indicator of their medical competence.

And yet in reality it is doctors' self-neglect that compromises medical competence. In one study 57% of participants said tiredness, exhaustion, or sleep deprivation negatively affected patient care. Work-related stress led to 50% reporting reduced standards of patient care (eg, taking short cuts, not following procedures), 40% reporting irritability or anger, 7% reporting serious mistakes not leading to patient death, and 2.4% reporting incidents in which the patient died.

“Ultimately, individual doctors will personally benefit from taking better care of themselves. Such efforts would probably lead to increased job satisfaction and overall wellbeing...The organisations employing doctors will benefit by having more productive and efficient health-care providers in conjunction with reduced absenteeism, job turnover, and recruitment and retention issues. And perhaps the patients themselves will benefit by receiving better quality of care,” concluded the authors.

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