It is fantastic to be running a workshop for RANZCOG addressing doctor’s mental health in one week’s time. I have been advocating in this space since 2003, when armed with the important role of AMA(Vic) President, Doctor-in-Training Subdivision. At the time we were rocked by the news of suicides among our registrar population. In 2003, some of the responses made by consultants included;
Maybe they weren’t cut out for medicine
Maybe they just weren’t ready to face the pressure
Maybe they shouldn’t have sat the exams
Maybe they chose the wrong career
What are the current factors impacting on doctor’s health and wellness?
In 2017, 14 years later, I hear the same thing. I hear that somehow when a tragedy such as suicide occurs, it must be something to do with the doctor’s weakness or vulnerability. Few real conversations have focused on the external factors that push doctors to the edge. Seldom do discussions focus on how doctors reach out for help, are spoken to in the workplace, or suffer when they speak out against intolerable conditions or heartbreaking situations.
Some shifts doctors endure contain enough graphic content that if a movie would attract a R 18+ rating. Doctors are inherently resilient because they turn up again the next day for more. So the conversation we need to have isn’t about resilience or self care. It’s about true advocates standing up for others so we can have safe, compassionate workplaces and rewarding careers.
So, after spending so much time in this space, participating in many committees and panels, speaking at conferences and treating so many doctors and medical students, I am using this opportunity to go straight to the heart of the matter. How to have a crucial conversation. What can happen when conversations go well and what can happen when they don’t. How breaking bad news can lead to suicide or a positive outcome. How third party regulators such as AHPRA and our colleges have conversations with us, whether we are prepared to hear them or not. Knowing when to put our hands up and ask for help and when to keep our opinions to ourselves and go elsewhere for what we need.
Communication is the key.
So, most of the agenda for the RANZCOG doctor’s health workshop will play out via role plays using the brilliant acting skills of Mr Glen Hancox, professional actor and director of ACTReal. Glen has worked with me for 7 years, and together we have run through hundreds of scenarios to display rather than preach valuable learning. We have coached and trained many doctors in key specialty areas, worked in the corporate world and now developing conversations around doctor’s mental health.
So what sort of conversations will we be examining in depth?
The clinical scenarios I have written to be included in the workshop are based on conversations and interactions I have either witnessed or have been involved with. They will encapsulate the following;
- doctor’s help seeking behaviour
- the need for every doctor to have their own GP
- managing performance rather than being labelled a bully
- how to relate to junior colleagues to be the mentor you truly want to be.
All are raw and controversial, designed to be so that we can have real conversations to evoke change. They are also completely fictional (including names).
Keen to read more? Here are the teasers:
- That corridor conversation. After a multidisciplinary team meeting, Dr Anne Salter, a psychiatry registrar working in consultation-liaison psychiatry (wanting to be a perinatal psychiatrist) is approached by Dr Alex Scott, an O&G registrar. Alex is being paged but wants to have a ‘few minutes’ with Anne to ask her opinion about something….
- Doctors treating doctors. Dr Alex Scott consults with Dr Simone Davige, a GP in a busy family medical centre. Alex is nervous but after talking to his wife, and trusting in Anne, he decides to open up and be honest about how he is struggling…..
- The supervisor asking “So, how’s it going?”. Dr Ian Anderson is a senior consultant in the gynaecology department. He is well meaning, but quite detached from the issues facing junior doctors. His idea of mentoring a junior doctor is to share his own experiences that he thinks are valuable to hear about rather than listening….
- The consultant delivering negative feedback. Dr Peter Richard is a consultant and supervisor. He has had feedback from the college and other peers that his registrar Dr Sophie Donald is ‘not up to scratch’ He hates conflict but knows he has to tell her some hard truths….
By working through these scenarios, and with the guided expertise of Dr Mukesh Haikerwal, and Ms Mayada Dib, we hope to uncover what is at the heart of the matter for doctors who have mental ill-health and need our help. They are, after all, valuable, meaningful people who have devoted their lives to helping others. We owe it to work out how to help them, or not put them in a situation where they are distressed.
And all kudos to RANZCOG who are holding their regional scientific meeting in Albury NSW after they lost a fellow to suicide in Albury in 2016. They have opened the event up to all health professionals regardless of specialty.
If you would like to contribute to the discussion to help our colleagues please register here
See you in Albury,