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claim, the likelihood of a doctor being involved in an adverse incident leading to a second claim increased to 14.4%. An increased risk of being involved in a successive clinical negligence claim was found to remain so for a two-year period. It is also interesting to look
at which specialties are worst affected by stress. According to the BMA’s Doctors for Doctors, the most frequent calls come from GPs, followed by those working in psychiatry, general medicine, surgery and anaesthetics. Users of the MPS/MAS counselling service in New Zealand were, again, predominantly GPs.13
Dr Mike
Peters, who is the head of Doctors for Doctors and also a GP, said that GPs work in a unique set of circumstances. He said: “General practice is
demand led: it is difficult to say that, within a day, ‘I am going to be free for myself’. The stresses may not be patients, as practice staff are used to dealing with them, it might be that a GP has put half an hour aside to perform personal tasks, and the nurse tells them there’s an urgent visit required – that would be the stress of the day. The other thing is that if you are continually over-running surgeries this can become a real problem. “I think one of the main
problems is that there often isn’t compassion from colleagues because they are working at the ‘coal face’ and it’s difficult: everyone is under stress. Organising time for reflection with colleagues is really important.”
A professional view MPS has launched its new counselling service worldwide after similar services in New Zealand14
and South Africa15
received positive feedback from those who used them. The current service in South Africa will be staying the same. Professional help with stress and anxiety is often the best way of rooting out the issues that are at the core of the problem. Jenny Lanyon is Head of Clinical and Service Development at PPC Worldwide, who are facilitating the counselling service for MPS. Ms Lanyon says that counselling
a ‘vicious’ with a ‘virtuous’ circle. In practice, this takes the form of replacing emotional symptoms with behavioural tasks. So, for a client who feels tired and anxious 80% of the time, the aim would be to begin to reduce – rather than eliminate – that high percentage. Monitoring stress symptoms on a daily basis would therefore be an important part of the process,
sleep pattern. This would need to be realistic and gradual – behavioural change takes time. It might begin with the client setting an alarm to remind him/ herself to go to bed at an agreed time every night. The following week might introduce a period of relaxation before bed – a walk with the dog, a conversation with a partner, reading a book, or use of a relaxation tape.
can be an “enormously liberating” experience. She said: “Counselling is a
‘stress-busting’ activity. Talking to a neutral but caring person allows clients to be open about the stressful situation, without losing face. Also, as counselling services are available on both a telephone and a face-to- face basis, it is possible to speak to a counsellor at the time which is most convenient. Telephone counselling is a 24/7 service, and it fits particularly well into busy lives. Online counselling – a real-time, ‘chat’-based service – is an alternative way of seeking help and support at any time, day or night. “PPC’s counselling
focuses on seeking practical solutions to issues, rather than unravelling the past. It is helpful to look at the reasons for the development of the stressful situation, but always with a view to replacing
so that even small changes can be registered as progress. “The counselling process
might continue to look at sleep patterns and, particularly, sleep deficit – a very common cause of stress. The counselling would then focus on putting in place a plan to remedy the poor
SPECIAL FEATURE
ASIA CASEBOOK | VOLUME 19 | ISSUE 3 | SEPTEMBER 2011
www.medicalprotection.org
NIKOLAY MAMLUKE/
ISTOCKPHOTO.COM
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