12 “Depending on the client’s
needs, the counselling might then look at exercise patterns and increasing the time spent on enjoyable leisure pursuits. Scales of 0-10 are used to assess progress at every stage, and counsellors will always discuss with clients how they will handle setbacks. It is normal for progress to be ‘stop-start’, and it is important not to become demoralised, so that the whole project is abandoned.” Dr Fiona Donnelly is the
chairman of the Doctors Support Network in the UK, an online forum that acts as a peer support group for doctors. Dr Donnelly established the service after suffering stress and depression in her own life. While her story demonstrates how a problem like stress can be turned into a positive action, it showcases the perils of leaving stress unchecked. Dr Donnelly said: “I got
involved in this group because I experienced stress and depression in my own life. It was brought on by a series of events that occurred in a short period of time. I got married, bought my first house, started my first psychiatry post doing the job of a higher level trainee as my consultant was off sick, and then I was assaulted by a patient. “I left my illness for a very
long time. I had no idea how ill I was. I felt very guilty, as there was a perception that people made things like this up to get out of work. I could do the job fine, but when I got home I wouldn’t leave the sofa or speak to my husband. “How effective stress
management is depends on the local culture of where someone is working: some areas take a hard line on illness, and offer support and encourage staff to take time off. However, I know of other areas where the attitude is old-fashioned – if you can’t take the stress you shouldn’t be doing the job. “GPs struggle because in
comparison to a hospital, it is harder for a GP to go off sick as they feel they are letting their business down. So their stress builds up. Also it is harder for them to access occupational health facilities
compared to hospitals, which have designated departments.” Dr Donnelly was an in-patient
for six months. Following this, she resumed her career and has since had two children – successes that she puts down to sharing her feelings and dealing with them.
Accessing the MPS counselling service The MPS counselling service is available to members who have experienced an adverse incident or medicolegal issue and are experiencing emotional or psychological difficulties. If you feel you might benefit
from accessing the counselling service, simply contact your medicolegal case handler, who will provide you with the appropriate contact details. If you have not reported a medicolegal matter to MPS, but are suffering from stress due to an adverse incident or medicolegal issue, contact MPS and ask to speak with a medicolegal adviser. PPC Worldwide offers a
service tailored to the individual’s requirements and it is delivered by fully trained, qualified and registered psychologists and counsellors. PPC’s in-house telephone counselling provides immediate access to support 24 hours a day, seven days a week, and face-to-face counselling sessions can be arranged near to you and at your convenience, all funded by MPS. The service provided by PPC is entirely independent and confidential – MPS will not be informed of any contact with PPC.
With thanks to Dr Tony Behrman and Mr Al Neaber for their help with this article. REFERENCES
CASE STUDY: DR A
Dr A, a GP based in South Africa, recently sought assistance from the MPS counselling service. Although MPS’s counselling services are completely confidential, Dr A wished to share his story and this case study is published with his full consent. Dr A is now retired but was in practice for 40 years. He was named in a clinical negligence claim and his case took five years – during that time Dr A fell ill with stress. He couldn’t sleep; his ability to concentrate at work was affected. Dr A developed an acute peptic ulcer that eroded a blood vessel, leaving him in hospital, vomiting blood. The Health Professions Council of South Africa (HPCSA) wrote to Dr A, summoning him for a consultation surrounding a complaint of alleged misconduct. Following a difficult experience at the HPCSA, Dr A broke down and was unable to work. To make matters worse the patient contacted the local press. It was at this stage that Dr A considered taking his life. Dr A’s wife contacted MPS and said that her husband had made up his mind to kill himself. MPS arranged for assistance for Dr A – an intervention that Dr A attributes to saving his life.
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5. Department of Health, Invisible Patients. Report of the Working Group on the Health of Health Professionals, Crown (2010)
6. Dowell AC, Hamilton S, McLeod DK, Job Satisfaction, Psychological Morbidity and Job Stress among New Zealand General Practitioners, NZ Med J 113(1113):269-72 (2000)
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8.
www3.ha.org.hk/oasis/en_index.html 9. Wong J, Doctors and Stress, Hong Kong Medical Diary 13(6):4-7 (2008)
10. Cunningham W, Cookson T, Addressing Stress Related Impairment in Doctors. A Survey of Providers’ and Doctors’ Experience of a Funded Counselling Service in New Zealand, NZMJ 122(1300):19-28 (2009)
11. Firth-Cozens J, Interventions to Improve Physicians’ Well-being and Patient Care, Social Science and Medicine 52(2):215-22 (2001)
12. Passineau TL, The Effects of Medical Malpractice Litigation on Subsequent Physician Performance, Presentation at the International Conference on Physician Health (September 1994)
13. Ibid 10 14. Cookson T, A Problem Shared, Casebook New Zealand 18(1):7 (2010)
www.medicalprotection.org/newzealand/ casebook-january-2010/a-problem-shared
15. Gillespie G, Putting the Stress on Anxiety, Casebook Africa 17(2):7 (2009)
www.medicalprotection.org/southafrica/ casebook-may-2009/Putting-the-stress-on-anxiety
SPECIAL FEATURE
ASIA CASEBOOK | VOLUME 19 | ISSUE 3 | SEPTEMBER 2011
www.medicalprotection.org
DANIEL LAFLOR/
ISTOCKPHOTO.COM
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