Doctors Find A Bad Case Of Rhythm and Blues

17 Oct 2013 3:11 PMChristine Barnes

A recent study by Beyond Blue found that the percentage of doctors considering suicide was over 4 times the rate of the general population, and that a greater percentage of doctors were experiencing very high psychological distress, much greater than the wider community.

More than half of doctors acknowledged a stigma regarding mental health and nearly half felt other doctors would feel less of doctors who had had depression or anxiety. Add to these findings the fact that doctors have easy access to drugs. As a potential patient I would be concerned.

Beyond Blue chairman, The Hon. Jeff Kennett AC, said the survey serves “as a wake-up call to the Australian medical community that more must be done to tackle things such as over-work and discriminatory attitudes.”

I believe healers (doctors, naturopaths, etc), as a prime responsibility, should take care of their own health - including mental health - for the benefit of themselves and their patients. A poor state of mind can significantly impact on a practitioner's ability to deliver optimal care. And after all, if you can't look after yourself, why should a patient trust you? 

 

Certainly in my own practice I made the decision long ago to only accept a very limited number of patients per week, partly because of the potential for consultant exhaustion and possible burn-out, and partly because I need time and space to deliver the best care and create the best opportunities for positive outcomes for my patients. That approach may not be sensible from a financial point of view, but it has a lot of plusses from a health perspective. However, it should be said, I'm in a position where I can make that choice - many practitioners, for various reasons, do not have that option available to them.

I actually didn't need a survey to know that many GPs are stressed. Through the years I've come into contact with quite a few GPs who could do with my help in reducing their anxiety and stress, as well as raising their levels of wellness. Certainly, orthomolecular medicine, nutritional medicine and lifestyle-wellness protocols are all well researched in alleviating many mental health and emotional issues, and these are tools used by accredited professional naturopaths.

Whenever I've visited a GP myself, I've really felt the tension in both the waiting room and surgery. It arouses in me the feeling of being rushed and also of being on a non-stop factory assembly line. It reminds me of cattle being rounded up in a herding pen and one by one going down a chute to get dealt with. From the point of view of the doctor, there are targets to be met and a timetable to be adhered to. The never-ending churn is very impersonal and stressful for all concerned. And the waiting rooms are a smorgasbord of germs and nasties that I know I'd rather not come into contact with, or be in the same room with. I can't imagine having to deal with that situation on a full-time basis. I have a great respect for doctors and their skills (which are very different to mine), but the way the public health system uses them is not healthy and does not promote wellness, neither for doctors nor for patients. No wonder so many doctors get stressed, become anxious and even suffer from depression.

From a naturopathic point of view, there are many ways of reducing stress but their effectiveness depends on the individual being part of the solution. For example, breathing practices, meditation, yoga, lifestyle adjustments, nutrition, acupuncture, massage, supplementation etc. However, although these methodologies can tackle many of the symptoms, as a naturopath, I also like to tackle the root of the problem. When thinking of the stress that many doctors clearly feel, one of those root problems I would suggest, is the health system itself - our perception of how it should work for us, who pays and how much.

I refer to Dr.Mohamed Khadra's excellent book "Terminal Decline" (2010) in which he diagnoses the Australian health-care system. He advocates "We need to fundamentally change the funding model to general practice so that GPs are not forced to see volumes of patients to earn a living". He proposes that we look at models in Sweden and New Zealand where GPs are paid to keep communities well. Certainly that would encourage a very different health system mindset, and I would suggest there would be a lot of wellness merits in following that train of thought. It might also take some of the stress away from our doctors.

 

I would also suggest that challenging the idea of "free health care" via "bulk billing" etc might well be another important consideration. Despite governments of various persuasions over the years using the carrot and stick approach to getting people into private healthcare plans and taking more personal responsibility, those concepts of "free" health care, particularly at the GP level, linger on and somewhat diminish the idea of taking responsibility for one's own health. Is it possible that if the cost of a visit to the GP was raised to a more realistic non-subsidised level, people might try harder to not get into a position where they needed to spend more of their own money directly from their own purse on a visit to the doctor? Perhaps more time and energy might be spent on choosing to be well, selecting appropriate foods, avoiding poor lifestyle choices, and concentrating on staying healthy, rather than using the medical system as a go-to-free-patch-me-up service after behaving badly and without enough care for one's mind and body. I think of the way in which people spend their money – for example, there seems to be an acceptance of spending many hundreds of thousands of dollars on houses - and then I contrast that to the spending on personal health where a few hundred dollars of expenditure on expert consultation fees is very much resented. I also think of all the cigarettes that are paid for and smoked by individuals who then require "free" health care courtesy of the taxpayer - where is the personal responsibility? Ditto with the abuse of alcohol and drugs - the tab for behaving inappropriately is not being picked up by the person responsible. And I also think of the results of poor food choices and the resulting health costs (financial or otherwise) to the individual and the nation. The boundaries between community responsibility and individual responsibility when it comes to health continue to be a challenge for politicians no matter left or right, but perhaps restoring a more realistic and personally responsible approach to individual health within the community might have the added benefit of reducing the pressure on some GPs who currently service too many patients and get over-stressed as a result.

Allow me to play devil's advocate now and pour doubt on everything written above.

I would suggest it might be interesting to explore another explanation as to why GPs as a whole get more stressed, feel more anxious, and get more depressed than the rest of the population, and its an area that has nothing to do with overwork. Perhaps they, as a whole, would feel and respond the same no matter what job they were doing! Certainly musicians and artists seem to be more prone to pyroluria than other segments of the community, but what about doctors? In my experience, an indicator of emotional fragility is above average intelligence - and performing extremely well academically is certainly a criterion for becoming a doctor in the first place. Is the resulting higher level of feeling stressed just the "nature of the beast” for the most academically gifted of the population? Perhaps if we chose different types of people to become doctors in the first place, the stress rate might come down. But then, who knows - we might end up with worse doctors! Just a thought!

 

If you are depressed or finding it hard to cope, help is available 24 hrs a day at Lifeline 13 11 14 24.