Wellness - individual

‘Doctor – Don’t Heal Thy self’

Dr Natasha Yates

Natasha, what do you think are the three most important reasons for a doctor to have their own GP?

1. For the sake of our patients: 

Having our own GP helps us focus on being the best Doctor we can, while someone else (ie our GP) helps us maintain our health. It is part of our Code of Conduct (Good Medical Practice) to be responsible for maintaining our own health, and we all know that people’s health is best when they take a team approach. 

2. For the sake of our colleagues: 

If we are not at our best, our colleagues are the ones who have to pick up the slack. We owe it to each other to keep as well as we can. In addition, doctors who don’t have their own GP will often turn to a colleague for ‘corridor consultation’ advice. This may put colleagues in a very tricky situation medicolegally and morally. I’ve spoken to many doctors who have felt ‘put on the spot’ by colleagues asking for their advice, who were not sure how to politely and kindly say ‘no, see someone who has the proper time and medicolegal cover to give you the care you need’.

3. For your sake: I left this for last as I generally find doctors put themselves last. It’s not that we don’t value health, but perhaps we spend so much of our lives dealing with the very unwell that we feel our own health is “good” in comparison. However, I believe we should lead by example by optimising our health (and that of our families).

What are the barriers to doctors seeking general health advice from a GP?

The biggest barrier is not seeing our health as important enough. Doctors often wait until things have really become bad before they seek help. Although we know the evidence for prevention and early intervention, and try to educate our patients about it all the time, we somehow feel it doesn’t apply to us! 

I think a second reason that applies to non-GP colleagues is that most actually don’t realise the full scope of what GPs do. In my teaching role I interact with a range of other specialists and I love the diversity and learning that brings to me and our students.  However, I am struck by how often my non-GP colleagues are surprised by the range of things GPs know about and can do. Similarly, on a number of occasions my (non-GP) doctor patients have remarked that they would never have thought of X.. Y…Z… and yet what I have been suggesting to them is something most GPs would have suggested too. Remember that GP training is a solid extra three years on top of Residency training, and those years significantly expand on what we learned already in our hospital practice! 

Perhaps it is a case of ‘not knowing what we don’t know’, and blindly assuming that our own knowledge about our health is going to be just as good as any other clinician’s. But even if that is the case, we could all benefit from an extra, less biased pair of eyes on our health.

A third and very practical reason is that GPs tend to work during office hours. We have to be motivated to find a GP who has sessions at a time we can attend, or even decide to take time off our own work to get there – which comes back to my first point – we will only do this if we actually see the value in it.

http://www.dhas.org.au/wellbeing/having-our-own-gp.html

What do you think are the barriers to doctors seeking mental health advice specifically?

Doctors who need Mental Health support may avoid seeing a GP because they worry, they will be reported to AHPRA. This is a very unfortunate misunderstanding of mandatory reporting laws. In my experience, any doctor who has been concerned about their own fitness to practice has had sufficient insight to get the help they need to continue safely in their practice. They therefore did not need to be reported. 

The worst thing to do is wait until something irreversible happens at work, often resulting in loss of reputation and possibly a long journey back to recovery. Better to get in early before you are at that point, and let your GP help you navigate some support systems and strategies so that it never comes to that.

What is it like to be a doctor who treats doctors? 

I will be honest: Doctors (and nurses) are amongst my more challenging patients. While I find it a privilege, the challenge is for both of us to see the relationship as therapeutic and not collegial. What I mean is that doctors need to be there as a patient, and I need to treat them as such – taking in to account their greater health literacy, but never assuming they know or understand anything until I have checked. 

It is helpful when patients tell me upfront, they are a doctor so that we can establish expectations early. We can be honest about their own ideas about how a consultation should go, recognising we all have our own ways of approaching a problem. It’s important to be abundantly clear with each other as none of us can read minds; assuming the other person knows or understands something could lead to important information being missed.

Finally, the least helpful interactions with other doctors is when they present with their own clear ideas of what is going on and they simply want me to rubber stamp their ideas, provide them with their scripts and referrals, and are not really interested in my opinion and input. I remember in my earlier years being honoured when a highly regarded specialist came to see me. He gave me a clear history of symptoms of a rare but serious condition, lucidly outlined why that was the only thing it could be, and then asked to be referred to another specialist for some quite invasive investigations. I felt unable to question him and simply went along with this. Months later, after much investigation, he was found to have a very simple and straightforward illness, which I could have diagnosed on history alone. I have never again allowed myself to be over-awed and railroaded like that!

If there is doctor reading this who does not have their own GP, what would you most like to say to them?

I would like to ask them respectfully, “Why not?” 

It’s not lack of time – we all make time for things we believe are important. 

It’s not lack of money – GPs cost less to see than any other specialist, and certainly less than getting in an electrician or plumber! In addition, many GPs will bulk bill colleagues (although that is a contentious and fading tradition so best not to expect it).

I would like to suggest that every doctor reading this just give it a go. Find a GP, as a tangible objective you can achieve this year. Don’t wait until you actually need one, find one now while you have time to look around – it’s often a bit like dating where you have to see a few options before you find a good fit!  Develop a trusting therapeutic relationship so that if/when the time comes for you to seek help you aren’t starting from scratch.

About Natasha Yates

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