Doctor as Patient – Sick GPs and the self-treatment dilemma

There are a couple of things I’d like to broach in this blog post:

1. When doctors fall ill – to work or not to work?

2. How doctors decide when (and for what) they need to see their own doctor

Firstly, it’s always annoying and uncomfortable being sick with a viral URTI or gastroenteritis, but on top of this there is the dilemma of deciding if you are ‘sick enough’ to stay home from work. This decision is all the more important, I think, for those of us in the healthcare industry, as we are in contact with people all day, including those who are potentially immunocompromised and therefore more vulnerable to illness. On the other hand we have a great responsibility in our work and as type A personalities, generally a heightened sense of loyalty and conscientiousness about us. A sick day can mean huge disruptions to patient appointments and increased workloads for our GP colleagues and reception staff with rescheduling of appointments, not to mention a back-log of work when we return. It really feels like a catch 22 situation.

Unhelpful attitudes to calling in sick prolong the unhealthy decisions to ‘push through’ and attend work when you are truly unwell, likely ‘sharing the love’ of the virus to all whom you come into contact with. For example, a sly comment from administration like ‘have a big night last night did we?’ can be really disheartening for someone who is genuinely unwell & may well mean that next time they are ill, they will attend work despite this and spread the ghastly bug to said administration person (I like to call this ‘comeuppance-itis’).

If you do make the tough decision to go to work despite sickness, you then deal with dirty looks from patients and colleagues leaning away making crucifix signs saying ‘don’t infect me’! I have often wondered if others understand the heart-renching decision-making process we have to go through as sick doctors about our return to work. I recently had a viral URTI (again) and as usual, ended up losing my voice with laryngitis as I started to feel better. I took a day off work when I was most unwell (experiencing all the guilt and dread that comes with a sick day) and decided to return to work the next day, as I was better, despite my voice sounding like a cheap adult phone line lady after too much whiskey. I was going ok until about lunchtime when my voice really started to give way and I finally had to abandon ship after one patient gave me ‘evils’ after hearing me call her name in my sheepish husky voice. What is a doctor to do?

Secondly, it was drilled into my medical class that it is hugely important for all doctors to have their own GP. I don’t disagree with this – in fact, I whole-heartedly agree that this is a healthy thing to do. However, now that I work in a rural setting, it is much harder for me to find a GP nearby where I can feel completely relaxed that all is confidential and without bias. I don’t feel comfortable consulting my GP supervisor or colleague friends for my 2-yearly Pap smears or for concerns about breast lumps, and actually I tend to think they may not feel comfortable with that either. I might feel ok seeing them for more ‘benign’ things like a repeat pill script and a blood pressure check, yet then again, I can check my own blood pressure (with the automatic machines anyway) and write my own pill script – with this in mind, where does one draw the line in the issue of self-treatment and self-prescription?

There are obviously some mandates restricting doctors’ rights in script writing for themselves and family members, yet I believe a lot of other ‘grey areas’ fly under the radar to the detriment of the doctor concerned. One issue that comes to mind is mental health concerns. It takes courage for a doctor, who is supposed to ‘have it all together’ and be able to help others with mental health issues, to admit that they are feeling stressed, anxious, depressed or struggling with alcohol or drug use. Depression in doctors has been discussed in a couple of other blogs (by the gorgeous Ash Witt and eloquent Ronan Kavanagh) and articles recently so with time I suppose doctors may feel more able to tell of their own difficulties as stigma is addressed. We are all human after all and medicine is a stressful and busy career, so it’s no wonder that doctors have mental health troubles from time to time. I have certainly felt very stressed at times and had my own personal issues through my training, and I am grateful for the support from my own GP, family and friends at these times. There are thankfully a few peer support services available for doctors to seek help, and I would encourage anyone who feels they need a hand to contact these organisations – I hope that these services will continue to be available and even further developed for years to come. On top of these doctor-specific services there are of course the nation-wide resources including Beyond Blue, Life Line (13 11 14), Headspace…the list goes on.

I would be interested to hear others views and experiences on these two issues for doctors and would love you to leave your comments here or on twitter via @drmelclothier

Remember to look after yourselves and your family as a priority!

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5 thoughts on “Doctor as Patient – Sick GPs and the self-treatment dilemma

  1. Great post, Mel! I agree whole heartedly with the dilemma of the sick day. I had one horrific experience last year where I had already taken a day off the week before and was mostly better apart from persistent post-viral cough and (horror of horrors) epistaxis which arose during patient consultation. NOT a good look.

    I have a great GP and am lucky enough to be in a big city where I don’t come across her professionally. However, working in a trendy inner suburb I have seen quite a few doctors as patients, which is fine, but I sometimes feel a bit awkward when they are more senior / experienced than me. I’m sure I’m not as confident as I usually am with patients as I try to defer to their knowledge. A tricky one from both sides!

  2. Hi Mel

    Interesting topic!

    I have no trouble taking time off. Rest is needed when you’re unwell. The only way my patients will follow what I say is if I (Jonathan Ramachenderan) actually do what I tell them!

    Its absolutely essential for us to have a GP.

    My GP was instrumental in helping me through a difficult period of burnout a few years ago.

    I haven’t as yet had the pleasure of treating a colleague as a GP but look forward to the honour of being selected!

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