Health impairment allegations against doctors: Qualitative analysis and insights for Australian general practitioners
Year: 2023
Type: article
Abstract: As doctors, we live in a fantasy that ill-health only happens to other people.[TP1] Doctors experience higher rates of depression, anxiety and substance abuse than the general population. 1 Known risk factors include work stress, excessive work hours, exposure to workplace trauma, unsupportive workplace cultures and easy access to prescription medicines.2 Many doctors neglect their health, work when sick and self-medicate, 3 predisposing to substance dependence.4 General practitioners (GPs) consult with a wide spectrum of patients and will often encounter other doctors as patients (hereafter 'doctor-patients') during their career.GPs can play a crucial role in the recognition, early intervention and treatment of doctor-patients.5 They are able to support doctor-patients' wellbeing by establishing a therapeutic alliance and encouraging regular preventive and mental health screening.This can assist doctor-patients to overcome many of the barriers that doctors generally face when trying to access healthcare, which include stigma and fear.6 Being doctors themselves, GPs are uniquely placed to understand some of the challenges faced by unwell doctors who work within a system that expects resilience and stoicism.7 Section 5 of the Health Practitioner Regulation National Law Act 2009 (Qld) ('the National Law') defines 'impairment' as 'a physical or mental impairment, disability, condition, or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect his or her capacity to practise the profession'.Sections 140 and 141 of the National Law require treating practitioners to notify the Australian Health Practitioner Regulation Agency [AHPRA], the Medical Board of Australia, the Queensland Health Ombudsman, the Health Care Complaints Commission and the Medical Council of New South Wales (NSW) (hereafter, collectively referred to as 'regulators'), if they 'form a reasonable belief ' that a colleague or doctor-patient is placing the Owen Bradfield, Matthew Spittal, Marie Bismark Background General practitioners (GPs) are pivotal in supporting and treating unwell doctor-patients.However, little is known about the precursors or associations of medical regulatory processes against allegedly impaired doctors. MethodsA thematic analysis was conducted of semistructured interviews with 21 doctor-patients and four doctors' health experts. ResultsDoctor-patient participants had experienced a past or family psychiatric history, personal loss or trauma, access to drugs at work, workplace stress or recent patient death or suicide.Many avoided seeking care and were significantly unwell when notified to medical regulators.Regulatory processes caused distress, symptom relapse, suicidality, financial pressures and work difficulties.Doctor-patient participants sought assistance from GPs, doctors' health services, medical defence organisations, recovery groups and benevolent associations. DiscussionWhen treating doctor-patients, GPs can consider targeted mental health screening, openly discussing mandatory reporting obligations and accessing advice from their medical defence organisation or local doctors' health service.Trust and clear communication benefits doctor-patients and the wider communities they serve. Health impairment allegations against doctors Qualitative analysis and insights for Australian general practitionersHealth impairment allegations against doctors: Qualitative analysis and insights for Australian general practitioners Research
Authors: Owen Bradfield, Matthew Spittal, Marie Bismark
Institution: The University of Melbourne
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4375856496