11/5/09
HEALTH AND WELLNESS
FOR DOCTORS
MEDICAL ASSOCIATION OF JAMAICA
Blossom Anglin-Brown
DM(MED).MPH.FACG
HELPING THE WOUNDED
HEALER
“coming together
is a beginning
Staying together
is progress
Working together
is success”
Henry Ford
ISSUES RELATED
TO DOCTORS HEALTH AND WELL BEING
Doctors
avoid seeking formal health care for themselves
Continue to
work when unwell and self-treat
Have great
difficulty in adopting the patient role and in treating other doctors
ISSUES RELATED
TO DOCTORS HEALTH
Doctors
Are more likely
to receive inferior health care when ill
Have major
concerns about confidentiality
Experience
high rates of depression, suicide and substance abuse
Only a minority
of doctors have a personal G.P.
WELLNESS
State of well-being
Integration
of the physical mental and spiritual selves of individuals into a harmoniously
functioning whole
WHY ARE PHYSICIANS AT RISK
Long working
hours
complexity
of problems
Intense application
of one’s skills at the cost of self care
Relentless
perfectionism
ADD
Genetic predisposition
Tendency to
self treat
Denial
INTERVENTION
WHENEVER A
PHYSICIAN APPEARS IMPAIRED IN THE WORKPLACE HIS OR HER ILLNESS IS FAR
ADVANCED
BACKGROUND
RECOGNITION
OF THE IMPORTANCE OF SUPPORTING ILL MEMBERS OF THE MEDICAL FRATERNITY
INITIATED
BY MEDICAL ASSOCIATION OF JAMAICA
PHYSICIANS RESPONSE
WILL TYPICALLY
DENY
WHAT DO OUR OWN
COLLEAGUES SAY
The community of doctors
has a special responsibility to identify, address and provide the support
for those colleagues whose performance is jeopardized for any reason.
The approach must never be punitive and the strategy required will have
to be creative as the nature of the problems are as many and varied
as are the causes.
Dr. Margaret Green
Past President, MAJ
. All of us must
be a part of the solutions if acceptable outcomes are to be achieved.
The task will not be easy as the roads to recovery are usually long
and often tedious.
WHAT DO OUR OWN
COLLEAGUES SAY
Dr.Barbara Johnson
Past Chair Impaired Physician
The Medical Association
of Jamaica is aware that in the profession are colleagues whose ability
to work, may be compromised by alcohol or drug dependency, mental illness,
senility, physical impairment or aberrant behaviour due to stress.
Any of these are conditions
which could interfere with the safe practice of medicine. It is
important to recognize that such impairment does not necessarily imply
medical malpractice. Our aim is to intervene before malpractice occurs.
WHAT DO OUR OWN
COLLEAGUES SAY
Recognition of the impaired
physician is often elusive and, even when detected, measures to address
the needs of the physician are often stymied by a range of personal
and professional barriers.
It is imperative that
the impaired physician becomes the exemplary patient.
Dr. Knox Hagley
Past President MAJ
WHAT DO OUR OWN
COLLEAGUES SAY
Ramon Arscott
Past President , Medical
Students Association
The Hipocratic Oath
states in part “to reckon him who taught me this art, equally
dear to me as my parents, to share my substance with him and relieve
his necessities if required”.
This powerful statement
made since 425 BC charged us with looking after each other. It
is commendable that the Medical Association of Jamaica has taken up
the challenge to take care of its own.
CAUSES OF DISTRESS
IN DOCTORS
Stress
Burn-out
Depression
Chronic Physical
illness
Relationship
Issues
Marriage involving
one or two doctors
Poor financial
planning
Substance
Abuse and drug addiction
Retirement
issues
Chronic mental
illness
Professional
and social isolation
WELLNESS PROGRAMME
CONCERNED WITH
Prevention
Treatment
and
alleviation
of dysfunctions caused by any impairment of a Physician’s health
Support where
needed
OBJECTIVES OF PROGRAMME
Identify needs
Be Prompt
Be Efficient
Be Sensitive
Be Confidential
Be Compassionate
SERVICE OFFERED
Caring intervention
Confidential
discussion
Referral for
assessment and treatment
Recovery monitoring
Advocacy
SHORT TERM GOALS
Utilize existing
resources
Creative use
of existing facilities and personnel
Establish
‘stop gap’ programmes to meet current demands dealing with physicians’
health impairment
LONG TERM GOALS
To assess
the nature, extent, and distribution of the problems of impaired
physicians
To determine
the resources, facilities, and personnel necessary to meet the objectives
outlined
COMPONENTS OF
PROGRAMME
Twenty-four
hour emergency care and crisis intervention
Facilitation
of inpatient care
Education
on wellness and Physicians’ impairment
Community
consultation services
Research
Treatment Approach
Motivating
the doctor in need of help
Referral where
indicated for Pharmacotherapy, Psychotherapy, Family and Marital therapy,
Peer support, Financial Advice, Cognitive Behaviour Therapy.
PROPOSED STRUCTURE
COORDINATORS
SOUTH-EAST
NORTH-EAST
WESTERN
SOUTHERN
Dr. B. Anglin-Brown
Dr. D. Aarons
Dr. B. Salmon-Grandison
Dr. O. Golding-Beecher
METHODS OF REFERRAL
Self Referral
Colleagues
Family and
Friends
Concerned
individuals
Other committees
within the Medical Association of Jamaica
INITIATIVES
EDUCATION
Seminars throughout
the year. Available educational material for Physicians
PROMOTION
Encourage
paradigm shift to prevention.Medical students must be targeted
Coordinators
and coopted members.
RETREAT
North Coast
Hotel
Goals discussed
and documented
Action Plans
agreed on
WHAT HAS BEEN DONE
On-going sensitization
of colleagues e.g. Medical students as part of their clinical Psychiatry
clerkship, medical council of Jamaica.
One to one
support of colleagues mainly in the areas of alcohol abuse, grief
counselling, and marital discord.
CONCLUSION
Service set
up by doctors for doctors
To provide
an opportunity for those in need of help
To provide
support in a caring confidential and meaningful way
11/5/09
THE FUTURE
LET US BEGIN TO BE PART
OF THE MOVEMENT TO
To take care
of ourselves
To look out
for each other