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16 April 2015

It’s not surprising that, as a group, doctors experience stress-related health issues at a higher than average rate.

“Many are under enormous pressure,” says Dr Frank Meumann, a Tasmanian-based general practitioner (GP) and President of the Balint Society of Australia and New Zealand. “They work long hours, are very dedicated to their patients and the consequences of making a mistake can be very severe. Many doctors are also perfectionists and high achievers, which can help them to attain professional success but may predispose them to problems such as burnout.”

Being exposed to other people’s suffering, particularly when they can’t always alleviate it, can also lead to compassion fatigue, where doctors feel physically and emotionally exhausted and detached from the people around them.

“Many practitioners have little sense of how emotionally difficult and challenging their work can be, or the impact it can have on their mental health,” says Dr Meumann. “And they may not realise how many of their colleagues are grappling with similar challenges.”

Growing awareness

Dr Frank Jones, President of the Royal Australian College of General Practitioners (RACGP), has been a GP in his home town of Mandurah in Western Australia for the past 30 years. When he was training, no one mentioned these kinds of issues. “You just had to grit your teeth and get on with it,” he says.

Now there’s a better understanding of the need for self-care.

“Most medical schools are talking about what’s called the hidden curriculum,” he continues. “They’ve realised that training competent doctors requires more than scientific instruction. The goal now is to improve young doctors’ capacity for self-reflection and evaluation of their professional and personal experiences.”

Sharing experiences

In the 1950s, psychoanalyst Michael Balint pioneered the idea that GPs should look more closely at the emotional content of the doctor-patient relationship. He facilitated meetings where small numbers of GPs came together to help each other understand and manage the complexities of their work.

“Balint groups have been meeting ever since,” says Dr Meumann. “There are Balint societies around the world and, today, any health professional who works with patients is welcome.”

The university where Dr Jones teaches holds Balint introduction groups.

“Balint groups don’t suit everyone but Balint is a way of introducing the concept that doctors have to reflect on what they do,” he says.

Support for all practitioners

All of the doctors in Dr Jones’ practice meet weekly to discuss a range of issues including difficult cases and how they feel about them.

“Regular group sessions can be very helpful but not everyone has access to them,” he says. “A rural town, for example, may have only one or two GPs.”

The Balint Society is now extending support across the country through Skype and other digital platforms. The RACGP also offers a free GP support program which can be accessed online or by phone.

“This is in line with the RACGP’s commitment to fostering a culture of care amongst GPs that will help them to build resilience,” says Dr Jones. “Most importantly, wherever they are, all doctors need a personal GP. You can’t be objective about your own health.”

Strategies to help prevent compassion fatigue

  1. Follow the healthy lifestyle advice you give to your patients – get enough sleep, eat well, do regular exercise.
  2. Make time for your family and friends and to do things you enjoy
  3. Discuss your feelings with colleagues or talk to your own GP. Be prepared to ask for help when you need it.
  4. Allow yourself to be human and grieve when sad things happen.
  5. Develop realistic expectations of what you can achieve and ensure your workload is manageable.

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