| Project Objectives / Summary:
This projects primary aim was to identify attitudes to health care, prescribing and referral of an at risk group - junior medical officers; their knowledge of and attitudes to general practice services and how access to and utilisation of these services could be facilitated. The skills and knowledge gained would be widened for application to the broader medical community.
There is a great deal of evidence that doctors are not good at looking after their own health needs. Compared to the general public, doctors have high rates of stress and mental illness, reflected in a tragically high suicide rate, high levels of drug abuse, decreased job satisfaction and burnout. Recent increases in doctor suicides can be entirely accounted for by the deaths of Junior Medical Officers (JMOs).
The project methodology involved survey questionnaire, focus groups and GP education sessions.
Project Outcomes:
Knowledge of health care behaviour of JMOs:
The questionnaire survey produced detailed information about the health care prescribing habits and referral patterns, utilisation of health services, attitudes to GP services and attitudes to accessing health care services for JMOs. Information regarding the general health and stress levels of JMOs and how these relate to demographic details such as country of origin, year of graduation, etc was collected. Much of this data requires further analysis and will be the subject of future publications.
Barriers to the use of GP services by JMOs:
The significant barriers identified included time factors, prioritisation of health care, work pressures, lack of knowledge of GP services, easy access to inappropriate self-prescription and referral and significant cultural issues within the medical profession which make it difficult for junior doctors to access health services.
Characteristics of GP services:
A number of issues were identified including after hours opening times, anonymity and confidentiality which indicate both low prioritisation of health care for JMOs and lack of understanding of GP services by that group. The project results indicate more education for JMOs needs to be provided about GP services and that increased knowledge of local GPs in the AHS would facilitate utilisation of these services.
A significant group of GPs within the Division have increased knowledge and skills in the area of doctors' health and raised their awareness of the health needs of other doctors.
The activities in the program have generated quite a level of interest in doctors' health and identified a need in the Division to provide a service for local doctors. Following on from this program, the Working Group has already commenced drafting a health survey to be administered to the GPs in the local area.
Recommendations:
Recommendations to Area Health Service (AHS).
While some of the material and results have been discussed at the level of AHS, Post Graduate Medical Council and National Confederation of Post Graduate Medical Councils, more collaboration with these groups needs to be undertaken before a consensus recommendation is made.
Solutions to help minimise the non-help-seeking behaviour of doctors are:
- Education - both pointing out the dangers of self-prescribing or prescribing for colleagues without a formal consultation; and
- Encouraging hospitals to make it easier for JMOs to visit a GP on a regular basis.
- Doctors (including JMOs, SMOs, registrars, GPs and specialists) should be encouraged to turn to a GP for their health needs. To assist this process, they should be made aware of GPs who have completed some or all of the GP education sessions.
- Consultations between doctors need to be formalised. In such consultations, doctors should not be afraid to conduct physical examinations. They should also be encouraged to ask the doctor patient about stress, alcohol and drug use, etc. framed as a normal question asked of all patients.
- Recommendations are being developed suggesting that all junior doctors be encouraged to have an annual health check with a GP and that this should be facilitated by medical administrations perhaps to the extent of paid leave.
Disseminating Project Information:
Conferences:
- Three presentations at Post Graduate Medical Council National and State meetings;
- Royal Australian College of Physicians Annual Scientific Convention, 2001;
- RACGP Annual Conference in Townsville, 2000
- RACGP Annual Scientific Convention, Sydney, 2001
Publications:
Articles have been published in:
- Newsletter of RACGP Training May 2001
- The Medical Observer 25 May 2001
Lessons / Assessment:
When it comes to seeking help for health problems, doctors have available to them "shortcuts", which are not available to the general public. These shortcuts are:
- Treating themselves (especially self - prescribing)
- Getting a corridor consultation (including a subscription or advice without a formal consultation).
There are also barriers to them seeking help. While time is one of the barriers (especially for JMOs at hospitals), time constraints are not unique to doctors. However, specifically because they are doctors, unique barriers resulting from this fact are that they:
Sometimes feel they should be able to handle the situation themselves.
Have confidentiality concerns.
Possible solutions to help minimise the non-help-seeking behaviour of doctors are:
- Education - both pointing out the dangers of self-prescribing or prescribing for colleagues without a formal consultation
- Encouraging hospitals to make it easier for JMOs to visit a GP on a regular basis.
The project outcomes provide valuable material for use by Divisions and other GP groups in encouraging doctors to seek and obtain help in relation to their own health. It was an exploratory project. |
