Clinical News

Time to promote wellness and foster prevention for doctors

By November 15, 2016 No Comments

Confucius said we learn in three ways, by reflection (which is the noblest), by imitation (which is the easiest), and by experience (which is the bitterest). When it comes to looking after the well-being of doctors, as a society we have clearly forsaken nobility. Issues with staffing levels and service provision are clear for all to see but complaining about the HSE is like shooting fish in a barrel, too easy to be useful and ultimately futile. The task of looking after ourselves and as a consequence our patients, rests within our own community. Drawing upon personal experience of my time in both mental health and education, I want to explore how we might make our working lives better. My move to psychiatry was like meeting the woman a your dreams after a me, divorce – a revelation. The first insight for someone who came from a lifetime of somatic hospital-based medicine was the enormity of the issue for doctors, patients, families, businesses, and society as a whole. There are few households who have not been touched by addiction, depression, stress, anxiety, or suicide. Yet, in spite a the pervasive nature a mental health problem, they remain shrouded in stigma and non-disclosure; unwillingness to acknowledge a problem will only lead to blindness to methods of prevention. My second observation was that even in hospitals with large liaison services there is a failure to acknowledge that mental and physical health are inextricably linked. We all know that an athlete may be perfectly physically prepared but fail to perform because a psychological pressure; therefore most professional sports organisations have a psychologist on staff. Yet, in health settings we seem reluctant to embrace the benefits of positive psychological environments for not only our own but also for patient physical well being, why? Now, I may be in the first flush of a new relationship, but a striking observation I have made is that there is a genuinely democratic and compassionate attitude in mental health teams towards trainees, multi disciplinary work, patients and staff. This is all the more staggering because of its total absence in other branch of medicine that I have experienced, typical of the HSE’s signature contempt for its employees. Venting aside, what practical lessons can we apply, Four out of five North American companies with more than a 1000 employees have staff wellness programme, not to treat disease, but to prevent it. Google alone has 35 massage therapists at their Silicon Valley head quarters, while other common approaches include healthy catering, in-house gyms, yoga, mindfulness sessions, and staff empowerment through suggestion forums and democratic control of work environment. If you dismiss this as ‘new age babble’, compare the retention, sick day and productivity rates of Google, Amazon, Apple or Facebook with the HSE. Most doctors would be considered to be working in at-risk environments, struggling with issues such as poor sleeping patterns, unstable work or living arrangements, lack of exercise or activities, financial uncertainty and bottling up fears or anxieties. The help currently available is reactive, given after problems arise and part of a punitive atmosphere, there is nothing to promote wellness or foster prevention.

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