A medical career does not offer protection from illness or disease.
In fact, the opposite is true. Occupational health and safety risks in medical workplaces abound and include unhealthy workplaces and work-practices, unsafe hours and fatigue. Doctors have easy access to drugs and self-prescribing, investigation and referral is legal in most jurisdictions. Doctors experience poorer health outcomes as a patient in the health system through over or under-treatment.
Unfortunately, clinical knowledge often discourages early presentations of illness and the competitiveness of medicine encourages self-reliance and avoidance of disclosure of symptoms of illness.
Like the general population, doctors are healthier if they have their own doctor. However, an effective doctor–patient relationship faces some hurdles. If you are a treating doctor, or a doctor-patient, considering the impact of your professional status on the consultation will likely be beneficial in terms of health outcomes.
Once in the consulting room, doctor-patients may use their clinical skill to unwittingly corrupt, or knowingly manipulate, the consultation. Equally, the treating-doctor may forgo their usual standard of professional care by avoiding awkward areas of enquiry and allow the intrusion of social content into the consultation at the expense of the clinical.
The process of completing a detailed medical history questionnaire as part of the assessment is enlightening for many doctors who may have never completed one, but on completion can see ‘at a glance’ where some of their risks actually lie buried in their family history, lifestyle choices and work habits.
The completed health questionnaire also gives permission for the treating doctor to explore areas of potential discomfort such as mental health, sexuality, prescribing for self and family, medico-legal duress, needle-stick injury management and domestic violence.
Our experience over the last 6 years at the Doctors’ Health SA after-hours clinic is that a consultation with a doctor-patient is a most satisfying experience, but it’s not usually a ‘standard’ medical examination. It requires adherence to professional practice, additional time in order to build rapport and trust, and patience to unravel the patient context and extent of blended self-care.
It is our experience that the majority of doctors practise a ‘blended’ mix of formal and informal health care in order to minimise disclosure and medico-legal risk and maximise control, privacy and convenience.
Delivered effectively, the doctor-patient check-up offers a non-stigmatising platform to enable a more detailed exploration of the personal and professional risks facing the doctor at that time and the opportunity to identify, quantify and mitigate physical, mental, lifestyle and professional risk in the setting of an unhurried, professional, empathetic consultation.
Career transitions represent an important point at which personal risk increases and health checks can be particularly valuable. Career transitions are associated with doctors carrying an increasing burden of clinical, academic and medico-legal responsibility, yet being expected to work flawlessly under duress in often unhealthy, unsafe and under-resourced workplaces.
Transitions represent periods when doctors are even more inclined to avoid disclosure and privately self-manage their distress, denying themselves the benefit of a skilled and independent GP to advocate for them in the health system and connect them with any additional assistance they may need.
Doctors have overt and covert risks derived from their family history, lifestyle choices, social life and their work. A periodical review of these in the setting of transitioning across a most demanding career is entirely appropriate.
The opportunity exists to encourage all doctors, particularly those undergoing career transitions to voluntarily undergo a confidential risk assessment and health check-up with their GP prior to starting work. This enables the patient to leverage the benefit derived from the GP connecting the patient with the wider health system, using their unique advocacy and more appropriate referral networks.
Your health is important. To help you achieve a beneficial consultation with your GP we encourage you to download our Health Assessment which was prepared in conjunction with Doctors’ Health SA. It includes a Pre-consultation Medical History Questionnaire, Examination Guidelines for your GP and a Certificate of Assessment which enables you to claim Points as part of MIGA’s Risk Management Program. You can access the Health Assessment from the link below.