“I haven’t gone back to work since the patient died” 
 
“I’m sorry I’m crying, I’m not sure why this is affecting me so much” 
 
“I can’t sleep. I can’t stop thinking about it. Why would they complain about me? I did everything I could!” 
 
“The hospital has reported me because they think I’m impaired!” 

These are phrases the team at MIGA hear from our members as their response to a terrible outcome or a complaint. We understand that often you are calling us because there has been an adverse event that has taken you by surprise. It could be a poor clinical outcome, an unexpected death or a mistake due to human or systems error.

Equally, complaints, claims and aggressive patient interactions can cause enormous stress on you as practitioners. Reports of bullying and harassment are growing, your unpaid hours are increasing, and horrible social media reviews are becoming common in the medico-legal space; not to mention your obligations under Medicare, privacy, child protection and mandatory reporting obligations.

A recently published study in the BMJ¹ found that one in four junior doctors are currently working hours that are associated with a  doubling of their risk of common mental health problems and suicidal ideation.

We know from the 2013 Beyond Blue survey² of Australian medical students and doctors, that doctors reported a substantially higher rate of psychological distress and suicidal thoughts compared to both the Australian population and other Australian professionals.

Sometimes it simply becomes . . . . too much.

We are by your side
In 2018/2019 the MIGA Claims & Legal Services Team received 5,150 calls for assistance from our members. This is the highest number of contacts we have had in our 120 year history.  We have also seen a 100% increase in notifications regarding employment or industrial matters reported to the team.

We are hearing that the regulatory frameworks in each State and Territory frustrate you. We know that you feel patient expectations are frequently unrealistic and that many of you feel you work in a culture of blame. We understand that when a peer disagrees with your approach it can cause great angst and sometimes anger.

Talking to someone independent of the situation can be really helpful (see the services listed at the bottom of this article).  Where personal or emotional issues arise as a result of an incident or claim MIGA offers a Practitioners’ Support Service providing both peer and professional support to help you regain and maintain your perspective on the situation. Your team member at MIGA will discuss your individual needs and agree the best support framework we can provide. Please just ask us.

I’m worried about a colleague
Our team also receives calls from concerned practitioners who have noticed a peer deteriorating mentally, behaving erratically or their usual excellent clinical care is off-course.

We assist by working through the context (i.e. private practice, hospital employed or network peer), what precisely the MIGA member has observed and provide support as to various options for initiating discussions that will hopefully lead to a healthy, caring approach as opposed to trigging a mandatory notification that is not in line with the guidance under the National Law. Mandatory notification is a last resort and the threshold is high.

We urge those of you in this position to call us. It could be the first step in you making a real difference to your peer’s career or life.

I’m worried about me! – What can I do?
Positive change is occurring to assist you.  As Timothy Bowen, Senior Solicitor reported in our February bulletin, treating practitioner mandatory reporting reforms have commenced in all States and Territories (except Western Australia). The reforms are positive for doctors and are intended to encourage practitioners to seek help without the fear of an unnecessary mandatory report to the regulator.

We encourage you to:

  • Ensure you have an independent general practitioner, see them regularly and in particular if you feel your stress levels are increasing
  • Seeing a counsellor or psychologist can be a pro-active approach to your wellbeing – not just a reactive one
  • Debrief clinical incidents or episodes with colleagues
  • Check in with peers who may be struggling, if you feel comfortable doing so
  • Talk to senior colleagues or administrators if you have concerns you think they can assist with
  • Engage with the Employee Assistance Program if that is available as an employee (it is confidential and independent of your employer), or remind colleagues of its availability
  • Take your vacations – don’t leave it too long between breaks
  • Sleep, hobbies, time with friends and family and eating well are important
  • Don’t forget your MIGA team is here to help.  We are by your side if you need assistance – please call our 24 hour medico-legal support service for emergencies.

Please remember, your role is challenging and complex, the work you do is extremely important.  That brings many different pressures.  As with life generally, there will be ups and downs.  So when you need help, please seek it, we want you to succeed and enjoy your career.

https://bmjopen.bmj.com/content/10/1/e033525 
https://www.beyondblue.org.au/docs/default-source/research-project-files/bl1132-report—nmhdmss-full-report_web.pdf?sfvrsn=4 

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