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Supports for struggling doctors

Most doctors who are struggling are aware of their situation and may need additional emotional support.

The degree of support needed varies with all doctors. The initial meeting with the doctor should acknowledge the stress of low performance and offer resources including:

Internal supports

DCT/MEO/SIT/hospital wellness officer/peer support/mentors

External supports

Many doctors are concerned that referral to a psychologist, employee assistance program (EAP) or a doctor due to stress or anxiety will have implications for registration, medical indemnity or references.

The doctor should be advised that notifiable conduct is defined by AHPHA as conduct that behaviour that puts the public at risk. Similarly, medical indemnity organizations follow the same principles. Most indemnity organizations acknowledge the stresses of a career in medicine. Their goal is to have healthy members so they provide assistance to members with no penalties for those who seek assistance.

Extract from AHPRA

That is, the requirements focus on behaviour that puts the public at risk of harm, rather than not liking the way someone else does something or feeling that they could do their job better.

Similarly, if the only risk is to the practitioner alone, and there is no risk to the public, the threshold for making a mandatory notification would not be reached. For example, in a case where the risk is clearly addressed by being appropriately managed through treatment and the practitioner is known to be fully compliant with that, mandatory notification would not be required.

Section 140 of the National Law defines ‘notifiable conduct’ as when a practitioner has:

  1. practised the practitioner’s profession while intoxicated by alcohol or drugs; or
  2. engaged in sexual misconduct in connection with the practice of the practitioner’s profession; or
  3. placed the public at risk of substantial harm in the practitioner’s practice of the profession because the practitioner has an impairment; or
  4. placed the public at risk of harm because the practitioner has practised the profession in a way that constitutes a significant departure from accepted professional standards.

https://www.medicalboard.gov.au/codes-guidelines-policies/guidelines-for-mandatory-notifications.aspx

Local medical officers

All doctors should have a GP

Hospital employee assist programs (EAP)

The services are run by independent organizations and provide qualified psychologists who generally offer up to three free consultations. The number of referral and nature are fed back to the employer but the client identity and details of the consultation are confidential.

Victorian Doctors Health Program (VDHP) provide support for doctors and medical students with emotional and mental health issues as well as substance abuse and physical health issues. For doctors facing formal investigation a referral to VDHP should be a part of the process.

http://www.vdhp.org.au/website/services.html