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THE OTHER SIDE OF PRIMUM NON NOCERE
By: Dr.Ashwini M.Madawana , Malaysia
In a recent study, 74% of doctors said they saw burnout in others, and over half said their workload had harmed their mental health (Carpenter, 2019). Doctors commit suicide at twice the rate of the general population. Concerns about accessibility, caseload, patient volume, and litigation have increased medical professionals’ stress levels over the last half-century. Not to mention third-party documentation systems, insurance companies, and their patients’ struggles can be challenging to deal with if they do not perform well. Physicians need more help than ever managing their mental health, but the same stigmas exist in the medical profession. Doctors dread filling out forms that ask if they have a mental illness. It is a system that encourages people to hide their mental health issues due to the risks of being honest. The unspoken assumption between doctors and patients is that patients represent illness, whereas doctors represent health and immortality.
So, how can we assist doctors in breaking free from the shackles of stigma?
Specialist mental health services for doctors, as advocated by the British Medical Association, could be a key to unlocking the oxygen masks for doctors who are suffocated by stigmas. The service runs on a non-profit basis, with fees varying depending on the doctor’s grade and circumstances. A health practitioner support group, such as the NHS Practitioner Health, founded in 2008, helps doctors and dentists struggling with mental health or addiction issues significantly if they are interfering with their work. It is a self-referral service. It is provided to health professionals by health professionals who specialize in mental health support. Some of the few helplines that provide face-to-face counseling, a listening ear, or peer support groups for Doctors are Health for Health Professionals Wales, BMA Wellbeing Support Services, Psychiatrists’ Support Service, and RCS Surgeon to Surgeon. Occupational Health Practitioners, for example, can be helpful and help in allowing a doctor to be patient by being their patient as they create a trustable relationship together.
It is becoming increasingly clear that doctors do not make suitable patients and may require ‘permission’ to be ill, particularly mental health issues. Doctors are not equipped with an immunity shield to fight mental illness; in fact, doctors have higher rates of depression and anxiety than the general population, and female doctors, in particular, have significantly higher suicide rates than the general population. Doctors are advised to “put patients first,” which means acknowledging situations in which they cannot provide the level of care they require, such as exhaustion or illness. Instead, Doctors should be mindful of their health and how it may affect the patients. They should “act without delay” if they suspect they or a colleague endanger patients’ safety. In most cases, this means telling them to take a break, leave the office, and seek help.
Doctors are a valuable and costly resource for society, and their absence due to preventable illness is a waste to the health service, a loss to patients, a strain on colleagues, and a disruption to individual careers. Avoidable causes of illness in the system doctors work must be addressed, and doctors must have timely access to confidential assistance. Perhaps it is time, to be honest with patients and accept that being a good and safe doctor means letting go of the exclusive and somewhat idealized medical role that requires us to serve patients come rain or shine. Instead, we should take a more mature role that includes self-care and balancing the needs of doctors with the demands of patients. When caring for caregivers, I believe employers and policymakers should take a Primum Non Nocere approach.
Harper Harrison is a reporter for The Hear UP. Harper got an internship at the NPR and worked as a reporter and producer. harper has also worked as a reporter for the Medium. Harper covers health and science for The Hear UP.