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Managing Doctors in Difficulty & Doctors who Present Difficulties

News and updates from today's conference in London focusing on managing doctors in difficulty and difficult doctors including; managing the clinical team, enabling resolution and remedial/developmental action, managing and supporting health professionals with health issues and developing preventative approaches through resilience, time to think and mindfulness techniques.

Managing Doctors in Difficulty, and Difficult Doctors: Professor Stephen Powis Medical Director Royal Free Hampstead NHS Foundation Trust 
Dr Stephen Powis, Medical Director, spoke with Dr Vivienne van Someren, Associate Medical Director of the Royal Free. They discussed case studies of issues they have faced in managing and working with doctors in difficulty and difficult doctors within the Royal Free including managing doctors with health issues, issues with social media, and poor performance/unacceptable conduct. 

Full presentation

Managing and supporting health professionals with health issues, and developing preventative approaches through resilience, time to think and mindfulness techniques: 
Lucy Warner
Chief Executive NHS Practitioner Health Programme
Lucy discussed the NHS Practitioner Health Programme experience of supporting doctors who become unwell.  Lucy said that they see commonly that doctors are one of the most unattended population in terms of health care - many are not registered with a GP and who have not consulted with anyone on a personal level or sought help from a health professional in many many years. 

There are also personality factors within doctors that mean they do not seek help - perfectionists (I want to do this right, mistakes are intolerable), narcissists (I am the greatest), compulsives (I must do this and cannot give up until I finish), denigrators of vulnerability (people who need help are failures), and martyrs - putting their patients first and not wanting to let patients down. 

Lucy discussed the numbers presenting to them. Lucy said two areas worrying them greatly at the moment are younger doctors (under 35) which represent 67% of their caseload which has grown considerably in the last few years. Lucy recommended 'Tea and Empathy' a facebook group for younger doctors to talk and have a place to offload. Another area is supporting doctors from international doctors coming from overseas.

Doctors and illness - mental ill health in doctors is a big issue, doctors committing suicide are common and ongoing. Female doctors are 2.5 times more likely to kill themselves than men which is contrary to general population. Health issues in doctors are worse than the general population. In America findings have shown 1 in 4 doctors are depressed.  Doctors also present late for many reasons - they are unable to seek help during office hours, frequently moving, feees for career progression, difficulty with disclosure, stigma, career suicide, and psychological barriers to self disclosure. 

Lucy went on to describe their services at the NHS Practitioner Health Programme which mainly supports mental health issues but does cover some physical issues.  The service is commissioned by CCGs. NHS England has now commissioned a mental health and addiction services for GPs, the service is due to start on the 1st January 2017. For secondary care doctors there are currently no plans for a comparative service to exist.  Our most common presentations are from Psychiatrists, Anaesthetists and Paediatricians. PHP are seeing an increasing number of A&E doctors presenting. 

We have found doctors recover quicker than the general population. 78% return to work. The cost of PHP is £1m, the cost of sickness absence in doctors in London is £50m.

Full presentation

Managing and supporting Clinicians in Difficulty: Dr Neil Margerison Adviser National Clinical Assessment Service 

Full presentation


Also of interest:

Consultant Job Planning
Tuesday 4 October 2016, Hallam Conference Centre, London

Clinical Audit for Improvement
Wednesday 5 October 2016, The Studio Conference Centre, Birmingham

Caldicott Guardians: National Annual Conference
Thursday 6 October 2016, The Studio, Birmingham

UK Physician Health Summit 2016
Monday 10 October 2016, Hallam Conference Centre, London

Hospital Mortality Annual Summit: Mortality Monitoring & Reducing Avoidable Deaths attributable to problems in care
Thursday 20 October 2016, Hallam Conference Centre, London

Effective Clinical Director
Monday 7 November 2016, Hallam Conference Centre, London

13 September 2016


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