Friday 4 June 2021 The Calile Hotel, Brisbane 8:00am – 5:00pm
Doctors’ Health in Queensland promotes health and wellness for our Queensland Doctors
This past year has highlighted that a focus on doctors’ health is vital for the delivery of high quality, safe health care for our community. Supporting the health of doctors benefits the individual doctor, their health care team and the patients they care for.
Building on our previous learnings and recent experiences, this New Horizon Forum focused on establishing strong leadership across the profession with the aim of improving the health of doctors and medical students in Queensland. Previous forums have explored the health issues experienced by doctors, the difficulties in help-seeking and recognised the need for cultural and organisational change.
Leadership is the key to enabling positive change. Leadership enables the individual to be proactive in their care and reduces stigma. Leadership provides health care teams with interventions that suit the workplace needs. Leadership ensures that robust policies are in place and implemented so that grassroots desire for cultural change is embedded into routine practices. Building on a foundation of research evidence and experience in caring for doctors, together we can establish the compassionate leadership we need for our doctors now and into the future.
Introduction from Dr Anne Ucoq, Past President, Doctors’ Health in Queensland
On 4th June 2021, Doctors’ Health in Queensland hosted “The New Horizon” Forum at The Calile Hotel in Brisbane. Working together with a clear focus on leadership, the participants at the Forum reflected on key issues related to health and wellness of the medical profession. This was an interactive forum with a series of presentations from experts in doctors’ health integrated with focused working groups for participants at the event and online.
Below we provide a Summary of the Forum, including insights shared by the presenters and ideas that emerged from the working groups.
Physician health and wellness has always been an important issue; however, these issues have become more visible during the Covid-19 pandemic. Doctors’ Health in Queensland has been working in this field supporting doctors and medical students for over thirty years, responding to those in difficulty and enhancing awareness about doctors’ health and wellbeing through education and advocacy.
Doctors’ health is vital for the delivery of high quality, safe health care for our community. Supporting the health of doctors benefits the individual doctor, their health care team and the patients they care for. Doctors work in a complex health system.
Leading change to enhance doctors’ health and wellness requires a collaborative approach. Building on previous doctors’ health forums that had focused on “Reducing physician suicide” in 2017, and “Doctors’ wellness” in 2019, this Forum, focused on “Leading doctors’ health into the future”. It enabled the sharing of ideas across the health services and across health sectors, including public and private setting and specialist and primary care services.
Leadership is key to enabling positive change. Leadership enables the individual to be proactive in their personal self-care. Leadership reduces both perceived and real stigma. Leadership provides health care teams with interventions that suit a breadth of workplace needs. Leadership ensures that robust policies are in place and implemented so that grassroots desire for cultural change is embedded into routine practices.
Building on a foundation of research evidence and experience in caring for doctors, together we can establish the compassionate leadership that our doctors need – now and into the future.
Dr Anne Ulcoq Past President, Doctors’ Health in Queensland
Facing a complaint, litigation or a disciplinary hearing can be one of the most stressful events a medical practitioner may encounter during their career. And yet, despite the personal and professional impact of a claim or complaint, some practitioners pretend that it does not affect them at all. In this opening discussion there was a discussion about how to recognise the impacts of a claim or complaint and how to manage them.
The challenge of leading doctors to health and healthcare - lessons and opportunities with Dr Jillann Farmer
Dr Farmer provided reflections on a career spanning 30 years where clinician health and wellbeing has been a central theme. In work ranging from student advocacy to the corridors of the United Nations, Jillann reflected on what has evolved in this space, and what appears to be the intractable problems, with little movement towards resolution in that time.
As Chair of RACS wellbeing working group, Ruth Bollard has been leading the development of The Doctors’ Wellbeing Charter as a collaborative document with many people from many colleges working together with the intention of enabling doctors as individuals and collegiate organisations to voice their commitment to doctors’ wellbeing.
For many organisations, there has not seemed to be a clear or cost-effective way forward. The evidence base regarding the negative impact of doctor burnout on patient care and the health care budget is strong. There is now growing evidence for investing in the Chief Medical Wellness Officer (CMWO) position – provided it is resourced and supported by the highest levels of governance in an organisation. In this session Dr Richards will share her CMWO journey and provide some insights and tips about addressing the issue of medical officer burnout and wellbeing in a large healthcare organisation.
Jan spoke to create a greater understanding around suicide and that doctors are people first. She highlighted the importance of balance in life, the need to promote systems to support doctors to seek help early without fear of reprisal. Doctors are more likely to end their own life than the general population. There are unique and complex issues that surround losing a loved one to suicide; there is a culture of blame and shame
‘Process Communication Management’ is a communication tool taught and used throughout Sonic Healthcare Australia. This model was initially introduced locally at Sullivan Nicolaides Pathology at Dr Fairweather’s instigation some years ago. This talk outlined how and why this program is useful from both a personal and professional point of view.
Dr Harrington’s talk will encompass what it could look like to mould meaningful wellbeing strategies for your workplace, how the Mayo Wellbeing Index could fit into that strategy. She will also share some of what she has learned on her slightly atypical path in wellbeing advocacy over the last four years.
The session was led by the facilitator at each table.
For 35 minutes, participants shared some examples of what they thought needed to happen, in the near future, to make practical changes in the workplace. Followed by feedback of key ideas with our panel sharing their reflections/insights.
For 20 minutes, participants briefly shared some examples of what they felt was working in their workplace.
Being an on-call doctor for the Doctors’ Health in Queensland helpline is an important part of supporting our medical colleagues and medical students. The role of peer-to-peer support, being available to provide this timely, confidential and compassionate assistance will was illustrated.
Dr Caroline Walker tailored this presentation for Doctors’ Health in Queensland designed to reflect on our experiences as the global pandemic of Covid-19 impacted our lives in different ways with a key focus on how we can focus forwards and maintain our wellbeing into the future. Themes of hope, gratitude and power of the human spirit were examined.
As the CEO/Director of Clinical Services at Belmont Private Hospital (the largest provider of private acute Mental Health care in Queensland), Mary has a keen interest in ensuring that members of the medical profession are able to access care in a private, confidential, compassionate and dignified manner. Acknowledging the extremely difficult position that doctors find themselves in when experiencing any level of mental health concerns or serious life stressors is important, and hopefully validating.
At The New Horizon Forum, Doctors’ Health in Qld brought together speakers who are leaders in doctors’ health together with leaders in the medical community. We came together, as we have a collective desire for change, we know the need to show leadership in doctors’ health and wellbeing. We can no longer ignore the loss of doctors’ lives, the exodus of doctors from clinical practice, early retirement, the distress and discontent of doctors in training, GPs, specialists, and international medical graduates. We need a powerful, positive response. Together we have a voice.
Doctors are individuals. They come to their role with their own personality, life experiences, cultural and family lessons, their own physical and mental health and practices of self-care. For the most part, doctors are healthy and resilient. The role of being a doctor, the expectations of the medical profession as a whole, society and the organisations we work in, forge how we then move forward. These expectations can rise us up to be brilliant doctors and make great achievements, but the downside can be the great personal cost. Sometimes we only see the current horizon and that horizon can look bleak.
Cultural change, organisational change, systemic change, individual change, societal change is required to improve the health and wellbeing of our doctors. New habits make new horizons. Doctors need to be enabled to be proactive in their health care habits and leadership is a choice, not a position, and the quality of a leader is reflected in the standards we set for ourselves. By showing leadership in your workplace by practicing your own self-care and wellness and demonstrating this to your colleagues, you are being a leader and moving towards a new horizon. A leader is one who knows the way, goes the way and shows the way.
This summary document captures so many ideas and themes that have emerged from this forum.
This list captures a few highlights:
- Education of medical students and doctors about how to respond and cope when a medicolegal complaint is made is essential. The need to share this experience with our peers and our family is important as the impact of a medicolegal complaint can be profound. Stigma often prevents this sharing and burden can be intolerable. • There is heartbreak and there is joy in medicine. We need to make safety for our doctors a priority. Safety is about meeting basic needs, PPE, meal breaks, safe working hours, correct remuneration for hours worked, peer support after critical incidents, sick leave, holiday leave, support doctors to work in their skill set, protected education. • Using an occupational health model to keep doctors’ safe in our high-risk industry is one model that should be explored. Doctors who are not performing should be assessed holistically, maybe they are not well rather than bad.
- Connectedness, loss of connection leads to a greater risk of burnout especially with our younger doctors. How do we support connectedness? – intimate communal eating areas, peer to peer support groups, e.g., Balint groups. Everyone has different needs. There are unique ecosystems and cultures within every organisation, identify and build on what is there to encourage connectedness. We need to feel part of a family, so having conversations with your colleagues, celebrating birthdays, if you feed them, they will come!
- Self-compassion and self-reflection are important skills to have for doctors’ health and wellbeing. This should be taught to medical students and doctors. Education around doctors’ health and leadership around this is important. • Flexible workplaces that allow flexible work hours and training and take into account the need for doctors to balance work, training, social and family life. We need the trickledown effect of cultural change for all, cultural safety is for all.
- Doctors need to have a GP, and this is something that we need to prioritise. Encouraging doctors to have a GP, to normalise time off to attend appointments and noting that COVID-19d has enabled telehealth as an option.
- The Doctors’ Health Charter is an important document whose development has been championed by the Royal Australasian College of Surgeons. This document should be adopted by all medical colleges. Any document needs to be translated into behavioural change and this is an important step in having a charter.
- Having a Chief Medical Wellness Officer and having this embedded in your workplace is something that every workplace should aspire to. Assoc Prof Bethan Richards has shared her framework and how this would look. Your local workplace data can be a powerful lever to enable this to happen. Be prepared to start small, be strategic and build on what is already there. This approach was reinforced by Dr Harrington’s talk about the Mayo Wellbeing Index. You do not need to reinvent the wheel.
- The loss of a doctor to the profession comes at a great cost to society that can be measured in financial terms. The loss of a doctor from suicide is devastating to the community and the family. Doctor suicide needs to be examined and addressed no matter how painful.
- Kindness and compassion need to be front and centre in all our interactions with each other. Stigma around mental health needs to be acknowledged. We need to know how to show compassion for colleagues when they are unwell.
- Words of wisdom from today, “medicine is what you do, not who you are”. “Doctors are people too” • Recurring themes are gratitude, connectedness, compassion, self-compassion, joy, fun, communication.
- Take home messages: have a GP, see your GP.
- Often the doctors’ health leader in the organisation is not necessarily the person who has the title of lead in that department. Clinical champions in the workplace make a huge difference. The doctors’ health space is moving, forward. The next generation will bring a fresh approach, energy and hope to doctors’ health, claim your space! Senior doctors need to support the new generation in this endeavour.
Leadership that prioritises wellness and doctors’ health is more than “Knowing” about doctors’ health. Leadership in education around doctors’ health, and the need to deliver education to medical students and doctors about this arose many times . Leadership includes having overt statements about doctors’ health like the Charter. The challenge is to translate these documents into real change in behaviour in the workplace.
Each step will reveal a New Horizon. We have taken the first steps at this Forum. The challenge for us all is to have the courage to take the next one.
Doctors’ Health in Queensland would like to thank you all for being part of our Forum – for your thoughts, your contributions and your time. Our Forum focused on how we can craft positive and meaningful leadership in doctor’s health. We look forward to working together in the future.
The Wellbeing Charter for Doctors aims to define wellbeing and describe the principles that guide the wellbeing of doctors in Australia and New Zealand. The Charter also describes the shared responsibility of wellbeing for the medical profession. The Charter demonstrates a unified approach to doctors’ wellbeing so that we can advocate with one voice to institutions, governments and policy makers.
Throughout the DHQ Forum, a number of key concepts emerged from the many presentations and subsequent discussions between the many key experts in doctors’ health who were present.
Thank You to our Sponsors:
Doctors’ Health in Queensland is a registered charity that provides support for doctors and medical students. Our service is independent of other organisations and relies on our volunteers to answer the helpline and support the organisation’s many activities.
DHQ is incredibly grateful for the platinum sponsorship of Avant Mutual. Avant provides medicolegal support for their doctor members and holds, as a priority, the health and well-being of their members. We thank them for their ongoing generous support of DHQ. Tracy Pickett, a medicolegal expert from Avant and champion of Doctors’ Health, contributed to our Forum as a speaker.
DHQ are grateful for the generosity of Sullivan and Nicolaides, Belmont Private Hospital, RACGP Qld, AMA Queensland and QDHP who also have provided support or sponsorship of this important event. Each of our sponsors were represented at the event by leaders of their organisations who presented, facilitated, assisted with the technology and supported the event in many ways.
This forum was also held in memory of Dr Kate Rodwell. Kate’s family, her work community, colleagues and friends were present at the Forum. Donations made in Kate’s memory were used to host the event and her Mother, Jan Rodwell, spoke in the afternoon.
Thank you to those who contributed to the smooth running of the event by introducing and thanking our presenters:
Dr Frank New – previous President DHASQ and Chair QDHP
Dr Ross Phillipson – Chair QDHP
Dr Jenny Schafer – Medical Director QDHP
Dr Peter Norris – Member of DHQ On Call Panel
Michael Kennedy (retired GP) – Vice-President DHQ and
Dr Ira van der Steenstraten (Life Coach, Breeze Life Coaching) – Management Committee DHQ
The interactive sessions were led by Vicky Dawes, an experienced counsellor to doctors and medical students, and is herself a former doctor. Her expertise enabled the sessions to be lively, productive and enjoyable.
Doctors’ Health in Queensland is very appreciative of the work of the ten facilitators who supported our interactive sessions: Ms Mary Williams, Dr Di Khursandi, Dr Bruce Willett, Dr Naseera Naeem, Dr Jenny Schafer, Dr Maree Patane, Dr Ira van der Steenstraten, Dr Kathryn Hutt, Dr Sue Gardiner and Dr Lydia Pitcher.
Together, with their scribes for the day, they enabled DHQ to capture the many ideas presented here.
Thank you to the Convening Committee from DHQ whose hard work enabled this event to take place: especially Dr Margaret Kay, Dr Anne Ulcoq, Dr Di Khursandi, Dr Ira van der Steenstraten, Mr Michael Kennedy supported by Ms Lisa O’Donnell.
This Forum was approved for RACGP 13 CPD Activity Points