Sick doctors are reluctant to become patients, a conference was told yesterday.
Speaking at the first national conference on the Health of Doctors, in Dublin, Dr Paul Farnan, clinical co-ordinator of the Physician Health Programme in British Columbia, Canada, said 25 per cent of doctors who were unwell had serious substance abuse problems.
Over half of those treated in the Physician Health Programme had emotional health issues, ranging from stress and burnout to depression. The programme emphasises the early identification of health problems by the doctor himself as well as by doctors' families and medical peer groups. "The retention of resilient physicians is a key aim," he said. "But we prefer to err on the side of action and if necessary to remove a sick physician from practice."
Dr Farnan said similar health programmes were operated by other Canadian states for the country's 67,000 doctors.
The primary prevention of health problems in doctors must start in medical schools by looking at how medical students are selected. He highlighted the need to change the culture of medicine so that the public see that "doctors are human too".
"If you don't look after yourself, your work and your patients will suffer." The Physician Health Programme is co-funded by British Columbia's state medical council and by the Canadian Medical Association. Dr Farnan provides some of the care to sick doctors himself, while certain problems require referral to specialist centres in Canada and the US.
Dr Andree Rochfort, director of the Health in Practice Programme of the Irish College of General Practitioners, which co-hosted yesterday's meeting with the Medical Council said a survey of GPs had found that most doctors have been unable to take time off work when they were ill.
"Doctors' medical education teaches them to diagnose and manage the health of patients. There is no education on how to manage their own symptoms or how to deal with colleagues who display signs of illness," she said.
Some 52 GPs, 21 occupational health physicians and 12 psychiatrists were now part of a healthcare support network for GPs, Dr Rochfort told the meeting.
Prof Anthony Clare, consultant psychiatrist at St Patrick's Hospital, Dublin, said there was a need to look at the inappropriate systems doctors work in, as much as examining ways of fixing the doctor.
"How do we help ourselves survive this crazy career? It is very important that we learn to admit that we are going to be ill. We must tell medical students they do not have to be super-doctors."
The conference agreed a consensus statement put forward by Dr John Hillary, president of the Medical Council.
It emphasised that health is a professional responsibility and that both the culture and system of medicine needed change.