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  • Safeguarding your physical health

    There is a tendency for doctors to ignore the warning signs of ill health, with many choosing to push on with their work, self-medicate – even while they are seeing their own GP [1] - or simply hope the problem will go away[2]. But with no room for error, and community expectations that doctors are competent, professional and unimpaired [3], it is important that you strive to optimise your own health and contentment.

    Safeguarding you health

    Threats to doctors’ physical health

    Doctors generally enjoy a good level of physical health due to their high level of health literacy and socio-economic advantage. They have lower than average mortality rates [4] and are less likely than the general population to suffer lifestyle-related illnesses, such as smoking-related disease [5].

    However doctors, like the general community, are at risk of chronic diseases, especially those related to a sedentary lifestyle. The nature of their work also puts them at increased risk of liver cirrhosis and some communicable diseases such as Hepatitis B and C and influenza. And there are health impacts inherent in working long hours, doing shift work, and working in rural and remote locations [6].

    Taking responsibility for health

    Doctors are responsible for their own physical health, including lifestyle management as well as proactively seeking treatment and establishing a continuing therapeutic relationship with their own GP.

    “All doctors, even specialists, need to have their own GP and to see them more than once a year,” says Avant Medical Advisor Dr Joe Lizzio, a general surgeon. “For the same reasons as you are not encouraged to treat your own family, you are not objective when it comes to your own health.”

    Regular self-diagnosis, treatment and prescribing are discouraged. Self-treatment can be chaotic and poorly documented, involving medications prescribed for family members or taken piecemeal out of the cupboard, and doctors are notorious for failing to finish courses of antibiotics.

    Lifestyle management

    “It may be hard for doctors to find time for adequate self-care, but lifestyle management is an important part of maintaining physical wellbeing and performing optimally as a doctor,” says Marianna Kelly, Avant Senior Risk Advisor.

    That means being proactive about exercising, eating healthily, avoiding being overweight and cutting down on alcohol consumption. Ms Kelly says it is also important for doctors to structure their work environment as much as possible to ensure they have the work/life balance essential for good health. For example, doctors should take regular leave and introduce strategies that ensure they will not be disturbed while they are away.

    Other strategies include working sensible hours, taking time to stretch your legs if you are desk-bound, and having a hobby and social life that are separate from medicine.

    Cautionary Tale

    Case Study

     

    Physical Health

    Dr D is an emergency physician in a rural hospital.  She is also very active and enjoys rock climbing and bush walking.  She had recently returned from a trip to Nepal where she walked to the Mt Everest base camp.  She suffered a bit of gastro on her return home, but nothing too serious, although she did chat to a colleague at work about how much time she should take off before going back to work. 

    On her first day back at work, she was seeing a patient in resuscitation when a wave of nausea overtook her.  She hastily left the room with the patient notionally in the hands of the Registered Nurse.   As she left she said “perhaps I came back to work too early”. 

    While Dr D was out of the room, the patient suffered a cardiac arrest, and the emergency response team attended.   The patient recovered but an incident report was completed noting that Dr D had left the Emergency Department unattended. 

    On reviewing the incident report, the hospital administration noticed that there had been a number of incidents over the past couple of years where Dr D had injured herself and been unable to work.

    Dr D was called in for a meeting with the hospital administration.  They were concerned that she was not looking after herself properly, and was putting herself and her patients at risk. 

    As a result of this Dr D took a step back and reflected on things. She conceded that perhaps she did push herself too much and that she may have come back to work too early after injuries in the past.  She decided to take better care of herself and to ensure that if she did injure herself in future she was fit for work before coming back.

    Tips

     

    Maintain your physical health

    • Have a good General Practitioner and see them regularly – don’t self-treat
    • Take regular leave – plan it annually
    • Have a life outside medicine
    • Be proactive about exercising
    • Eat healthily and cut down on alcohol consumption
    • Focus on having good time management
    • Structure your work environment to ensure a good work/life balance
    • Know there is help out there if you need it
    • If you have had a serious injury or illness, get the opinion (preferably in writing) of an experienced specialist about recommended time off work
    • If you travel a lot, give yourself enough time to recover from each trip
    • A rigorous adventure trip may cause weakness and physical exhaustion, and it may take some time to recover to full health, even if you were fit and strong before leaving.
     

    References

    1. SA Doctors’ Health Working group survey, 2007.
    2. Kay M et al. Developing a framework for understanding doctors’ health access: a qualitative study of Australian GPs. Australian Journal of Primary Health 2011; 18: 158–165.
    3. Royal Australasian College of Physicians position statement 2013. Health of Doctors.
    4. Frank E et al. Mortality rates and causes among US physicians. American Journal of Preventive Medicine 2000. 19(3):155-9.
    5. Frank E et al. Health practices of Canadian physicians Canadian Family Physician 2009. 55(8):810-811
    6. The health and wellbeing of doctors and medical students – 2011, Australian Medical Association.