Physician Health Services: First, Do No Harm—To Yourself

Today, external risks and threats to one’s personal safety abound. The news is filled with stories of people being on high alert for a wide variety of real and perceived threats. But, what physicians in particular should also be on the lookout for are personal and professional risks that can potentially threaten their medical practice. In our August 2016 issue of CRICO Insights¹, we highlight five obstacles that create challenges for many physicians practicing today:

Garnered from a 2015 CRICO podcast, Physician Health Services: Social Media Ills Added to Substance Abuse for Intervention Needs ², the above issues touched upon are becoming more prevalent in today’s culture. At CRICO, we want physicians to know they are not alone and that there are services available to help.

It’s clear that “First, do no harm” should not only apply to keeping a physician’s patients safe, but, it should also extend to physicians protecting themselves—professionally, physically, and mentally. It’s important physicians feel able to ask for help for themselves and for their colleagues who are facing obstacles.

Dr. Steven Adelman, director of the Massachusetts Medical Society’s Physician Health Services, Inc. (PHS) and commentator on the above-mentioned CRICO podcast, says he believes,

“ The traditional culture of medicine has created some unrealistic expectations that doctors have of themselves. There’s a selflessness which to a point isn’t a bad thing, but when you’re taking care of other people before you take care of yourself or in lieu of taking care of yourself, you’re at risk.” ²

This conundrum is further highlighted in a July 28, 2016 Medscape article, titled Physician Suicide ³, which emphasizes the ever-present dangers of clinicians feeling professionally unsafe to seek out help, or being unable to diagnose their own needs. The article’s author says,

“ Physicians are demonstrably poor at recognizing depression in patients, let alone themselves. Furthermore, they are notoriously reluctant to seek treatment for any personal illness.”

Ultimately, the Medscape article states, “Litigation-related stress can precipitate depression and, occasionally, suicide.” ³

So what can be done to help physicians help themselves and their colleagues?

One way is to tap into the non-profit services available through PHS, which was founded by the Massachusetts Medical Society and is funded in part by the major medical professional liability companies in Massachusetts, including CRICO. The service is described as “A confidential resource for physicians and medical students who may benefit from help addressing stress, burnout, work-life balance issues, and a variety of physical and behavioral health concerns that sometimes arise in today’s hectic health care environment.⁴”

Anyone is welcome and encouraged to contact PHS on his or her own behalf. Also, referrals are received from colleagues, family members, friends, hospitals, medical schools, and the Massachusetts Board of Registration in Medicine.

Dr. Adleman says one way to help physicians get over their reluctance in seeking assistance is to think of intervention as a form of coaching. At PHS, the coaching model is a wellness model, where they ask first, “What’s right about this person?” ²

A key perspective on the assistance provided by PHS is revealed by Dr. Adelman’s podcast comment that the most important thing is to preserve the contributions and talents of valuable clinicians, and reduce threats to their performance and to their patients. And, he adds, the best kind of intervention comes early—he likens it to calling for help putting out a 1-alarm fire, instead of waiting to put out a 5-alarm inferno.²

References

1. CRICO Insights. August 2016. CRICO.
2. Augello T. Physician Health Services: Social media ills added to substance abuse for intervention needs. [Transcript and podcast.] CRICO. Published January 6, 2015.
3. Andrew LB. Physician suicide. Medscape. July 28, 2016.
4. About Physician Health Services. Physician Health Services, Inc. 2016.