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13 Jun 2019

BY DR RODERICK MCRAE, CHAIR, AMA COUNCIL OF PUBLIC HOSPITAL DOCTORS  

In this column, I offer an overview of where AMA’s influence is being brought to bear in alignment with a small but important October 2017 amendment of the Declaration of Geneva of the World Medical Association that was discussed at the 2019 AMA National Conference (and even by me in the Workforce Issues debate); “I will attend to my own health, well-being, and abilities in order to provide care of the highest standard.”

Self-care is a critical virtue, but I also insist that there is an associated obligation that we all care for our colleagues, enquire about their wellbeing by regularly ‘checking in’, and encourage them to seek support at the earliest indication of something being not quite right. Don’t forget the President awarded his President’s Medal to Dr Geoffrey Toogood of Crazy Socks 4 Docs fame. Of course, employing public hospitals must show the same level of concern and care by providing a safe workplace and having good, empathetic management systems.

The AMA is participating in the development of a Federal Government funded national framework for tackling mental ill health in doctors and medical students.  The framework will assist design of safe, supportive environments (in universities, Learned Colleges and hospitals) and provide strategic direction on improving mental health and reducing suicidal behaviour.

The AMA continues to consolidate the national health program for doctors and medical students with funding support from the Medical Board of Australia.  The AMA’s subsidiary, Doctors’ Health Services Pty Ltd (DrHS), is coordinating the delivery of services by doctors’ health advisory services in every State and Territory. Under that umbrella there are some funded support and training packages in late development stage anticipated to have real positive practical effect.

Particularly from your CPHD’s perspective, we should never overlook the positive duty our employing public hospitals have to care for all of their staff.  This goes to doctors’ mental health and general wellbeing but also, now that I think of it, goes to issues I have recently tackled in my Australian Medicine columns, like NSW trying to implement open-plan office space and the lack of a nationally consistent rules to transfer parental leave entitlements between jurisdictions.  Additionally, I’m aware of several health services who are bloody-mindedly interfering in a workplace entitlement related to clinical support time for over-worked and over-stretched employed doctors. These perverse examples demonstrate workplace rights and entitlements go to the very heart of professional respect which have an obvious nexus to doctor wellness.

The OECD has noted that macro-economic statistics such as national GDP don’t offer a picture about peoples’ lived experience.  The measurement of well-being (and ‘real’ progress), says the OECD should include health status; work life balance, social connection, involvement and governance.

So, wondering out loud, should we have public hospitals investigating the effect their workplace is having on health and wellbeing in conjunction with traditional clinical and financial indicators?

At a minimum, perhaps hospitals need to start asking doctors what the impact is on them when there is (poor) hospital clinical engagement and variously dysfunctional organisational decisions, fatigue reduction strategies and managerial styles.  The measured results are unlikely to be good but what if these became annually reported public hospital KPIs? We do tend to be motivated to achieve positive change in the areas we transparently publish and are held against.  A public hospital ‘wellness index’ may well be a well-judged (puns intended) treatment plan.  Perhaps a new AMA report card is on its way….


Published: 13 Jun 2019