Buddy doctors offer support to GPs in distress
GPs find themselves at high risk of burnout, addiction and suicide thanks to the stress of their job – so a doctors’ organisation is introducing a support system in the hope of changing the profession’s culture
General practitioners (GPs) have a lot of responsibilities. As well as an extremely busy schedule and difficulties in balancing life and work, there’s the constant risk of making the wrong decisions.
Research shows GPs to be at risk of burnout, addiction, depression and suicide. A study by GP association Domus Medica shows that four Flemish GPs kill themselves each year and female GPs run a higher risk of killing themselves than the average Flemish woman. Other studies have shown one in 12 trainees suffers burnout and one in three GPs is at risk of alcoholism.
Still, it would be wrong to blame these troublesome statistics on the pressure that comes with the job, experts say. According to Annelies Van Linden, a GP herself and a co-ordinator at support group Doctors4Doctors, most of the cited numbers aren’t that different from those of the general population.
“Increasing societal pressure is taking its toll everywhere,” she says, “but the real problem GPs face is that they aren’t inclined to ask other doctors for help. They feel they should be able to solve the issue themselves. Asking colleagues for help is a deeply ingrained taboo.”
According to Van Linden, society at large, including physicians and specialists, mistakenly sees a doctor as someone who should know everything. “Which is impossible,” she says, “but precisely because of this myth most of them think they should be able to heal themselves.”
In rare cases where they do ask for help, they experience feelings of shame and powerlessness, she explains. “They couldn’t heal themselves and so they must not be a good doctor. Admitting to colleagues that they can’t solve it on their own, well, that’s just admitting failure. It ruins their self-esteem.”
We’re dealing with a group of very vulnerable people. If it wasn’t for our empathy, we wouldn’t have become doctors
While the first ideas for the prevention and promotion of doctors’ health date as far back as 2007, the first real support group, Doctors4Doctors or D4D, was founded at the end of 2013 by physicians in the field. From the start, D4D aimed to build a network of trained counsellors – “co-doctors” – that other physicians can reach out to in times of mental distress.
In 2015, a pilot project was started in Antwerp province, and now the Flemish government has decided to roll out the project over the whole region, starting in early 2017. Doctors4doctors aims to have one or two co-doctors for each practitioners’ circle, a group consisting of anything from 20 to 300 GPs.
According to Van Linden, rolling out the project is not the final step in the process. “Right now the project is limited to GPs,” she says, “and we’re leaving out specialists in hospitals, who suffer from the same fears and doubts. In the end, we will need teams of co-doctors in all Flemish hospitals as well.”
So far, 31 GPs have completed the training to become a co-doctor. Caroline Helsen from Meerhout, Antwerp province, is one of them. She took part in the 2015 pilot after seeing how many young colleagues quit because of impossible expectations.
“We cannot afford such a loss of talent,” she says. “Most of them start to think it’s normal to work impossible hours, to keep on achieving and be invulnerable to anything that might happen. When it turns out they can’t keep it up, they think they’re bad doctors and quit. Remember, we’re dealing with a group of very vulnerable people. If it wasn’t for our empathy, we wouldn’t have become doctors.”
According to Helsen, very few colleagues have asked her for counselling yet. But as she sees it, this is not the right way to measure the project’s success.
“We need to let this sink in,” she says. “It’s a large cultural change we’re trying to bring about. As co-doctors, we are starting the conversation in our circles. We put these issues on the agenda, we make them discussable. The fact that we’re here in the first place will make doctors think differently.”
In an ideal world, she says, doctors will be convinced of the need to take care of each other and to accept help. “The fact almost no GPs have their own physician says a lot. That too needs to change.
Van Linden agrees: “Paradoxically, we will only be successful when the breed of co-doctors becomes extinct. We hope we’ll not need to repeat our message too many times. Solidarity between doctors has to increase.”