- If you know or suspect your judgment or performance could be affected by your health, you must consult a suitably-qualified colleague (such as your GP, occupational health doctor or psychiatrist) and make any changes to your practice they advise.
- Don't be tempted to self-prescribe to alleviate symptoms such as exhaustion or anxiety. Self-prescribing could leave you vulnerable to a GMC complaint. Instead, seek objective medical advice.
- Speak to your colleagues and seek their support. They may be able to reduce the pressures you face at work.
- Seek help early if there has been a clinical incident or the GMC is involved.
Of 1,000 doctors surveyed by the Royal Medical Benevolent Fund (RMBF) in 2016, 82% reported knowing of other doctors experiencing mental health issues such as depression and anxiety. Key factors contributing to the pressure on doctors included patient caseloads, increased scrutiny and working hours. However, 84% of respondents said that they would be unlikely to seek help with mental health issues.
Doctors are human and suffer from ill health. However, we are often silent patients, reluctant to come forward and seek help. This hidden burden of illness amongst the profession is perhaps most pronounced in relation to mental health conditions, where concerns about confidentiality and potential stigma can be a disincentive to come forward. However, we should not be afraid to get help when we need it. You don't have to 'just get on with it', and recognising our limitations is important to practise safely.
We should all be registered with a GP outside our family. Their role is to provide objective advice about how to prevent and manage any health concerns you might have. You may have access to an occupational health service via your employer as well. If you are unwell, it's important not to rely on your own assessment of your health or 'corridor consultations' with colleagues.
Every doctor has a duty to support a colleague who has a problem with their health or performance. Your colleagues will understand the strain you are under and may be in a position to help relieve the pressure of work. They may also be able to spot if your health is beginning to affect your performance. Accept help that is offered, and listen and respond to their concerns.
In addition, the below resources might be of help.
The RMBF's 'Vital Signs guide' provides practical advice, support and resources. It sets out key stress and pressure points and encourages doctors and trainees to get help early if experiencing stress or difficulty.
BMA Wellbeing Support Services
These confidential services are available 24 hours a day, seven days a week, offering counselling and peer support. Doctors in distress can speak to counsellors or other doctors for help with coping strategies and general support. Access is for all doctors, not just BMA members.
NHS GP Health Service
The NHS GP Health Service launched in early 2017 for GPs and GP trainees in England suffering mental ill health and addiction. The free, confidential service operates on a self-referral basis and offers access to clinicians and therapists for help with:
- mental health conditions, including those relating to a physical health issue
- substance misuse
- rehabilitation and return to work following a period of mental ill health.
For more information, visit their website, contact them by email or call 0300 0303 300.
Practitioner Health Programme
This NHS service was set up in 2008 specifically to treat health professionals with mental health and addiction problems. Doctors resident in London can self-refer; other doctors in England can access the service via a GP referral.
British Doctors and Dentists Group
This is a peer-run recovery group specifically for doctors and dentists addicted to alcohol and/or drugs.
The GMC and doctors' health
Doctors who are unwell may come to the attention of the GMC if their practice is affected – for example, if there has been a complaint, clinical incident, or if the doctor is advised to self-refer because of ill health. No doctor wants to end up under GMC scrutiny, so it's vital to seek help when it's needed to hopefully prevent the situation reaching that point.
In addition, GMC investigations arising from matters unrelated to health are stressful and this may impact on a doctor's wellbeing.
The BMA Doctor Support Service provides free, confidential peer support for all doctors under GMC investigation, including those who are not BMA members.
In the MDU's experience, the GMC is sympathetic towards doctors with health problems providing the doctor co-operates with health assessments and shows insight. Many doctors with health problems affecting their fitness to practise will be able to continue working with voluntary undertakings agreed with the GMC, or with more formal conditions imposed by the MPTS. These will be designed to ensure the doctor has the individual supervision and support necessary for them to practise safely.
Your medical defence organisation
We support thousands of doctors with responding to complaints and investigations each year, seeing first-hand the personal stresses doctors can face. We also help many doctors who find their health is affecting their practice.
Come to us for help at the earliest opportunity; we can provide advice on how to respond to the concerns and may also be able to suggest additional sources of support.
If you are off sick for more than a month, the MDU can also put your membership on hold, meaning you will not have to pay a subscription for the period you are not able to work.
This guidance was correct at publication 23/01/2019. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.