Doctors told to 'practice what they preach'

Doctors have been told to "practice what they preach" in a study that has found medical professionals regularly risk infecting their patients and colleagues, because they fail to meet their own health needs.

The study, which was published in today's New Zealand Medical Journal, suggested overwhelming desire and pressure to work, reliance on self-medication, toxic work environments and poor general wellbeing were behind the "potentially harmful" practice.

A change in attitude is desperately needed, according to New Zealand Medical Association chair Dr Mark Peterson.

"This is of concern, both for the doctors' own health, and for that of the patients they treat," he said. "We appreciate that doctors don't want to leave their colleagues in the lurch, and don't want to feel as though they're letting down their patients. But to take care of patients, they must take care of themselves."

One survey referenced in the study found more than 80 per cent of workers surveyed at a district health board had worked while sick. Another found only 71 per cent of GPs had their own family doctor and only 11 per cent visited their doctor for regular checkups.

Twenty eight per cent of female GPs surveyed had not undergone recommended cervical screening.

When combined with stress, fatigue, depression or general psychological distress, such lack of basic self-care could lead to treatment or medication errors, the failure to fully discuss treatment options with patients, reduced attentiveness and less caring behaviour towards patients, the study found.

It was suggested improvements would be made if doctors registered with a GP, sought formal healthcare when necessary, acquired appropriate insurance and ensured basic wellbeing by eating well, exercising regularly and having work/life balance.

Specific advice included: "when you visit your general practitioner, leave your 'medical mantle' at the surgery door" and "when ill health strikes, seek help early (as you would like your patients to)."

Finding ways to manage early stressors, such as student debt and the pressure to make career decisions early on, was also recommended.

Royal New Zealand College of General Practitioners medical director Dr Samantha Murton agreed it was not ideal for doctors who were unwell to work, but said there were many situations when it became difficult to take time off, especially if there was a full day scheduled and no-one to take over the care of the patients.

"Practices need to work out their own arrangements for managing illness amongst staff, especially at this time of the year,'' she said.

"We would encourage them to discuss this amongst the team and work out what is best for both staff and patients, recognising that this may require everyone to be more flexible.''