Healthy Doctors: Healthy Patients in review - Autumn Conference 2014
The Autumn Conference 'Healthy Doctors: Healthy Patients' took place on 7th November at Friends House in London and was very topical in the light of the concern of the profession over the effect the proposed contract changes will have on doctor wellbeing and patient safety. The delegates ranged from students to retired members and represented a wide range of specialties. As usual there was a packed programme but there was still plenty of time during breaks for networking, looking at the poster presentations and catching up with other members.
Dr Clare Gerada, the opening speaker, summed up the theme of the conference with her talk entitled 'Pull your own oxygen mask down before helping others'. Figures from the Practitioner Health Programme in London show a marked rise in the number of young female doctors presenting to the service (out of proportion to those graduating). The constant reorganisation of the NHS and increasing workload along with the frequent moves and excessive monitoring of those in training grades are amongst the causes. Shorter working hours and shift patterns may not be helping as they fracture relationships with colleagues and erode the continuity with patients which is important for learning and job satisfaction. The good news is that doctors do well with treatment and 75% get back to work.
Dr Deborah Cohen presented some results from a survey of attitudes to mental health issues amongst doctors. Whereas doctors might think they would seek help at an early stage and from an appropriate agency such as Occupational Health, when it comes to it they disclose their difficulties late and often to a colleague in the first instance. Doctors in training grades present later than consultants and GPs and this may partly be due to fear of jeopardising their career progression.
Anna Rowland from the GMC gave us an overview of Fitness to Practice, particularly with regard to the health of the doctor and its impact on patient safety. The GMC has received criticism of its procedures in the past, especially when doctors under investigation have committed suicide. They are reviewing how they deal with health cases and introducing safeguards to try to protect vulnerable doctors as well as the public.
The Dame Rosemary Rue lecture was given by Professor Jane Anderson, a clinician and researcher in HIV. She described how Dame Rosemary Rue chose a career in medicine after a serious illness in childhood and how she persevered despite being told on more than one occasion that medicine was no career for firstly a married woman and then a mother. Professor Anderson linked the challenges to our expectations of what constitutes a good medical life (as in that of Rosemary Rue) with the life changing effect of a diagnosis such as HIV as both change peoples views of who they are and where they are going. In her own career she failed to get in to medical school at the first attempt due to failing physics A level. She later went back as a mature student and so graduated just as the HIV epidemic was starting and entered a specialty that would not have existed had she entered medical school earlier. Decade by decade she outlined to us the progress made since then so HIV is now considered a chronic illness rather than a life limiting one and controlled on just one pill a day. The resilience as shown by Dame Rosemary Rue is something she also recognises in her patients. A very enthusiastic speaker, she is clearly passionate about her subject.
There were three workshops to choose from:
- Career Pathways – Stepping off the Treadmill. Delegates attending this workshop learned that a medical degree does not just mean a set career training path but can lead to alternatives which may be more fulfilling for some individuals. However it is important to get proper careers advice before embarking on a specialty and before 'stepping off'.
- Complaints. There has been a rapid increase in complaints although 60% are discounted immediately. It is acceptable to say sorry, it is not an admission of fault and can prevent people from taking their complaint further.
- Zero Balancing. This is holistic therapy which assumes that the mind and body work together and that energetic processes are involved in health and disease as in Eastern medicine. The practitioner works as a facilitator to enable the body to rebalance and so heal itself and trust and touch are important. Our workshop leader Prof Sarah Stewart-Brown and Dr Meher Engineer felt that the principles of zero balancing are useful to all medical practice. Some delegates got an opportunity for a taster session of their own during the breaks.
From the abstracts submitted the organisers had chosen a selection which reflected the themes of the conference or topics of relevance to women doctors and patients. Amongst the abstract presenters were medical students and junior doctors who had taken the opportunity to present at the conference which is something the MWF is keen to encourage. The winning extract was 'Giving them a Voice: The Importance of a Junior Doctor's Forum in the National Health Service' presented by Dr Ceri Murphy. During a paediatric FY1 post she helped set up a Junior Doctor's Forum as a platform for suggestions with the aim of improving work-life balance and the working environment. Highly commended abstracts were 'Barriers to Black and Minority Ethnic Women in medical leadership roles; a trainee's perspective' from Dr Abeyna Jones and 'From Theatre Huddle to Clinic Cuddle...?' by Miss Elizabeth Bell, Consultant Breast Surgeon.
There were 15 posters, mostly by junior doctors, and the Elizabeth Garret Anderson prize was awarded to Dr Sheena Seewoonarain for the poster 'Alcohol abuse amongst Junior doctors' which outlined some shocking statistics, for example 70% of respondents reported at least one episode in the past year when they could not remember the night before. Dr Mary Denholm's poster 'Cervical Cancer Education in Livingstone, Zambia' and 'STeP – Student Teaching Programme – An integrated system to structure and reward junior doctors teaching' by Dr Elizabeth Grove and Alison Hills were both highly commended.
Other items in the programme included the awarding of the Junior Doctor prize. Dr Hassaan Afzal gave an entertaining presentation about 'The Gadget that will change my medical life' which was a mobile phone with apps to help organise all aspects of the working and training life. We also learned about 'Project Pipeline' which is a research project commencing at ExeterUniversity to look at why women's high achievement in education is not mirrored in employment. Our President Elect Professor Parveen Kumar showed us a short film about the Royal Medical Benevolent Fund of which she is President. A panel discussion inviting questions from delegates took place on 'Fitness to Practice' with panel members being Dr Ruth Mayall of the Sick Doctors Trust, Prof Parveen Kumar, Anna Rowland from the GMC and Prof Carol Seymour, medicolegal adviser with the MPS.
Our Conference dinner was at the Waldorf Hotel and the after dinner speaker was MWF Past President Ilora Findlay, Baroness Findlay of Llandaff. She entertained us with some amusing stories from the House of Lords, in particular the times when her medical expertise has been needed. We now know why she was unable to shake hands with President Obama! Prof Findlay is currently President of the BMA and she feels she owes a great deal to her time as an officer for the MWF when she 'cut her teeth' on committees in a friendly and supportive atmosphere and gained the confidence to take on positions of leadership in other organisations. This was a fitting close to an inspirational day.
Dr Judy booth
Speciality Doctor in Palliative Medicine at Wheatfields Hospice, Leeds