‘Looking after our own? It’s the biggest problem in medicine’

Feature

Dr Jennifer Schafer has no doubt where the most significant challenge facing doctors lies.

 

‘As a doctor, what do you do? You care for people,’ she told newsGP.

 

‘When you’re caring for people, it’s so evident that we have to care for our own – because that’s the biggest problem in medicine. We see patients as others, that we’re separate, we’re not vulnerable.’

 

The Queensland GP has worn enough different hats during her clinical career to have a broad perspective on her profession’s most pressing issues.

 

As well as more than three decades in general practice, she has worked as medical director of the MBBS/MD program at the UQ Faculty of Medicine, and a medical reporter for Channel 9.

 

She still carries out clinical trials research and is a fixture on a range of medically related boards and committees for everything from her local Primary Health Network to the Medico Legal Society of Queensland.

 

In her role as medical director at Doctors’ Health Queensland, Dr Schafer hopes her work can contribute to easing the shortfall she sees in the medical profession’s self-care.

 

‘Every doctor on the planet has been through times when they haven’t thrived,’ she said.

 

‘We all know what it feels like. Been there, done that, as everyone else has.

 

‘Often we feel like we’re stuck, like it’s all happening to us, and that we just have to respond and work longer hours and do more and be everything for everyone all of the time, the whole perfectionism myth.

 

‘We have just got to be real about it.’

 

Her four years at Doctors’ Health Queensland, working in collaboration with Drs4Drs, offering confidential support for doctors and medical students, have been a powerful reminder of those challenges and how often they occur.

 

It is a rare day when the volunteer GPs, working the Doctor’s Health peer support line do not receive a call from a clinician seeking help.

 

Dr Schafer reels off a quick list of the reasons behind many of the calls: physical and mental health issues, workplace conflict, adverse events, the death of a patient or receiving a notification.

 

‘Each of us can pick our way through a career, and have those things happen a handful of times,’ she said.  

 

‘But what it’s reinforced to me, these things happen every single day … people are experiencing this stuff all the time.’

 

The role has also underlined to her how lonely those moments can be.

 

‘Particularly when something bad’s happened, you don’t want to tell the whole world,’ she said.  

 

‘That’s why we do what we do, it’s confidential. It’s not your best friend, it’s not your mother, it’s not your sister, it’s not somebody that knows you in other contexts that you’ll have to keep facing.

 

‘This is someone who’s completely independent – but also they are experienced people.’

 

She stresses the benefit of having someone with clinical knowledge, and who knows the pressures of medicine, on the other end of the phone.

 

The oft-aired message that every doctor needs their own doctor is unequivocal, but she also acknowledges the altered dynamic of clinicians treating other clinicians.

 

‘I’ve been a GP for a doctor, and I’ve also been a GP as a patient, so you have to negotiate a slightly different relationship,’ Dr Schafer said.

 

‘We need to acknowledge that it can be hard for a whole bunch of reasons, but if we know what the awkwardness is, then we can address it.

 

‘You’re not going there because you don’t know what to do. You’re going there because you want independent assessment.

 

‘If I was to have a car accident on the way home and I was taken to emergency and I was unconscious, if you rang my beloved husband of 35 years and said, “tell us her medical history and any medication she’s on”, he would not be able to answer.

 

‘If you rang my doctor, she can give you everything. It’s that discipline of having a complete medical history. It’s a longitudinal history, not just a snapshot in time.’

 

On a positive note, Dr Schafer believes the ‘perfectionism myth’ is not as potent as it once was.

 

‘We’re getting better at accepting wellness is a requirement,’ she said. ‘We’re getting away from the “I’m a hero because I worked all weekend without sleep, because that’s what I grew up with” mentality, which is good.’

 

However, a hobby horse of hers (‘I have a few, so beware,’ she warns) is that the profession still does not do enough to proactively look after its own.

 

This includes general practice.

 

‘Even in working in a group practice, as I have, my bestie was in the next room, and we would barely see each other,’ she said.  

 

‘It’s socially isolating. You’re solving everyone else’s problems, you’re not solving your own.’

 

She believes the whole medical profession, from general practices to hospitals, would benefit from more input from occupational physicians.

 

‘They look at work quite differently,’ Dr Schafer said. ‘They look at “well, what are the risks inherent in this job? What we can do to prevent, manage, mitigate, and rehabilitate, and who pays them?”.

 

‘The mining industries and big factories will go, “let’s look at this job objectively and work out what we need to do”.’

 

For now, the cohort most likely to use the Doctors’ Health service remains doctors in training.

 

Dr Schafer describes the reasons as ‘very, very logical’, with the pressures of early career work often combining with ‘hatching and matching and finding partners and children and mortgages and things’.

 

‘They’re trying to do it all in a very intense time, when your career is early, your relationships are early, financially it is still early,’ she said.

 

‘Everything’s still in the building phase.’

When speaking to early career colleagues, she tells them directly that a career in medicine is not meant to be easy.

 

‘What we do is important, and anything that’s important is often difficult and stressful, absolutely –but you can navigate your way through that,’ she said.

 

She believes her old position directing the academic program at the UQ Faculty of Medicine has put her in good stead for her new role.  

 

‘I like to think that I was seen then as an advocate for the wellbeing of the students,’ she said.

 

‘This seems like a natural extension of all the work that I’ve ever done.

 

‘As you get further through your career, that becomes your legacy. It’s not what you achieve or what you do, it’s how you can help them to do what they do.’

 

‘[I tell them] I am on PGY43, and I still love my job, and what I want for you is that in 43 years’ time, you will still love your job.

 

‘You just need to know how you navigate your way through that so that you can thrive.’

 

Further resources

Drs4Drs is an independent program providing confidential support and resources to doctors and medical students across Australia. The Drs4Drs website provides coordinated access to mental health and wellbeing resources, training on becoming a doctor for doctors, community news and navigation to each state/territory helpline and referral services. Confidential phone advice is available 24/7 for any doctor or medical student in Australia.

 

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