July 2002

Doctor health program offers care for carers

By Dr Naham (Jack) Warhaft, Medical Director, Victorian Doctors Health Program

Doctors are highly trained to deliver the best possible health care to their patients but may be poorly equipped to attend to their own health needs.

The prevalence of both physical and mental disorders—including substance use disorders—is much the same in doctors as for the general population.

It has been shown (Pullen et al, Med. J Aust 1995; 162: 481–484), however, that many doctors lack adequate medical care.

They tend to make poor patients for a variety of reasons.

They are trained as health care providers and may have great difficulty assuming the role of receivers of health services.

They may deny or rationalise symptoms in themselves that they would regard with concern in their patients.

They frequently attempt to self diagnose and self refer and sometimes may even self-treat.

Furthermore, they have relatively easy access to drugs.

The Victorian Doctors Health Program (VDHP) provides a confidential service for doctors and medical students with health concerns.

It is fully funded by the medical profession and is conducted by an independent five-member board of management.

It has broad support from across the profession, including the learned colleges and universities.

The service deals with a wide range of health concerns, including problems that may lead to impairment, such as alcohol and drug abuse, and mental health problems.

The VDHP provides a range of services to help hospitals in this area.

These include assisting with the formation of Medical Staff ‘Wellness’ committees, which focus on illness prevention and early detection and provide a point of contact between sick doctors and the VDHP.

When a hospital medical staff member has a concern regarding his health or another doctor’s he—or she—can contact us confidentially for advice.

The VDHP can then assist with intervention and refer the doctor for assessment and treatment.

It can provide the appropriate aftercare and monitoring if and when indicated.

Since its inception, the VDHP has been working with hospital administrators.

It has been well received by management, who are often in a dilemma as to what to do with doctors in whom they suspect a health problem—especially if there may be a question of impairment.

Their concern for patient care and the maintenance of hospital standards may require that some action be taken.

There can be no place for attempting to deny or conceal these types of problems but there is genuine concern for the welfare of the doctor and the impact of any decision that may be under consideration.

Often the VDHP can lead to a satisfactory solution to this problem by timely intervention and the provision of appropriate therapeutic measures.

Patient safety is assured and the doctor gains access to high quality services in complete confidence.

In some cases, this approach can be regarded as an appropriate alternative to a disciplinary action and, when effective, may lead to genuine resolution to the satisfaction of all concerned.

• The Victorian Doctors Health Program is located at Level 8, Aikenhead Building, 27 Victoria Parade, Fitzroy 3065; telephone 9495 6011. The Medical Director is Dr Naham (Jack) Warhaft. All enquiries will be handled in strict confidence; the identification of the caller is not necessary.