How healthy is your doctor?

GPs often neglect their own health, but many can restore the balance through mindfulness, writes CHARLIE TAYLOR

GENERAL PRACTITIONERS (GPs) may be good at assessing the health of others, but when it comes to minding themselves, many fail to do so. Numerous studies have shown that GPs are among the worst offenders in terms of self-care, with high rates of addiction, as well as physical and mental health problems.

Moreover, when GPs do realise they have difficulties they often seek to treat themselves rather than turning to others. An Irish Medical Journal study published in 2007 revealed that 49 per cent of trainee GPs admitted to neglecting their own health, while 92 per cent had self-prescribed on at least one occasion. A more recent study carried out by Prof Colin Bradley, from the Department of General Practice in University College Cork, and Dr Andrée Rochfort, director of the Irish College of General Practitioners’ Health in Practice programme, and published in Occupational Medicine last year, showed that selftreatment is strongly embedded within the culture of both physicians and medical students and seen as an accepted way to enhance and support work performance.

In an attempt to bolster better health among physicians, the ICGP’s Health in Practice programme is designed to help GPs help themselves. In addition to offering training in such areas as leadership skills and cognitive behavioural therapy, one of the increasingly popular programmes endorsed by the ICGP is an eight-week course focusing on stress reduction and mindfulness.

Based on the work of US physicians Dr Jon Kabat-Zinn and Dr Michael Krasner, who have been at the forefront of promoting mindful meditation in clinical settings, and with specific adaptations for doctors in general practice in Ireland, the course has been running since February 2010 and has been well received by GPs. Mindfulness is about bringing awareness to the present moment. It is a simple, practical skill which helps people find calm and stability in their relationships with themselves and others.

While it hails from Eastern spiritual traditions, mindfulness has in recent times been adapted into well-researched, secular programmes that are widely used in medical, mental health and wellness settings. The ICGP, the body responsible for

education and training of the State’s 18,000 GPs, is a supporter of the mindfulness programme, which it believes can go a long way to helping general practitioners take better care of themselves.“We know that doctors need specific targeted help to counteract the barriers that they have to their own healthcare.

“Their professional training shows them how to look after the health needs of others but does not teach them how to appropriately manage their own health. It is not in their psyche to behave as patients do,” says Rochfort. “The course is an additional activity which we would see as being of benefit to GPs and it would certainly seem to have made a positive contribution so far,” she adds.

Debbie Correll, a psychotherapist, accredited supervisor and trainer who operates the course, has herself been overwhelmed by its popularity. “What did take me aback a little bit was the receptivity from GPs from the beginning,” she says. “I wasn’t surprised the ICGP was so open to the idea of the course because the evidence surrounding mindfulness internationally is so prolific.

“But I did wonder how open GPs would be to it. In the end I experienced little or no resistance to me or to the programme, which I realise now is not as unexpected as you’d think because once doctors are told of the body of evidence surrounding mindfulness, they tend to be more open to it.”

According to Correll, the quantifiable learning outcomes collated since the programme began in February 2010 consistently indicate development in all areas of emotional intelligence (EI), including advanced empathy, resonance and relational competencies. She adds that participating GPs themselves said how much they valued their increased levels of awareness, not just because it allowed them to be more responsive to their own healthcare needs, but because it enabled them to be more attuned to the needs of their patients.

Padraic Doherty, who has a general practice in Sallynoggin, Co Dublin, and who recently participated in the course, says he would happily recommend the course to other GPs. “It exceeded my expectations overall. I knew I was stressed but didn’t know quite how stressed till I took part in the course. I found the course to be deeply life-changing as it helped me reconnect with my life again and the people on it.

“There’s a compassion fatigue or burnout in general practice whereby if you don’t care about your patients then you’re not involved, and yet by caring you are risking involving yourself too much, leaving yourself exhausted. “Mindfulness has helped me to reduce my stress levels and this in turn has had a knock-on impact on my work with patients.”

He adds: “GPs are activity-based and feel like they have to fix clients, give them medication, send them for tests, etc and sometimes we forget about the power of just being with them and listening to them. Mindfulness has reminded me of the importance of this and I think it has a very positive role to play in medicine generally.”