Doctors confess: we're human
It’s planning time at the MJA for five doctors-turned-editors. Ideas spill freely as the coffee flows. Debate turns to whether doctors' health merits an entire issue — after all, why shouldn’t doctors have problems just like anyone else? The catch is that doctors are powerful forces within the healthcare juggernaut, daily negotiating, even manipulating, it on behalf of others. This somehow confounds our behaviour in our own sickness and health, which may impinge on our patients'. So, perhaps it’s time to examine a subject that most doctors are really good at avoiding — ourselves.
Reality check
Even if you don’t have your colleague’s God complex, turn to some powerful stories on addiction (Jurd, Helping addicted colleagues), depression (Tolhurst, The black hole of depression: a personal perspective), diabetes (Stocks, Diabetes, my constant companion), being sued (Kerr, The personal cost of medical litigation), and the semi-confessional Health Bytes throughout this issue. And don’t miss full-time GP and playwright Ron Elisha’s account of the pathophysiology behind events when "we" (doctors) turn into one of "them" (patients) (→ The thin line) . . .
Does medicine attract personalities particularly vulnerable to stress, or is it the job that makes us so? Riley dissects this chicken-and-egg conundrum in Understanding the stresses and strains of being a doctor. Galletly describes how to avoid the slippery slope to patient exploitation (→ Crossing professional boundaries in medicine: the slippery slope to patient sexual exploitation). We also have good news for surgeons with needlestick injury (Watson, Surgeon, test (and heal) thyself: sharps injuries and hepatitis C risk), a checklist for your next check-up (preferably by an independent GP!) (Kay et al, Doctors do not adequately look after their own physical health), and news on how the UK (Oxley, Services for sick doctors in the UK.), US (Brown and Schneidman, Physicians' health programs — what’s happening in the USA?.), and Canada (Puddester, Canada responds: an explosion in doctors' health awareness, promotion and intervention.) treat their doctors' health. Schattner et al (→ Doctors' health and wellbeing: taking up the challenge in Australia.), Wilhelm and Reid (→Critical decision points in the management of impaired doctors: the New South Wales Medical Board program) and Warhaft (→The Victorian Doctors Health Program: the first 3 years) describe how Australia measures up.
Families First initiative
Our future doctors are already imbued with quixotic concepts of balancing career and life, say Tolhurst and Stewart (→Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students' attitudes). Not such a bad idea, though, when one study shows psychological problems and burnout are common, at least among interns (Willcock et al, Burnout and psychiatric morbidity in new medical graduates). Doctors do bring unique qualities and issues to the family table, according to two Canadians (psychiatrist Myers, Medical marriages and other intimate relationships, and medical parent Puddester, Staying human in the medical family: the unique role of doctor-parents) and an Australian mother of four (Kang, Confessions of a medical mother).
Acknowledgements: Dr Ann Gregory was our principal in-house editor for this issue - ably assisted by an external working group (Dr John Buchanan, Dr John Court, Associate Professor Jill Gordon, Dr Craig Hassed, Associate Professor Geoffrey Riley and Associate Professor Kay Wilhelm). We'd also like to acknowledge the assistance of experts all over the globe, including Dr Lizzie Miller (UK) and Professor Johannes Siegrist (Germany), as well as notable locals Dr Peter Arnold, Sandra Davidson, Dr Riju Ramrakha and Dr Alex Wodak for efforts above and beyond the call of duty.