Written by Sarah Walls
A recently published book, A PERILOUS PROFESSION: The Dangerous Lives of Doctors, says that the receipt of allegations of medical negligence is a significant stressor for doctors, and one that could be readily avoided by the institution of a no-fault claim scheme. Please support our petition for no-fault compensation for Australian injured patients.
Dr Kerry Breen, a retired physician and gastroenterologist and former president of the Victorian Medical Practitioners Board and of the Australian Medical Council, published the book to draw attention to the increased sources of stress for doctors, especially medical students and junior doctors in training, and to the need for reform of the national scheme regulating doctors’ registration.
He says: “[…] the advantages of a no-fault indemnity scheme include faster, fairer and less random compensation for injured patients, less dilution of the benefits on legal costs, less distress for mostly competent doctors, more willingness of doctors to be open with patients when things go wrong, and more ready identification of possible adverse events and ‘near-misses’ by doctors along with their positive participation in processes aimed at reducing the occurrence of adverse events. In addition, through removing the threat of legal action, a reduction in defensive medicine and over investigation should follow. Thus a no-fault scheme is the ultimate win-win situation (for injured patients and for stressed doctors). It is well past time for our politicians to act on this matter.”
This compassionate and eloquent book draws attention to the risks doctors face in daily practice, ranging from murder and assault to infection with respiratory or blood-borne viruses, from substance abuse, sleep deprivation resulting in fatal motor car accidents, to harassment, bullying and other sources of harm which may even lead to suicide. Dr Breen is particularly critical of the system of mandatory reporting of unwell doctors which was introduced with the national scheme for doctors’ registration in 2010.
He says, “[T]he law deters unwell doctors from seeking help, drives the issue underground, and contributes to an increased risk that unwell and impaired doctors will continue to practice”. He believes that it would be better to rely on the treating doctor’s ethical obligation to report a doctor whose condition impairs suitability to practice, rather than making it a legal obligation.
Dr Breen describes the value of doctors’ health programs, such as the Victorian Doctors’ Health Program established in 2000, the first in Australia. As a former chair of its board, he has first-hand knowledge of its operation. It was deliberately set up separately from the Victorian Medical Board so that doctors, who frequently do not have their own GPs, could be assured of confidentiality and not discouraged from using the program’s services.
The epidemic of stress-related mental illness in the community has not spared doctors and medical students. In 2001, 30 of the 42 doctors seen by the program had substance abuse disorders. By 2015, only four new clients with substance abuse were seen. Of the 148 new attendees that year, just over half the entire group (87 attendees) were categorised as having a diagnosable mental illness, while 68 were assessed as being unwell through stress and distress.
Dr Breen believes that it is not good enough to focus on better preparation and support for doctors experiencing the stresses involved in medical practice. The conditions under which they study, train and work also need to be examined. In other words, the solutions to stress are not just individual but need to be social as well.
His concern and empathy for his colleagues and the young people following him into the medical profession are evident. Anyone who wants to know about the challenges of being a doctor in Australia today should read this book.
Please encourage everyone you know to sign and share our petition. The more signatures we have, the better the chance of getting politicians to act on no-fault compensation for injured patients, as Dr Breen advocates.
We are very grateful for your continuing support.
Sarah and Vickie