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Stress hits new levels

By Robin Stride

Mounting numbers of independent practitioners are being helped to reduce stress levels brought on by rising pressures in private practice.

Psychologists at one City practice say tension factors include financial concerns arising from higher expenses on indemnity cover, rooms and secretaries.

They are also losing out due to static income from private medical insurers, having to work harder to match previous year’s profits, and fears about being selected for a costly tax probe.

Increased administrative paperwork and red tape from newer requirements – including Care Quality Commission (CQC) insp­ections, revalidation and appraisal – is also taking its toll.

Consultant counselling psychologist Dr Michael Sinclair told Indep­endent Practitioner Today: ‘I am seeing increased stress among doctors in private practice, consultants and GPs.

Dr Michael Sinclair

Dr Michael Sinclair

‘I can’t give figures, but there are a larger number coming along for psychological assistance.

‘Stress leads to burn-out and you find you are running on empty. Motivation and enthusiasm goes and that has a dramatic impact on running a successful business, the finances and clinical practice. It can dramatically affect performance.’

Dr Sinclair, clinical director of City Psychology Group, said another reason for a rise in numbers was that professionals were now more willing to own up if they were not coping too well.

His group, with London clinics in Liverpool Street, Harley Street and Canary Wharf, is reporting increasing demand across the board and has doubled its number of psychologists to 25 in a year.

He said doctor patients had spoken of how their costs had risen, the impact on finances and incr­eased expenses arising from the Com­petition and Markets Auth­ority (CMA) private healthcare probe.

‘CQC preparation is lengthy and laborious on top of the stresses and strains and administration. It’s another extra. All these situations we are hearing from doctors mean they meet the criteria for stress.

‘They are threatening and taxing, and people don’t have the resources to meet demands. Doctors are already busy meeting the demands of clinical practice.’

Dr Sinclair said divorces were also on the rise. ‘Working in a high-pressured role and job is demanding on our time. It takes us away from home life and can impact on personal relationships and when stressed at work, it can change our behaviour.

‘That can have a negative impact on our relationships at home, causing unrest and people are stuck not knowing which way to turn. They need to earn and support the family and then come arguments – and it’s costly.’

Requirements of the Private Healthcare Information Network (PHIN), which the CMA has directed to publish consultants’ fees and outcomes, could create more pressure, he added.

‘Anything that exposes us and makes us feel under scrutiny can put us under stress.’

Steve Crone, Royal Medical Benevolent Fund (RMBF) chief executive, said most of the charity’s beneficiaries last year asked for help due to mental health problems affecting their ability to work.

‘We can see a clear trend over recent years: stress-related issues are on the rise across the medical profession,’ Mr Crone said.

‘Helping doctors through these difficulties is the reason we jointly launched DocHealth with the BMA last year, a confidential psychotherapeutic consultation service that has so far supported nearly 150 doctors with stress-related anxiety and depression.’

Drive to spot stress

The Royal Medical Benevolent Fund next month launches a campaign Together for Doctors to spotlight the stress problem and encourage struggling doctors to seek help.

RMBF’s boss Steve Crone said: ‘Doctors tend to have high-achieving personality traits that can lead to a reticence to seek help, but nobody is immune from the stresses and strains of working in medicine. I would urge any doctor in difficulty to reach out. No one should feel too proud or ashamed to ask for help.’

Dr Phil Zack, MDU medico-legal adviser, said: ‘The high-stress work environment can take its toll on independent practitioners’ mental and physical health.

‘The unfortunate reality is that doctors who are unwell or struggling to cope may be more susceptible to errors and complaints, because they may not be able to practise at their optimal level. This could land them with a complaint or even a GMC investigation.

‘That’s why it is so important for clinicians to look after themselves and to get help early for the sake of their own health, to prevent medico-legal issues, and in the interests of their patients.

‘Sources of support include your own GP, colleagues, your medical defence organisation or specialist “sick doctor” services.’