Australia Day honours

Dr Roger Sexton’s commitment to helping colleagues struggling with their own health issues has lead to his being named a Member of the Order of Australia (AM).

After many years as a rural general practitioner in Mount Pleasant and as a rural locum, Dr Roger Sexton was driven to jump in to help doctors drowning in overwork, weighed down by their sense of responsibility to patients.

Seeing colleagues at the point of exhaustion and despair, Dr Sexton had a founding role in establishing the Dr DOC program in 1999 and Doctors’ Health SA Program in 2010 – the latter becoming a national benchmark in educating and supporting doctors to build a sustainable working life.

During his involvement in medical complaints on the SA Medical Board, Dr Sexton became increasingly concerned that doctors who were clearly unwell and unable to practise to the best of their ability were being subjected to a disciplinary complaint process. He was convinced that this should be recognised as a health problem rather than something warranting a punitive process.

Since then, he has used a range of forums to champion doctors’ health and wellbeing, including as a director of the national Doctors’ Health Services board, chair of the Australasian Doctors Health Network, vice chair of medical indemnity provider MIGA and recently as convenor of the Doctors’ Health Conference in Adelaide.

For this work in doctors’ health, and for service to the medical profession, he was in January included in the Australia Day Honours List as a Member of the Order of Australia (AM).

The award follows his admission last year to the AMA Roll of Fellows, ‘for his contribution to the health and well-being of medical students and medical practitioner colleagues’.

‘I was seeing colleagues experiencing multiple barriers to health care for themselves, as well as those in various stages of burnout – they were facing complex cases, on call all the time and not able to get the rest they required to do the job sustainably,’ Dr Sexton says.

‘There was also very disturbing news of doctors who had suicided and I felt that this was not being acknowledged for the sentinel event that it was. There did not appear to be a profession-wide and system-wide response.’

This became the impetus to work towards a program that would support doctors, and particularly those in rural areas, who lacked access to peer and professional support. The focus became educating doctors about how to ‘stay well’ in a very demanding profession and providing health services for doctors via phone support, telehealth, after-hours support and crisis intervention.

While his own workload seems heavy, Dr Sexton is a strong proponent of balance and harmony in all things: work balanced with sleep, exercise, nutrition, creative interests, and a focus on relationships because many busy doctors find that they lose their place in the family by working too much.

There’s plenty more to do though, he says – particularly as GPs are in crisis after years of too little funding in the sector. He says doctors are trapped by their desire to do the best they can for their patients and feeling that they have to do more and more with less.

This vulnerability is leading to a dangerous ‘scope creep’ from other professions that will inevitably lead to lower patient care, Dr Sexton warns.

‘I’m energised by the impact of helping doctors. If, for every doctor you help to become sustainable, you are helping 2000 Australians, that’s pretty rewarding,’ he says.

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Why are you a plastic surgeon?

I think I always thought that being a doctor was a good thing to do. My father was a surgeon and had a very driven work ethic to help treat patients. I was drawn to plastic and reconstructive surgery as it is made of diverse challenges in surgery. In particular, it was in the emergence of microsurgery that was most challenging and complex. The tangible and visible changes in surgical procedures were appealing as a way to help patients manage their conditions and treatments.

What work do you do for Interplast?

Interplast is an Australian and New Zealand not-for-profit organisation that assists with plastic and reconstructive surgery in 17 different countries in southern Pacific and Asian countries. Since becoming involved in Bhutan, I have been on seven trips and become the Bhutan country coordinator for Interplast. An intrinsic love of remote travel and seeing what surgical challenges were needed made me interested in this region.

We have a formal agreement with the Bhutanese Government to allow us to visit and treat patients in the hospitals. We bring a team of surgeons, anesthetists, theatre staff and hand therapists.

We also bring surgical equipment and supplies so we are self-sufficient and don’t use their precious resources. We are asked to see and treat patients who have conditions that the local surgeons are unable to treat. This includes burn injuries, cleft lip and palate, complex wounds, hand injuries with tendons and nerves and a broad range of plastic surgical conditions.

One unique injury we are often asked to treat is the Himalayan bear maul that may remove part of the face of the unlucky individual caught out in the mountains.

We are also training a young Bhutanese general surgeon in plastic and reconstructive surgery to help provide the country with some continual and independent treatment. We are meeting with the Bhutanese government on our next trip this year to try to establish a second trainee in this field.

Why do you support professional associations?

What starts as a small involvement turns into a bigger one! Working with your associations is actually one of the most interesting involvements that you can have, as you work with peers from all states and NZ. Examining the candidates in Royal Australasian College of Surgeons fellowship examinations is particularly challenging and rewarding.

What are you most proud of?

I don’t think in terms of pride, more completing a job as safely and appropriately as possible. I can think of one of these occasions when working for the Australasian Foundation of Plastic Surgery in the Northern Territory, undertaking wound healing teaching programs in remote communities. There we could train and then guide Indigenous health workers learning how to sew wounds which they mastered very quickly.

Getting thanks from patients from any type of work is rewarding. Providing surgical treatment to patients in Bhutan where there is no treatment available provides some personal rewards.

What does receiving the Australia Day Honour mean to you?

This is an unexpected honour and doesn’t really cross your mind. The honour is proposed by your colleagues who act to nominate you. I am sure a large number of worthy individuals have never been nominated.

What advice would you offer to someone starting in plastic surgery?

Firstly, get yourself the best possible training you can. You will need the best possible decision-making skills, dexterity, accuracy and efficiency. You will need all sorts of tools to help with time management, making back-up plans and providing support for patients and for your staff and yourself. Overseas travel and training help with skills you can bring home.

Secondly, there will always be a pathway alongside your training and career that allows you to contribute. It may be to involve yourself in the registrar training society, your College, or a benevolent institution. Whatever it is, it takes you out of your comfort zone and you help others. It may not be something you take up straight away in your training or early career, but keep your options open and seek them when they arrive. In my experience it will reward and sustain you.