chorus of voices’

The health of the medical profession was the focus of the biennial Australasian Doctors’ Health Conference held in Adelaide in December 2022. The conference title of ‘The thriving doctor: towards harmony, productivity, longevity’ deliberately asked delegates and presenters to consider ways to optimise the health of doctors at home and at work, over the long-term.

This was a significant event for many reasons.

It confirmed the existence of the growing and connected movement of concerned individuals and leaders across Australia who are committed to improving the health of the profession. It exposed a shift in awareness of the significant work, health and safety obligations of employers and their need to provide safe workplaces and humane work practices for their doctoremployees. And it highlighted three systemic issues: the need to include doctors’ wellbeing criteria in the accreditation of training places and practices, the need to address the regulatory duress and personal stress arising from Ahpra’s complaints process, and the expectation that doctors must simply adapt as best they can to whatever workplace conditions are offered to them.

International keynote speakers presented via Zoom. They included Dr Helen Garr, a British GP who heads the NHS Practitioner Health Program in the UK. This service has expanded from caring for doctors to now caring for the other health professional staff working in the NHS. It is a large, well-funded, whole-of-system service that is firmly embedded in the NHS structure. Nothing like this exists in any Australian government jurisdiction.

Dr Tait Shanafelt is a physician from California who has led the Stanford doctor wellbeing program for many years. His presentation emphasised the importance of embedding wellbeing officers in workplaces as advocates for change and the potential impact of even small changes in workplaces and to work practices. He discussed ways to highlight to administrators the return on investment.

Individual stories are always powerful. Delegates heard many moving presentations from exceptional doctors, working in difficult personal and professional circumstances, that were cathartic for the presenters and enlightening and inspiring for their audiences.

I found the rural presentations especially moving. They personalised and underlined the key messages of the conference:

• the personal obligation to prioritise and optimise our own lifestyle habits and health care with a GP and a network of personal and professional advisers

• at the workplace level, the obligation of employers to provide a legally safe and humane working environment that supports doctors in their work and does not require excessive, stressful adaptation. Imagine, as one conference paper described, having to eat boiled rice for two weeks while working 24/7 in a remote community!

• at the system level, where accreditation of practices and training places includes doctor wellbeing criteria, and where the regulatory process around complaints is clearly understood by all involved as being efficient as possible and compassionate towards doctors.

Important connections were made at the conference. The national network of doctors’ health programs currently chaired by Doctors’ Health SA, has strengthened and will build their local program capacity. More wellbeing officers in tertiary hospitals will emerge. Aphra is examining the impact of its regulatory processes. Accreditation is emerging as a tool of change.

The conference affirmed to me the value of being persistent. Everyone gains from a healthier medical profession: our patients, ourselves, our colleagues and the next generation of doctors, the taxpayer and the health system. Programs must be independent and funded adequately to do the job properly.

We need a chorus of loud, coordinated voices to entrench self-care as a personal and professional obligation from medical school entry. We must advocate fearlessly for healthy workplaces and work practices and health systems that compassionately consider the wellbeing of doctors, wherever they work.

So, as I settle into my evening meal tonight, I will think of boiled rice and how special our colleagues really are.