Should we add more emphasis to tackle family physicians' stress?

Kwok-keung Ng 吳國強

HK Pract 2013;35:105-106

It is well recognised that family physicians are under significant stress.^1-4 Among the possible causes of their stress, how many of them could be avoided? And how many can be better handled? Or, nothing can be done?

Our society

It was unfortunate that SARS took away not a few hundred lives in 2003 in Hong Kong⁵; but it was indeed fortunate also to witness how Hong Kong people united together to fight against that dreadful disease. We feel proud to witness how our profession, no matter in public or in private setting, strived to protect the lives of Hong Kong people. It was encouraging to witness the mutual trust and respect established between our profession and the community.

Ten years have passed. I guess most heroes who then fought against SARS are today still providing services to the community in public and private setting; however, how much of the trust and respect remains? It cannot be imagined that the heroes who could sacrifice their own lives to save others during the hard time then would turn into "villains" during the good time now.

It is reasonable to expect a high standard, in terms of quality of care as well as moral standard, for our medical profession. And there are always media attention and reports on medical incidents which appear to be on the increase. Is it a reflection of increasing negligence? Or is it a reporting bias? Irresponsible and unprofessional acts should always be condemned and penalised; however, have the altruistic acts been adequately reflected and rewarded? Should any measure be made to correct people's misunderstanding about our profession, if any? Could the doctor-patient relationship be put in a partnership position rather than in confrontation? Should our positive image not be reflected and promoted?

Our patients

Time is always limited. It is sometimes almost impossible to handle all health problems in a single consultation session. Although we always try our best to help our patients, there are rare diseases (and common diseases with unusual presentations) which make early diagnoses difficult, if not impossible. Would it be possible to help patients understand these realistic situations and co-operate with their family physicians to formulate practical healthcare plans? Could patient rights and patient responsibility be put in equal emphasis?

Our College

Long working hours is almost a norm in general practice setting. Apart from the huge amount of clinical and administrative duties, attendance at a number of CME and CPD activities is required. There is no doubt that we need to keep up with medical knowledge and treatment strategies, so as to provide the best and up-to-date evidence-based clinical service to our patients; it is also true that our psychological and physical well-being should remain stable. Could CPR and CPD also incorporate "Continuous Physician Relaxation" and "Continuous Physical Development"? Prevention is better than cure. Would positive psychology be promoted to this vulnerable group?⁶

Ourselves

It is worth exploring further the health-related behaviour among family physicians with respect to psychological / psychiatric problems.^7,8 Apart from profession-related stress, marital problems, parenting problems and even bereavement problems will be encountered during one's life. Ours is of no exception. It is advocated that everyone should have a family doctor. How many of us, doctors, do have our own family doctor? Should peer support network be established to look after our own psychological health as well, in which early mood symptoms can be recognised and managed timely?

Let us join hands to safeguard and promote our psychological health!