For your interest I copy part of the BMA News report on the proceedings of the 19th International Conference on Doctors' Health held in London this week.
Brian Marien (associate specialist in psychological medicine) said that doctors faced 'double jeopardy' since they constituted an at-risk group for stress-related illnesses and alcohol misuse but were more reluctant to seek help than the rest of the population.
Julia Bland (consultant psychiatrist) suggested that a 'harsh internal voice' is part of the personality structure of doctors and leads to high standards. But high family expectations, narcissism and perfectionism are potential factors that may have a harmful influence on doctors' mental health. She said that perfectionism among doctors leads to a kind of black-and-white thinking: “if I am not perfect, I am no good”. Dr Marien added that it is important for doctors to guard against sinking into a kind of 'rumination' that focusses on worry and guilt.
Paquita de Zulueta (senior lecturer in general practice) said she believed medical students are particularly vulnerable to a fear of failure that is dangerous to their health, and suggested that those responsible for the education system should include 'emotional awareness' in the curriculum.
I can certainly relate to that. Unfortunately the spirit of the age is firmly set against these ideas. Doctors (and indeed anyone in a position of responsibility) are expected to be perfect. Heaven help the social worker or doctor who makes a mistake in one of the few child protection cases that achieves notoriety. The medical defence societies remind us constantly to avoid mistakes. The requirements of revalidation currently being worked out are bound to demand that we demonstrate our high standards in rigorous detail. It is certain that no-one responsible for these requirements will err on the side of laxity or “good enough” doctoring. And the judgements of the GMC sometimes suggest that that organisation likes to shoot a doctor from time to time pour encourager les autres.
But I must stop ruminating!