Pegasus Health Pastoral Care Programme
Caroline Christie 1 , Simon Wynn-Thomas 1 , Bianca McKinnon 1
+ Author Affiliations
- Author Affiliations
1 Pegasus Health, Christchurch, New Zealand
Correspondence to: Caroline Christie, Pegasus Health (Charitable) Ltd, PO Box 741, Christchurch 8140, (401 Madras Street, Christchurch 8013), New Zealand. Email: caroline.christie@pegasus.org.nz
Journal of Primary Health Care 9(3) 225-229 https://doi.org/10.1071/HC17033
Published: 25 September 2017
Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: In New Zealand, 41% of general practitioners (GPs) intend to retire by 2025. Increasing workforce shortages and other stressors are putting doctors at risk of burnout, which in turn can put patients at risk of harm. Offering a range of resources can signal an organisation’s commitment to physician wellness while improving patient safety and organisational stability.
AIM: To replace the current reactive approach to impaired doctors with a proactive system of monitoring performance with the goal of identifying problems early.
METHODS: This paper reports on an initiative of Pegasus Health Charitable to provide pastoral care to GPs in Canterbury experiencing increased stress, burnout or problems leading to impaired performance.
RESULTS: The pastoral care programme has been running successfully for 9 years and has helped 32 GPs. Because of the low numbers, the programme needs to be individualised and confidential.
CONCLUSION: Recent developments have seen Pegasus Health adopt a systematic approach to monitoring and supporting health practitioners. This includes the monitoring of available data on GPs at risk. Data collection is being used to manage the “psychological health” of doctors, including complaints, prescribing, referral data and attendance at education sessions.
KEYWORDS: Pastoral care; primary health care; general practitioner
References
[1] Institute of Medicine. Preventing Medication Errors. Washington, DC: Institute of Medicine; 2006.[2] Brown SD, Goske MJ, Johnson CM. Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior. J Am Coll Radiol. 2009; 6 479–85.
| Beyond substance abuse: stress, burnout, and depression as causes of physician impairment and disruptive behavior.Crossref | GoogleScholarGoogle Scholar |
[3] Royal New Zealand College of General Practitioners (RNZCGP). Workforce Survey. 2015. [cited 2017 March 31]. Available from: http://rnzcgp.org.nz
[4] Medical Council of New Zealand. Doctors’ Health. Wellington: Medical Council of New Zealand; 2004 December.
[5] Rosen A, Wilson A, Randal P,, et al. Psychiatrically impaired medical practitioners: better care to reduce harm and life impact, with special reference to impaired psychiatrists. Australas Psychiatr. 2009; 17 11–8.
| Psychiatrically impaired medical practitioners: better care to reduce harm and life impact, with special reference to impaired psychiatrists.Crossref | GoogleScholarGoogle Scholar |
[6] LoboPrabhu SM, Molinari VA, Hamilton JD,, et al. The aging physician with cognitive impairment: approaches to oversight, prevention, and remediation. Am J Geriatr Psychiatr. 2009; 17 445–54.
| The aging physician with cognitive impairment: approaches to oversight, prevention, and remediation.Crossref | GoogleScholarGoogle Scholar |
[7] Paterson R. Good Doctor: What Patients Want. Auckland: Auckland University Press; 2012.
[8] Best M. Physician Assistance Programs address behavioral and performance problems. Compens Benefits Rev. 2010; 42 477–87.
| Physician Assistance Programs address behavioral and performance problems.Crossref | GoogleScholarGoogle Scholar |
[9] DesRoches CM, Rao SR, Fromson JA,, et al. Physicians’ perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues. JAMA 2010; 304 187–93.
| Physicians’ perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3cXovFGgsLw%3D&md5=10d2d8979057813dca94f9b7d186a143CAS |
[10] Uallachain GN. Attitudes towards self-health care: a survey of GP trainees. Ir Med J. 2007; 100 489–91.
[11] Kay MP, Mitchell GK, Del Mar CB. Doctors do not adequately look after their own physical health. Med J Aust. 2004; 181 368–70.
[12] Gustafsson Sendén M, Lovseth LT, Schenck-Gustafsson K,, et al. What makes physicians go to work while sick: a comparative study of sickness presenteeism in four European countries (HOUPE). Swiss Med Wkly. 2013; 143 w13840.
[13] Halbesleben JR, Rathert C. Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Health Care Manage Rev. 2008; 33 29–39.
| Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients.Crossref | GoogleScholarGoogle Scholar |
[14] Baldisseri MR. Impaired healthcare professional. Crit Care Med. 2007; 35 S106–16.
| Impaired healthcare professional.Crossref | GoogleScholarGoogle Scholar |
[15] Williams ES, Konrad TR, Scheckler WE,, et al. Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. 2001. Health Care Manage Rev. 2010; 35 105–15.
| Understanding physicians’ intentions to withdraw from practice: the role of job satisfaction, job stress, mental and physical health. 2001.Crossref | GoogleScholarGoogle Scholar |
[16] Bruce SM, Conaglen HM, Conaglen JV. Burnout in physicians: a case for peer-support. Intern Med J. 2005; 35 272–8.
| Burnout in physicians: a case for peer-support.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2M3htFKhsQ%3D%3D&md5=6dfa25a01990e8ed55af37feea3ed646CAS |
[17] Medical Council of New Zealand. Unprofessional behaviour and the healthcare team: protecting patient safety. Wellington: Medical Council of New Zealand; 2009. [cited 2017 March 31]. Available from: www.mcnz.org.nz
[18] McLaren K, Lord J, Murray S. Perspective: delivering effective and engaging continuing medical education on physicians’ disruptive behavior. Acad Med. 2011; 86 612–7.
| Perspective: delivering effective and engaging continuing medical education on physicians’ disruptive behavior.Crossref | GoogleScholarGoogle Scholar |
[19] Cunningham W, Cookson T. Addressing stress-related impairment in doctors. A survey of providers’ and doctors’ experience of a funded counselling service in New Zealand. N Z Med J. 2009; 122 19–28.
[20] Merlo LJ, Singhakant S, Cummings SM,, et al. Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program. J Addict Med. 2013; 7 349–53.
| Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program.Crossref | GoogleScholarGoogle Scholar |
[21] Peisah C, Adler RG, Williams BW. Australian pathways and solutions for dealing with older impaired doctors: a prevention model. Intern Med J. 2007; 37 826–31.
| Australian pathways and solutions for dealing with older impaired doctors: a prevention model.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2snpt1CisA%3D%3D&md5=92f004a131b60c643dc42abe8665084cCAS |
[22] Harada CN, Natelson Love MC, Triebel KL. Normal cognitive aging. Clin Geriatr Med. 2013; 29 737–52.
| Normal cognitive aging.Crossref | GoogleScholarGoogle Scholar |
[23] Peisah C, Wilhelm K. Physician don’t heal thyself: a descriptive study of impaired older doctors. Int Psychogeriatr. 2007; 19 974–84.
| Physician don’t heal thyself: a descriptive study of impaired older doctors.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2svptFensA%3D%3D&md5=fe058ed3fda96eb43e2ca5add77b0fa3CAS |
[24] Legha RK. A history of physician suicide in America. J Med Humanit. 2012; 33 219–44.
| A history of physician suicide in America.Crossref | GoogleScholarGoogle Scholar |
[25] Hulse G, Sim M, Khong E. Management of impaired doctors. Aust Fam Physician. 2004; 33 703–7.
[26] Humphrey C, Hickman S, Gulliford MC. Place of medical qualification and outcomes of UK General Medical Council “fitness to practise” process: cohort study. BMJ. 2011; 342 d1817
| Place of medical qualification and outcomes of UK General Medical Council “fitness to practise” process: cohort study.Crossref | GoogleScholarGoogle Scholar |
[27] Riley GJ. Understanding the stresses and strains of being a doctor. Med J Aust. 2004; 181 350–3.
[28] Dhai A, Szabo CP, McQuoid-Mason DJ. The impaired practitioner – scope of the problem and ethical challenges. S Afr Med J. 2006; 96 1069–72.
| 1:STN:280:DC%2BD28jis12lsw%3D%3D&md5=c54caac071b407d03f8bd67cb5184688CAS |
[29] Isaksson Ro KE, Tyssen R, Gude T,, et al. Will sick leave after a counselling intervention prevent later burnout? A 3-year follow-up study of Norwegian doctors. Scand J Public Health. 2012; 40 278–85.
[30] Iversen A, Rushforth B, Forrest K. How to handle stress and look after your mental health. BMJ. 2009; 338 b1368
| How to handle stress and look after your mental health.Crossref | GoogleScholarGoogle Scholar |
[31] West CP, Dyrbye LN, Rabatin JT,, et al. Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial. JAMA Int Med. 2014; 174 527–33.
| Intervention to promote physician well-being, job satisfaction, and professionalism: a randomized clinical trial.Crossref | GoogleScholarGoogle Scholar |
[32] Wile C, Frei M, Jenkins K. Doctors and medical students case managed by an Australian Doctors Health Program: characteristics and outcomes. Australas Psychiatr. 2011; 19 202–5.
| Doctors and medical students case managed by an Australian Doctors Health Program: characteristics and outcomes.Crossref | GoogleScholarGoogle Scholar |
