16. The health professional or health care worker as a patient

There are simple things to do first.

• Spread the word that health care workers, like anyone else, have to be patients sometimes and there is nothing wrong with that.
• This may seem self-evident to most of us, but it remains an anxious prospect for some.
  
• Look for indicators that the issue is being evaded, eg a colleague may seek an informal consultation such as asking about a chest pain.
• It is necessary to ensure that any complaint indicated in this manner is treated with professional concern in a professional location.

The consultation

• If a health care worker rings for a consultation there is a reasonable chance that he or she has acted out of desperation – he or she has reached the stage where the problem can no longer be ignored.
• That call is an urgent cry for help.
  
• Occasionally the cry for help has a Russian roulette quality about it: if the prospective rescuer is out or away, the caller may procrastinate once more until it is too late.
  
• Therefore, when a health care worker calls it is vital to ask directly about how ur-gent he or she perceives the problem to be and not to accept an equivocal answer.
  
• When health care workers arrive it is important for the staff encountered and doctor consulted to act in a routine manner.
• Make it clear that he or she is now a patient and explain everything as if he or she were an intelligent layman with no medical or health background.
  
• Give him or her the handouts other patients receive and write his or her prescriptions.
  
• Health care workers and their families should be given firm and definite follow-up appointments written on cards, and not expected to use their own judgment in making further contacts.
• If offers of help and warnings are not heeded then one must consider notifying the appropriate licensing authority so that enquiries can be made.
  
• This can be handled firmly and sensitively and can lead to a better outcome than if no action had been taken.

Doctors' Health Advisory Services

Over the past few years in a number of Australian States, a Doctors' Health Advisory Service has been developed as an independent, confidential and fraternal service to help impaired doctors and medical students.

These organisations commenced in Victoria with the development of an organisation bearing this name and linked to the Victorian Academy of General Practice.

In 1982 a steering committee was established in New South Wales representing the learned colleges and professional associations, and together with the Australian Medical Association developed the New South Wales Doctors' Health Advisory Service.

These organisations are independent of the Australian Medical Association, the medical boards and other professional bodies. However, the organisations are all involved in the development and organisation of these services.

A dedicated teleservice is available 24 hours a day in most States and calls for help come from many sources. These include the doctors themselves, their families, staff, patients and professional colleagues. In reviewing the calls received to date, it is interesting to note that a percentage of referrals do not come from the doctors themselves, but from friends or relatives concerned about the doctor's health.

All incoming calls are referred to a panel of senior general practitioners experienced with a doctor's health problems. The 'patients' may be managed by the general practitioners themselves or referred to the Doctors' Health Advisory Service Specialist Panel. In all cases, extreme care is taken to maintain confidentiality.

When calls for assistance are received from persons other than the doctor, strict procedures are followed before that medical practitioner is approached.

The Doctors' Health Advisory Service is independent of the Medical Board. The service will not report doctors to the board nor will it threaten to do so.

The 24-hour numbers for the Doctors' Health Advisory Services are:

New South Wales (02) 437 6552
Victoria and Tasmania (03) 241 9316
Queensland (07) 356 0628
South Australia (08) 273 4111

Note: All of these numbers are available 24 hours, 7 days a week with the use of answering machines and other call services.