Elizabeth McGrath, Head of Corporate Communications, reflects on the second of our series of Medical professionalism matters events in Newcastle last week. This time, we were focusing on resilience. She invites people to continue the #gooddoctors discussions and take part in a poll.
Resilience is a seemingly ubiquitous theme across many sectors at the moment, including health. But it’s one that means very different things to different people. I found Dr Alys Cole-King’s blog on the issue very helpful in clarifying some of the misunderstandings she has come across, and I was interested to hear how this resonated with clinicians, employers and others on the night.
Alys makes clear that resilience is not about toughening up, but about making sure people are supported and able to ask for help when they need it and that they have the tools and resources they need to thrive.
This view was echoed by everyone I spoke to on the night.
Danny Mortimer, Chief Executive of NHS Employers, kicked the evening off with a frank admission that he’s observed incredibly strong, supportive teams within many NHS organisations, but that he thinks this is all too often in spite of rather than because of the organisations those teams are based in.
Dr Andy Haynes, Executive Medical Director at Sherwood Forest Hospitals NHS Foundation Trust, then shared some of his personal reflections on resilience, including the key point that each person’s resilience changes at different points in their career and personal life.
Here are the slides from all of the resilience panels and keynotes [PDF]
We considered whether we need to select future doctors on the basis of their potential resilience, and also if medicine needs to have more flexible routes and potential exit points that make it less of a stigma to move on from if people realise it’s not for them.
Some wondered whether we ought to put more emphasis on people’s emotional intelligence in selecting future doctors, but Professor Jane Dacre cautioned we must not forget how challenging academically medicine is and how key to being able to cope with its rigours the academic aptitude to keep up with its study is.
These were all themes we followed up on in our table discussions.
Not knowing how or when to ask for help
Some consultants described how the expectation when they started their careers was that you ‘just needed to deal with things’, whereas doctors in training now are proactively offered support and asked questions to try and identify if anyone is struggling or otherwise vulnerable so they can be offered appropriate support.
They worried that that meant their peers who’d not had this built into their training were particularly at risk of not knowing when or how to ask for help.
Those I spoke to were unanimous in the view that doctors are not good at viewing each other or themselves as patients and that this puts doctors at risk of ill health and even of self-harm or suicide.
Dr Mike Peters reflected that one of the key reasons the BMA’s doctors for doctors service is available out of hours is because many doctors are so reluctant to seek help, that if they rang once to ask for it that opportunity could not be missed.
He explained that in his experience, the key things most doctors value when they are struggling is having their experience validated by another clinician who can say ‘I know, I’ve been there too.’
This chimed with anecdotes from other doctors of how their teams were starting to introduce informal practices such as going for a walk around the block or grabbing a coffee with another member of the team when things were difficult.
Worryingly, our poll of those in the room gave the very stark view that only 16% of those present would describe their current working environment as supportive. 46% also disagreed that if they were struggling they could ask for help without penalty.
Yet as Alys Cole-King summarised – asking for help is not a sign of weakness; it may be the bravest thing a doctor ever does and it could even save their life.
The event has left me, and I’m sure many of those who attended, with many more questions than I began with. There are clearly many opportunities to make improvements around supporting doctors not just to cope but to thrive in their careers, but there are also many and complex challenges in doing so.
For me, the conversation kept coming back to team level vs organisational/system cultures. And perhaps the biggest questions I was left with was the same that Danny Mortimer posed – how do we close the gap between the teams who are getting this really right, and those where people are struggling alone and don’t know where to turn? And who needs to be involved to make this happen?
We really want to continue the conversation to understand more about this. You can catch up with Twitter conversation on the evening via our Storify.
- Dr Alys Cole-King on “Doctors under pressure need resilience, not mental toughness“
- Niall Dickson reflects on why the GMC is delivering the Medical professionalism events and what we hope to achieve: Medical professionalism matters- Join the conversatio
- The collaborative doctor :Medical professionalism matters’ a summary of the first event in Bristol: Medical professionalism matters –Collaboration