More and more and more and more my conversations with colleagues are about the complaints that they receive from patients and the threat of litigation but worse, regulation.
Perhaps I have publicly put myself in a position where people talk about this but I don't believe that i'm the only one who is having these conversations.
This goes alongside my own fears for problems I have with my patients (which are not insignificant) and which lie as a background worry of a letter which will come through the door of the practice or my house.
In an extraordinary presentation at the recent Failure Conference one of my best friends in the whole wide world and exceptional head and neck surgeon Craig Wales, presented a case which broke the heart of everybody in the room (no details available) but the greatest lesson that Craig taught everybody that day was the need to develop skills in compartmentalisation.
I guess this ties in well with thet the film 'Eye in the sky' Alan Rickman's triumph of a last movie. Do your job, make your decisions, live or die by them and go home. Don't take them home.
I guess you have to do that in politics where you affect huge amounts of people. I guess you have to do it in banking (although there is little evidence that theses guys struggle with ethics and morals) and I guess you have to do it in healthcare.
The problem is that on one side of things we have to toughen up but in toughening up we lose the essence of what we provide and the empathy and the care for patients. We want to look after them. We want to feel their pain and anxiety. We want to walk the walk with them, but how much can we actually do that when the chopper hangs over our neck and the struggle to get it right it framed by what feels like horrendous complications.
At the end of the day though, most people are at risk of the sack in their job if it goes wrong. Perhaps dentists have had it so good for so long that they think their position is impervious or unerodable (is that a word?) Perhaps we have to face up to the fact that it's a harsh environment in the employment world now and you can be sacked and stopped working for any number of reasons.
The punchline here is that I don't think patients really want to be treated by people that are scared and I think we should tell them that we're getting scared. I think it affects their care and despite what the previous Chief Executive of the GDC said, I think it leads to defensive practice in medicine and dentistry and in the end that is a public health emergency.
For the moment though, try and find somebody you know who understands psychology and start putting the really bad things in the panic room in your brain and lock the door. The worst thing that can happen is the spiral of despair where the worries at work affect your relationship with your loved ones and your time outside of work which leads to you being a worse practitioner therefore leading to more problems and more worries and the cycle continues.
Blog Post Number: 1175