Recognising Health Problems in Trainees

October 2014Autumn Seminar

Approx 10% incidence addiction to drugs and alcohol in general population

Estimated 10-12% level in doctors (postal surveys, so could be under reported)

A 1998 study of junior doctors in Newcastle-upon-Tyne reported that:

60% exceeded the recommended safe limits for alcohol consumption36% of males and 20% of females used cannabis  13% of males and 10% of females used other illicit drugs

A BMA Working Group, also reporting in 1998, suggested that some 1in15 doctors in the UK may suffer from some form of dependence on alcohol and/or other drugs. This equates to approximately 13,000 doctors and suggests likely 400-500 new cases per year. The fitness to practice of all of these will be impaired.

From the GMC’s figures in 2007 of all their cases with health sanctions, a speciality breakdown showed

39% were GPs

17.5%, Psychiatrists

9% General Medicine

8.5% Surgery

6.5% Anaesthesia

6.2% Emergency Medicine.

Other specialities represented less than 2% each (reference Dobson B. Head of Case Review GMC 2010, personal communication).

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Factors stopping dusclosure

Fear affecting future career

Fear of losing respect

Loss of income

Fear of fitness to practice issues

Feel letting your colleagues down

Feeling a failure

Lack of support or supervision, real or perceived

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Warning signs

Changes in personality

Mood swings/anxiety

Drinking more alcohol

Dishevelled appearance

Unexplained minor injuries

Drug errors, poor handwriting

Arriving late, more isolated

Changing address a lot

Relationship problems

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More GP specific warning signs

More SEAs eg missed referrals

More complaints from staff and patients

Worsening MSF and PSQ scores

Worsening clinical performance eg debriefs

Reduced use eportfolio

Missing surgeries, deadlines etc

Missing meetings

More dr centred consulting