Physician-Heal Thyself Stress- It Goes With The Territory
Primary Care Physicians who receive patients for medical care for, especially chronic conditions, have long known that behavioral health is a major health issue and many have found as high as a 70% co-morbidity.
Physicians have only 10-15 minutes to diagnose, treat/triage, prescribe.
Those PCP’s who wish to expand their practice to include a behavioral health component- beyond their current services, face a daunting task of setup for assessment, treatment, costs and reimbursement. (Hunt, The Business Case for the Integration of Behavioral Health and Primary Care, counselingondemand.com)
There are estimates that about 40% of patients in treatment with a PCP at any particular time have a mental health or psycho-social component that must be addressed. Without question, family physicians need to be able to recognize, diagnose and treat or triage, a host of other psychological issues seen in the office. In addition, approximately 60% of patients with a diagnosable mental health disorder seek treatment from their PCP, not a mental health professional (Girgis & Sanson-Fisher, 1998) and it is estimated that half of patients with a psychiatric disorder go undiagnosed by their PCP (Rosenbaum, Ferguson & Lobas, 2004- quoted in Matthew Hunt, The Role of the Family Physician in Mental Healthcare, counselingondemand.com).
By its very nature, physicians become stressed.
“Physician distress is a well-documented phenomenon with costly consequences for individuals, patients, and society. Existing services are not informed by physician preferences and are consequently underutilized. 79% experienced either a serious adverse patient event and/or a traumatic personal event within the preceding year. Willingness to seek support was reported for legal situations (72%), involvement in medical errors (67%), adverse patient events (63%), substance abuse (67%), physical (62%) or mental health illness (50%), and interpersonal conflict at work (50%). Barriers included lack of time (89%), stigma (74%), lack of confidentiality (77%), and access (69%). Physician colleagues were the most popular potential sources of support (88%), outnumbering traditional mechanisms such as the Employee Assistance Program (29%) and mental health professionals (48%).
Despite the prevalence of stressful experiences and the desire for support among physicians, established services are underutilized. As colleagues are the most acceptable sources of support, we advocate peer support as the most effective way to address this sensitive, but important issue.” (Yue-Yung Hu, MD, MPH,Megan L. Fix, MD, Nathanael D. Hevelone, MPH, Stuart R. Lipsitz, ScD, Caprice C. Greenberg, MD, MPH, Joel S. Weissman, PhD and Jo Shapiro, MD, Physicians’ Needs in Coping with Emotional Stressors: The Case for Peer Support, ncbi.nlm.nih.gov)
This is where Counseling on Demand comes in.
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