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Managing your workload

03 April 2017

Medicine is a stressful, time-consuming and demanding profession, and while there are many benefits of being a doctor, an easy life is not necessarily one of them. In recent times, the job has arguably become more demanding – not least due to the fact that many patients have higher expectations of their healthcare provider. Medicolegal adviser Dr Katie Grant explains how you can prevent this becoming a problem.

Insight research carried out by MPS revealed that 86% of health care professionals surveyed in Singapore are concerned about the amount of pressure they are being put under. What’s more, 62% think that their work has become more stressful in the past five years – and 32% of these expect it to get worse.

A lot of these concerns centre on clinical negligence; 94% of respondents thought that the culture was becoming increasingly litigious in Singapore – the same amount predict the number of claims will increase over the next five years. Patient expectations were also cited to be adding pressure – so much so that 82% of those surveyed said they practised overly cautiously as a result.

In the face of increased pressure and difficulty, you must ensure you maintain high standards and act professionally, whilst also looking after your own wellbeing.

Maintaining standards

One of the biggest challenges facing doctors is balancing the increase in patients’ needs with maintaining high standards of care. Remember the importance of taking a thorough medical history and examination – and document both. Record keeping standards can easily slip if a consultation overruns, but it is important to stop and make notes before seeing the next patient.

Be aware, too, of ‘by the way’ comments where symptoms might be mentioned in passing as the patient is on their way out of the door. These symptoms can often be the real reason behind a consultation, so make sure you address them. If it is not urgent, or you do not have sufficient time to give the patient your full attention, you should ask them to come back.

If you find that you are so stretched that you consider patient safety may be at risk, or your health begins to suffer, you should take steps to reduce your workload where you can, or raise concerns through appropriate channels, for example with a senior colleague or your employer.

In the August issue of MPS Connect, I gave some advice for efficient and effective record keeping

Acting within your competence

Some private medical practitioners seek to maintain their income (as patients turn to the public sector) by choosing to take on a wider range of treatments (such as GPs undertaking cosmetic procedures), as well as more patients – paediatricians seeing adult patients, obstetrics and gynaecology consultants examining patients with breast lumps, and so on.

Doctors that choose to do this are practising in areas beyond their expertise and may fail to diagnose and treat appropriately, with obvious consequences. You have a professional obligation to work within your competence and you must be mindful of this.

Looking after yourself

Doctors may be reluctant to declare their own health concerns when stress or anxiety becomes too much. Fortunately such problems, if acknowledged early, can be managed in a way to minimise impact on your life and career.

Doctors must ensure they are fit to work. It can be difficult to tell others of a personal illness for fear of stigmatisation, and doctors may find themselves tempted to prescribe for their own difficulties or self-medicate, but this is problematic, both personally and professionally. Every doctor should have their own GP; someone they can share difficulties with and look to for help.

As doctors, we spend our time caring for others, but must also acknowledge the need to care for ourselves.

If you have any questions about any of the issues raised in this article, or are seeking medicolegal advice, contact Medical Protection on 800 616 7055.