Doctors' experience of a bespoke physician consultation service: cross-sectional investigation

Abstract

Aims and methodOur aim was to follow-up on a cohort of self-referred doctors who attended MedNet. We used a two-point cross-sectional design. Measures included three standardised self-report questionnaires administered before and after consultation. Doctors were also asked to complete a service user questionnaire, and data regarding engagement and onward referrals were gathered through case-note review.ResultsA statistically significant improvement in scores on all three questionnaires was found after intervention; however, scores on one subscale, the risk domain of the Clinical Outcomes in Routine Evaluation – Outcome Measure, did not change significantly. Of the doctors at no risk of suicide at intake, nearly two-thirds (n = 41/70, 59%) were sufficiently helped by the consultations provided to not need further treatment. Of the doctors at some risk of suicide at intake, two-thirds (n = 34/51, 67%) did need an onward referral. Only one doctor required hospital admission, an outcome that suggests the approach used is containing and clinically responsive.Clinical implicationsThis paper highlights the efficacy, need and importance of specialist services for doctors in difficulty. We found that the bespoke consultation model provided at MedNet is valued highly by the doctors as service users.

Doctors' health: stigma and the professional discomfort in seeking help

“…An essential aspect of bespoke services for doctors is the removal of barriers to engagement. 19,20 This is quite different from the provision of services to the general population, where triage is used at the point of entry, in part to manage demand on services. Doctors who need access to services do not need triage since they generally avoid seeking help; the problem is encouraging them to come in the first place.…”

“…Doctors who contact services have significant problems 18 and should always be offered a consultation, yet if they do engage with services, doctors have good outcomes. 19,21 In our clinical experience the key is the capacity to establish a therapeutic alliance and to offer an individually tailored programme of care. Equally important is to establish a network of support for those who are more seriously unwell EDITORIAL Garelick Doctors' health and to develop a good relationship with occupational health services who can support a doctor's phased return to work.…”

Readability analysis?

“…4,5 According to the literature, a Flesch-Kincaid 6th Grade (equivalent to UK reading age of 11-12 years) is the maximum recommended level for public health information, 1 and would be consistent with the average UK reading age quoted as being between 9 and 11 years. 4 There are, of course, a variety of different readability tests that could be used to examine the readability level of the College information leaflets, including Flesch-Kincaid and Flesch Reading Ease and Simple Measure of Gobbledygook formulae.…”

“…1 The provision of information is critical to my clinical practice and has often involved these very leaflets. I was also pleased that the authors acknowledged that 'much patient information is written in complex language and is poorly presented' as these are often barriers to patients accessing information.…”

“…These are widely available, contained within word processing packages, and have been used to evaluate patient information leaflets in other specialties 1 and standard appointment letters in child and adolescent mental health services. 2 When these measures are applied to the College leaflets (Table 3 in the paper), the mean FRE is 7.81 (7.1-8.4) and mean FKGL 63.13 (58.7-69.8).…”