Clinic for GPs tackling problems early

A pioneering health and addiction service for doctors has uncovered 'the bottom of an iceberg' of health problems.

Dr Gerada says in many cases no-one knows the GP has a problem
Dr Gerada says in many cases no-one knows the GP has a problem

Two in three doctors seen by the London-based Practitioner Health Programme (PHP) in its first year were previously unknown to the system.

Only one third of the doctors who have gone to PHP are known to the GMC or the National Clinical Assessment Service (NCAS), said Dr Clare Gerada, medical director of the service.

'In a large percentage of cases no-one knows the doctor has a problem. It may have been identified in appraisal or discussed with a trainer,' Dr Gerada said.

'In general practice we have seen the entire age range from trainees to GPs with 25 years experience.'

Younger women aged 23 to 30 and older men form the bulk of PHP's cases. Equal numbers of men and women have used PHP. 'Among young women, alcohol use is the predominant problem.'

Two-thirds of doctors seen by PHP have mental health problems and one-third addiction, with two-thirds of those alcohol-related, Dr Gerada said.

Eighty per cent of doctors with addiction problems have emerged abstinent after treatment at PHP. Some 175 doctors and dentists from a potential pool of 27,000 practitioners living within the M25 have used PHP, a two-year project funded by the DoH at £1 million a year.

The service was set up a year ago to provide an alternative to doctors self-medicating or consulting colleagues about their problems.

Care is free and confidential - doctors can use a pseudonym and notes are not uploaded to the electronic record. Doctors refer themselves or contact is suggested by their deanery, employer, family, defence society or GMC medical supervisor.

'If we can treat and manage a case in six months before a doctor sees the GMC, they hit it in a much better state,' Dr Gerada explained.

'There are other services like the BMA's helpline for doctors undergoing stress. But we are seeing the more serious end.'

Some practices should work in ways more 'conducive to good health,' Dr Gerada said.

She suggested that LMCs could support practices running into problems to stop 'scapegoating' of individual doctors.

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