title: Addressing stress-related impairment in doctors. A survey of providers' and doctors' experience of a funded counselling service in New Zealand.
abstract: OBJECTIVE
  In January 2006 the Medical Protection Society (MPS) and Medical Assurance Society (MAS) commenced a jointly funded counselling service for stressed doctors in New Zealand. Stressed and impaired doctors may impact negatively on patient care. This study aims to investigate the service's utilisation, acceptability, and utility, and to consider whether the service may improve the delivery of health services.
  
  
  METHODS
  Psychologist or psychiatrist providers of the service between January 2006 and July 2008 were asked to anonymously complete a questionnaire about the service. They forwarded a questionnaire to their Dr-clients requesting demographic and other data, and ideas as to how the service might be improved.
  
  
  RESULTS
  28 out of 41 providers submitted data on 39 out of 55 Dr-clients. 25 of the Dr-clients returned completed questionnaires. Most Dr-clients requiring 3 or fewer sessions suffered from work-related stress; those needing 10 or more sessions had diagnoses including depression, bipolar disease, prior sexual abuse, and personality disorders. Dr-clients valued confidentiality, choice, and independence of the provider, and funding of the service. They believed the service contributed to them remaining in or returning to work. Providers identified stress in both the work and home environment, noting that these overlapped. Respondents identified the need for greater publicity about the service.
  
  
  CONCLUSIONS
  The MPS/MAS-funded counselling service is effective and well received, but there is insufficient awareness of its availability. Stress may result in impaired performance which can impact negatively on patient care, and the provision of counselling for stressed doctors can potentially improve the delivery of health services in New Zealand.
authors.affiliation: Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Wayne.Cunningham@otago.ac.nz
authors.forename: Wayne
authors.initials: W
authors.lastname: Cunningham
authors.forename: Tim
authors.initials: T
authors.lastname: Cookson
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009786:Occupational Health Services; D010815:Physician Impairment; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires