Page last updated at 08:44 GMT, Tuesday, 18 November 2008

Addiction service to help doctors

By Jane Dreaper
BBC News health correspondent

Drink and drugs
Drink and drug problems are relatively common among doctors

Doctors and dentists who have an addiction or other health problems often leave it late to seek help because they fear being recognised or worry about putting their career in jeopardy.

But the launch of a specialist service on Monday may help push them to seek the treatment they need.

The government-funded project expects to see 500 cases a year.

It's already been getting inquiries before the formal launch.

The idea of specialised help was proposed by the Chief Medical Officer, Sir Liam Donaldson, some years ago.

But it gained momentum after inquiries into the serial killer GP, Harold Shipman, and other doctors who've mistreated patients.

GP-run

The service - named the Practitioner Health Programme - is based in a normal GP practice, near a busy transport hub in central London.

However, doctors and dentists who turn up here won't have to linger in the waiting area as confidentiality is a key priority.

The consulting room is more like a psychiatrist's study, with comfortable chairs and a coffee table.

Dr Clare Gerada
The over-riding emotion that doctors and dentists feel is guilt - guilt at having let themselves, their patients and their families down
Dr Clare Gerada

There is no computer sitting between the doctor and patient, and no examination couch.

Addiction to drink or drugs is expected to be a common concern.

By the time health professionals acknowledge that they need help, they're likely to be highly distressed - so up to two hours are set aside for an initial assessment.

The GP running the project, Dr Clare Gerada, said: "The over-riding emotion that doctors and dentists feel is guilt - guilt at having let themselves, their patients and their families down.

"Because they don't approach the normal avenues for help, their problems get complex.

"If we feel a doctor or dentist is putting their patients at risk, we have a legal responsibility to discuss it with them.

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"We could even talk to their employer or the General Medical Council as a last resort.

"But if they're not working, then there won't be a risk to patients."

It's expected that most doctors and dentists will need to take sick leave while they tackle their problems.

Most patients are expected to be from within the M25 - but this is just the pilot, and officials in Scotland have expressed an interest.

Recovery

Alasdair, who's based near Edinburgh and wants to be known by his first name only, believes he knows up to 2,000 doctors in the UK who are recovering well from an addiction and practising medicine safely.

He helps NHS staff who ring a helpline run by volunteers at the Sick Doctors Trust, and believes the new service will be highly valuable.

Alasdair began drinking heavily as a medical student.

Dr Michael Kaufmann
These doctors who've been exquisitely well trained at treating patients have not been especially well prepared for managing many of their own complicated life problems
Dr Michael Kaufmann

As a doctor in his thirties, he was sometimes downing ten pints of beer a night.

He said: "I thought I was magically protected against the diseases I treated.

"And I was frightened that if anyone found out I was an alcoholic, I'd be drummed out of the profession.

"Things were getting risky in the work setting.

"It's difficult to be precise, but my judgement wasn't as good as it should have been.

"I got help through Alcoholics Anonymous and have now been sober for many years. Life's good - beyond my wildest dreams."

Harold Shipman's horrific crimes have led to an overhaul in the way doctors are managed and regulated.

Experts have long argued that successfully protecting patients must mean helping doctors to stay healthy, though it's a tricky balancing act.

The hope is that a specialised service will encourage those who might put patients in danger to seek help at an early stage.

Dr Michael Kaufmann is a visiting expert who set up a similar project in Ontario, Canada. His message is that demand can only grow.

He said: "When I started in 1995, it was just me alone in an office, with a computer I had no idea how to use.

"Today we have a staff of 12, and we're looking for more. We respond to addiction, but also to many broader issues.

"These doctors who've been exquisitely well trained at treating patients have not been especially well prepared for managing many of their own complicated life problems."



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