Our last two articles have focused upon consultation skills and self care strategies that protect the individual physician from specific stressors.
However, no man (or woman) is an island and the impact of the wider team upon an individual doctor's stress levels is significant. This is why GP practices are increasingly engaging psychologists to run team development sessions focusing upon the establishment and maintenance of a culture, processes and shared understanding (or mental model in psychological terms) that support productive and healthy systems.
Gardiner and Kearns (2008) highlight that it is important for doctors to have staff "on their side" and for practice staff to recognise that "stressed and frazzled people do not make the best bosses". Therefore, healthcare delivery extends further than doctor-patient interactions. Indeed, doctors, nurses, practice managers, receptionists and administrative staff have a huge impact on each others' quality of life.
Inevitably, there are times when any team experiences challenges that can lead to reduced motivation, impaired communication and conflict. In our experience of GP facilitation, we have often observed the focus on meeting patients' needs over and above those of the team. Individuals within teams vary, for example, in relation to the need for praise, control, accomplishment and inclusion.
In the current climate of increased demands and stretched resources, the demands upon individuals and GP practices are significant. The BMA recognises that "sick organisations influence sick doctors". We would urge all practices to value and invest in themselves to protect against the inevitable challenges that arise in the delivery of healthcare, and to develop a culture and processes that provide adequate "emotional insulation" for staff at all levels.
Dr Louise Robb and Dr Anna Gough are chartered clinical psychologists, and Naomi Jefferies chartered occupational psychologist with Apex Psychology Services