While I accept the points raised in Oxtoby’s articles, in my view, there should be greater acknowledgement that doctors’ attitudes and behaviours are gradually changing over time. As highlighted, a key concern for most doctors who become ill is the potential impact on their ability to do their job, and for those off sick, when they will be able to return to work. NHS Occupational Health (OH) services can therefore play an important role in the management of doctors’ ill-health.
Earlier studies identified that doctors seldom consulted OH services and only did so when forced by regulatory requirements. In a more recent report looking at OH attendances and management-reported sickness absence in doctors and dentists, it was identified that the population of doctors studied did utilize OH services and that they attended for a wide range of health issues and services. A 3 year trend analysis in the same Health Board re-affirmed these findings and also found that OH management and self-referrals for doctors, absent from work, significantly increased over time.
In my experience as an NHS OH physician, there has been a gradual shift towards acceptance of ill health, the support available, and the responsibility to seek medical care, notably so for those affected by more significant medical conditions resulting in longer term sickness absence. Potential reasons for this could be cultural, generational, increased awareness or prompted by GMC requirements.
Work still needs to be done to improve perceptions of OH, understanding of the expertise and support the specialty has to offer and access to OH services. Specific fears around confidentiality need to be effectively addressed as well as appointment of Consultant OH physicians to manage these often complex consultations. Where high quality, competent OH services exist, doctors are likely to use them. While a case for specific services for this professional group in the UK has been highlighted, in the absence of additional resources and funding in wider parts of the country, the development of existing NHS OH services to effectively manage doctors’ health should be supported.
1. Kathy Oxtoby. Why doctors don’t take sick leave. BMJ 2015;351:h6719 doi: 10.1136/bmj.h6719 (Published 9 December 2015)
2. Kathy Oxtoby. Why doctors need to resist “presenteeism”. BMJ 2015;351:h6720 doi: 10.1136/bmj.h6720 (Published 9 December 2015)
3. Waldron HA. Sickness in the medical profession. Ann Occup Hyg. 1996;40(4):391-6.
4. Lalloo D, Ghafur I, Macdonald EB. Doctor and dentist contacts with an NHS occupational health service. Occup Med (Lond) 2013;63:291–293.
5. Lalloo D, Demou E, Macdonald EB. Trends in NHS doctor and dentist referrals to occupational health- accepted for publication by Occup Med (Lond) December 2015.
Rapid Response:
Re: Why doctors don’t take sick leave
While I accept the points raised in Oxtoby’s articles, in my view, there should be greater acknowledgement that doctors’ attitudes and behaviours are gradually changing over time. As highlighted, a key concern for most doctors who become ill is the potential impact on their ability to do their job, and for those off sick, when they will be able to return to work. NHS Occupational Health (OH) services can therefore play an important role in the management of doctors’ ill-health.
Earlier studies identified that doctors seldom consulted OH services and only did so when forced by regulatory requirements. In a more recent report looking at OH attendances and management-reported sickness absence in doctors and dentists, it was identified that the population of doctors studied did utilize OH services and that they attended for a wide range of health issues and services. A 3 year trend analysis in the same Health Board re-affirmed these findings and also found that OH management and self-referrals for doctors, absent from work, significantly increased over time.
In my experience as an NHS OH physician, there has been a gradual shift towards acceptance of ill health, the support available, and the responsibility to seek medical care, notably so for those affected by more significant medical conditions resulting in longer term sickness absence. Potential reasons for this could be cultural, generational, increased awareness or prompted by GMC requirements.
Work still needs to be done to improve perceptions of OH, understanding of the expertise and support the specialty has to offer and access to OH services. Specific fears around confidentiality need to be effectively addressed as well as appointment of Consultant OH physicians to manage these often complex consultations. Where high quality, competent OH services exist, doctors are likely to use them. While a case for specific services for this professional group in the UK has been highlighted, in the absence of additional resources and funding in wider parts of the country, the development of existing NHS OH services to effectively manage doctors’ health should be supported.
Drushca Lalloo
Consultant Occupational Physician
Glasgow, Scotland
1. Kathy Oxtoby. Why doctors don’t take sick leave. BMJ 2015;351:h6719 doi: 10.1136/bmj.h6719 (Published 9 December 2015)
2. Kathy Oxtoby. Why doctors need to resist “presenteeism”. BMJ 2015;351:h6720 doi: 10.1136/bmj.h6720 (Published 9 December 2015)
3. Waldron HA. Sickness in the medical profession. Ann Occup Hyg. 1996;40(4):391-6.
4. Lalloo D, Ghafur I, Macdonald EB. Doctor and dentist contacts with an NHS occupational health service. Occup Med (Lond) 2013;63:291–293.
5. Lalloo D, Demou E, Macdonald EB. Trends in NHS doctor and dentist referrals to occupational health- accepted for publication by Occup Med (Lond) December 2015.
Competing interests: No competing interests