1st Edition
Beneath the White Coat Doctors, Their Minds and Mental Health
This timely book offers a balanced and thoughtful review of the current mental health emergency and its impact upon and among medical professionals, supported by the best available evidence and illustrated through real-life cases. Recognising the increasing stressors in the role including the impact of the environment in which doctors work, the book examines some of the key emotional drivers for this unhappiness among doctors at work – shame, stigma, suffering and sacrifice – and offers practical steps to emotional and physical recovery.
Despite the obvious challenges and stresses of the role, with the right support in place the vast majority of doctors can thrive in their jobs. In reading this book, policy makers, politicians, educators, hospital managers will be reminded of the ethical duty to ensure that doctors are cared for and have access to the time, people and spaces to remain psychological healthy, while doctors will learn to recognize and seek actively the help that they need, and to support and guide one another.
Acknowledgements
Contributors
Preface
SECTION I. THE MAKING OF A DOCTOR
1. The making of a doctor: medical self and group of belonging
2. Mental illness in doctors: an historical context
3. What makes medicine such a difficult task master and doctors at higher risk of mental illness?
4. Rising levels of mental illness, fact or fiction?
5. Surviving and thriving in medicine
6. Resilience
7. Shame in medicine
8. Suffering, sacrifice and stigma
SECTION II. DOCTORS AND THEIR ILLNESSES
9. Doctors and mental illness: an overview
10. Doctors and substance misuse disorder
11. Autism in doctors
12. Burnout in doctors
13. Suicide in doctors and its sequelae
14. Bipolar disorder and other psychotic states
15. COVID-19 and mental illness
SECTION III. DOCTORS AS PATIENTS
16. Doctors as patients
17. Doctors treating doctors
18. The doctors’ doctor
19. How to be a good enough patient: from sickness to health
20. Services for mentally ill doctors
21. The migrant doctor
22. Medical students
23. Different specialities and risk of mental illness
24. Talking helps
SECTION IV. WHEN THINGS GO WRONG
25. Sticking to the rules: professional and unprofessional behaviour
26. Making sense of the regulatory process
27. Improving the outcome of a serious investigation
Index
Biography
Dr Clare Gerada has been a medical practitioner since 1982. Having first trained in psychiatry she became a GP in 1992, and has worked in the same practice ever since. She has been heading up a groundbreaking service for sick doctors (practitioner-patients) since 2008 which has rapidly become an international leader. Between 2010-2013 she led the Royal College of General Practitioners, the largest of all the of Royal Colleges, and only the second women to hold this Office in its history.
"Clare’s passion for medicine is profound and it is a thread that weaves its way through every page. This book will be invaluable to medical students, doctors and is equally relevant to nurses and other health professions. It will also be of interest to the general public. The research and references are truly impressive and will signpost the reader to a myriad of further reading. I anticipate it will be read for decades to come." -Dr Peter Carter, independent healthcare consultant, former chief executive, Royal College of Nursing
"Whether you have worn the white coat, worked with the white coats, or done your best to avoid them, there is something valuable here for you. Beneath the White Coat offers hope, but it is a difficult and serious journey. Looking at the dangers on the way to becoming and practicing as a doctor is painful and makes one want to look away. It takes courage to look honestly at the challenges along the way to becoming a healer. Dr Gerada takes us deeply into the journey and shines a light on what can go wrong. Reading the book is a comforting guide to our own journey in becoming a healer and finding help when we get off the path. The book offers excellent advice on helping doctors and mental health professionals." Dale C. Godby & Tina Ali Mohammad for the International Journal of Group Psychotherapy
