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                  A Self-care Guidebook
                  for Medical Practitioners
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                     Dr Danielle Clode BA(Hons) DPhil(Oxon) Research Associate
                     Dr Jennifer Boldero BSc PhD Associate Professor
                     Department of Psychology, University of Melbourne, Parkville VIC
                     Clode D, Boldero J (2005) Keeping the doctor alive: A self-care guidebook for medical practitioners, 
                     Royal Australian College of General Practitioners, South Melbourne.
                     Design by InfoPak Pty Ltd 03 9499 8186
                     Published by the Royal Australian College of General Practitioners
                     1 Palmerston Crescent, South Melbourne VIC 3205
                     © Royal Australian College of General Practitioners, July 2005
                     ISBN 086906 2662
                     This publication is copyright.  Copyright for the entire contents is vested in the Royal Australian College of General
                     Practitioners.  Apart from any fair dealing for the purposes of private study, criticism or review as permitted under the
                     Copyright Act, no part may be reproduced, stored in a retrieval system or transmitted in any form or by any means,
                     electronic, mechanical or otherwise without prior written permission.  
                     Enquiries to Dr Raymond Martyres, Royal Australian College of General Practitioners, 
                     1 Palmerston Crescent, South Melbourne VIC 3205    Ph: 03 8699 0414
               ACKNOWLEDGEMENTS
                     Production of this guidebook has been directed by the Professional Peer Support Program Committee:
                     Dr Raymond Martyres     PPSP Committee Chairman
                                             The Royal Australian College of General Practitioners, Victoria Faculty
                     Dr Varna Amarasinghe    The Australasian College for Emergency Medicine
                     Dr Bill Betts           The Australian Psychoanalytic Society
                     Dr Carole Castles       The Australian College of Psychological Medicine (Chair) 
                     Dr Lynette Chazan       The Royal Australian and New Zealand College of Psychiatrists 
                                             (Victorian section of Psychotherapists) 
                     Prof Peter Choong       The Royal Australasian College of Surgeons
                                             Chairman Victorian State Committee
                     Dr Peter Ebeling        The Royal Australasian College of Physicians
                     Dr Joanna Flynn         The Medical Practitioners Board of Victoria (President)
                     Dr Jack Warhaft         The Victorian Doctor Health Program (Director)
                     Dr Helen Kolawole       Australian and New Zealand College of Anaesthetists (Chair of Victorian State Committee)
                     Dr Louise Kornman       The Royal Australian and New Zealand College of Obstetrics and Gynecology 
                     Dr Peter McCall         Australian and New Zealand College of Anaesthetists
                     Dr John Meaney          General Practice Division Victoria (Chair)
                     Ms Anastasia Novella    Medical Defence Association of Victoria
                     Dr Richard Prytula      The Royal Australian and New Zealand College of Psychiatrists 
                     Dr Tamsin Waterhouse    The Royal College of Pathologists of Australasia
                     Editorial Support: Ms Susie Walker and Dr Maggie Broom.  
                     RACGP (Victoria Faculty) Support: Dr Leanne Rowe, Ms Caroline Parsons and Ms Mary Toye.
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                      KEEPING
                                   THE
                               DOCTOR
                                              ALIVE
                       A Self-care Guidebook
                       for Medical Practitioners
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       2
                             Contents
             Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
                Guidebook Aims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
                About the guidebook. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
                How to use the guidebook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
                How to set up a peer support group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
                Is this meant for me?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
                What is self-care?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
                The case for self-care. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
                What does self-care involve? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
             IDENTIFICATION
                Personality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
                    EXERCISE 1: Personality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
                Job Satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
                    EXERCISE 2: Job satisfaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
                Self-care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
                    EXERCISE 3: Quality of life assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
             PREVENTION
                Coping strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
                    EXERCISE 4: Coping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
                Lifestyle balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
                    EXERCISE 5: Lifestyle audit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
                Boundary issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
                    EXERCISE 6: Boundary issues. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
                Management Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
                    EXERCISE 7: Management skills. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
             SUPPORT
                Personal support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
                    EXERCISE 8: Support networks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
                Medical support—Your own general practitioner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
                    EXERCISE 9: Your own GP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
                Medical support—Avoiding self-prescribing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
                    EXERCISE 10: Self-prescribing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50
                Peer support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
                    EXERCISE 11: Peer support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
             When self-care is not enough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
             Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
             References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
             Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65