%0 Journal Article %~ Pubmed %A Tong, Seng Fah %A Low, Wah Yun %A Ismail, Shaiful Bahari %A Trevena, Lyndal %A Willcock, Simon %T Malaysian primary care doctors' views on men's health: an unresolved jigsaw puzzle. %B BMC family practice [electronic resource] %D 2011 %V 12 %N 1 %P 29 %@ 1471-2296 %X Men have been noted to utilise health care services less readily then women. Primary care settings provide an opportunity to engage men in health care activities because of close proximity to the target group (men in the community). Understanding attitudes towards men's health among Malaysian primary care doctors is important for the effective delivery of health services to men. We aimed to explore the opinions and attitudes of primary care doctors (PCDs) relating to men's health and help-seeking behaviour. %Z FOR Codes: 111799 %0 Journal Article %~ Pubmed %A Tong, Seng Fah %A Low, Wah Yun %A Ismail, Shaiful Bahari %A Trevena, Lyndal %A Willcock, Simon %T Physician's intention to initiate health check-up discussions with men: a qualitative study. %B Family practice %D 2011 %V 28 %N 3 %P 307-16 %@ 1460-2229 %X Although prevalent in primary care settings, men's health issues are rarely discussed. Yet, primary care doctors (PCDs) are well positioned to offer health check-ups during consultations. %Z FOR Codes: 111716 %0 Journal Article %~ Pubmed %A Nash, Louise M %A Walton, Merrilyn M %A Daly, Michele G %A Kelly, Patrick J %A Walter, Garry %A van Ekert, Elizabeth H %A Willcock, Simon M %A Tennant, Christopher C %T Perceived practice change in Australian doctors as a result of medicolegal concerns. %B Medical Journal of Australia %D 2010 %V 193 %N 10 %P 579-583 %@ 0025-729X %X OBJECTIVES: To explore the perceived impact of medicolegal concerns on how Australian doctors practise medicine and to compare doctors who have experienced a medicolegal matter with those who have not. DESIGN AND SETTING: Cross-sectional survey (posted in September 2007, with reminder 4??weeks later) of Australian doctors from all major specialty groups, trainees and a sample of general practitioners who were insured with a medical insurance company. PARTICIPANTS: 2999??respondents of 8360??who were sent the survey. MAIN OUTCOME MEASURES: Perceived practice changes due to concerns about medicolegal issues, beliefs about medicolegal issues, and the influence of medicolegal issues on both career choices and how doctors relate to their patients. RESULTS: Respondents reported changes in practice behaviour due to medicolegal concerns, with 43% of doctors stating that they referred patients more than usual, 55% stating that they ordered tests more than usual, and 11% stating that they prescribed medications more than usual. Respondents also reported improved communication of risk (66%), increased disclosure of uncertainty (44%), developed better systems for tracking results (48%) and better methods for identifying non-attenders (39%) and for auditing clinical practice (35%). Concerns about medicolegal issues led to 33% considering giving up medicine, 32% considering reducing their working hours and 40% considering retiring early. These proportions were all significantly greater for doctors who had previously experienced a medicolegal matter compared with those who had not. CONCLUSIONS: This Australian study, like international studies, confirms that doctors' concerns about medicolegal issues impact on their practice in a variety of ways. There is a greater perceived impact on those doctors who have previously experienced a medicolegal matter. %Z FOR Codes: 111714 111705 %0 Journal Article %~ Pubmed %A Nash, Louise M %A Daly, Michele G %A Kelly, Patrick J %A van Ekert, Elizabeth H %A Walter, Garry %A Walton, Merrilyn %A Willcock, Simon M %A Tennant, Chris C %T Factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors. %B Medical Journal of Australia %D 2010 %V 193 %N 3 %P 161-6 %@ 0025-729X %X OBJECTIVE: To identify factors associated with psychiatric morbidity and hazardous alcohol use in Australian doctors. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional postal survey of 2999 doctors (including all major specialty groups, trainees and general practitioners) insured with an Australian medical insurance company. The potential for psychiatric morbidity was measured by the General Health Questionnaire (GHQ), and the potential for hazardous alcohol use by the Alcohol Use Disorders Identification Test (AUDIT). The survey was conducted in 2007. MAIN OUTCOME MEASURES: Demographic, work-related and personality factors associated with a GHQ score > 4 and an AUDIT score >/= 8. RESULTS: Factors significantly associated with psychiatric morbidity in doctors were: having a current medicolegal matter, not taking a holiday in the previous year, working long hours, type of specialty, and having personality traits of neuroticism and introversion. Factors significantly associated with potentially hazardous alcohol use were being male, being Australian-trained, being between 40 and 49 years of age, having personality traits of neuroticism and extroversion, failing to meet Continuing Medical Education requirements, and being a solo practitioner. CONCLUSIONS: The mental health of medical practitioners is crucial to the quality of care their patients receive. Doctors should reflect on their hours of work and need for holidays. Involvement with medicolegal processes, such as lawsuits, complaints and inquiries, is a stressful part of medical practice today. Doctors need to be educated about these processes and understand how the experience may affect their health, work and loved ones. %Z FOR Codes: 111705 %0 Journal Article %~ Pubmed %A Nash, Louise M %A Kelly, Patrick J %A Daly, Michele G %A Walter, Garry %A van Ekert, Elizabeth H %A Walton, Merrilyn %A Willcock, Simon M %A Tennant, Christopher C %T Australian doctors' involvement in medicolegal matters: a cross-sectional self-report study. %B Medical Journal of Australia %D 2009 %V 191 %N 8 %P 436-40 %@ 0025-729X %X OBJECTIVE: To investigate the frequency of, and factors associated with, Australian doctors' involvement in medicolegal matters. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional survey of Australian doctors (specialists, trainees and general practitioners) insured with the medical insurance company Avant. A self-report questionnaire was mailed to Avant members in September 2007 to gather data on their involvement in medicolegal matters. Information on psychiatric morbidity and alcohol consumption was also collected using the General Health Questionnaire and the Alcohol Use Disorders Identification Test. MAIN OUTCOME MEASURES: Occurrence and type of past and current medicolegal matters with which doctors have been involved. RESULTS: Of 8500 doctors invited to participate, 2999 returned completed surveys (36% response rate). Sixty-five per cent of respondents had been involved in a medicolegal matter at some time, and 14% were involved in a current matter. The two most common types of medicolegal matter were claims for compensation and complaints to a health care complaints body. Doctors were more likely to be involved in medicolegal matters if they were male, worked in high-intervention areas of medicine (surgery and obstretics/gynaecology), and worked longer hours. CONCLUSION: Our study concurs with other studies in finding an association between medicolegal matters and being male, working long hours and working in high-intervention areas of medicine. Unlike other studies, we found no association between age and involvement in a current medicolegal matter. Our findings also pose the question of whether psychiatric morbidity in doctors is a cause or effect of the medicolegal process. %Z FOR Codes: 111705 %0 Journal Article %~ Pubmed %A Nash, Louise %A Walton, Merrilyn %A Daly, Michele %A Johnson, Maree %A Walter, Garry %A van Ekert, Elizabeth %A Willcock, Simon %A Tennant, Chris %T GPs' concerns about medicolegal issues - How it affects their practice. %B Australian Family Physician %D 2009 %V 38 %N 1-2 %P 66-70 %@ 0300-8495 %X BACKGROUND: General practitioners' concerns about medicolegal issues have been shown to influence the practice of medicine. This research looks at GPs' beliefs about medicolegal issues and how medicolegal concerns affect their practice. METHODS: A descriptive comparative design was used. A cross sectional self report survey was sent to 1239 GPs, 566 responded (46% response rate). Responses were considered as a group, and then comparisons were made between those who had experienced a medicolegal matter and those who had not. This data was sourced from surveys and medicolegal insurer records. RESULTS: General practitioners with previous medicolegal experiences were more likely than their colleagues to report believing the law required them to make perfect decisions and that medicolegal factors made them consider early retirement from medicine. They were also less likely to believe that inadequate communication is a factor in most complaints. More than half the GPs reported having made practice changes due to medicolegal concerns in the following areas: test ordering (73%); specialist referrals (66%); systems to track test results (70%); and communication of risk to patients (68%). Other changes were reported less frequently. DISCUSSION: This study found that GPs' concerns about medicolegal matters impact on their practise of medicine. While greater awareness of medicolegal issues may lead to positive impacts, the negative impact of their concerns is that some changes arise from anxiety about medicolegal matters rather than from the exercise of good clinical judgment. %Z FOR Codes: 110319 %0 Journal Article %~ Isi %A Phillips, J. %A Davidson, P. M. %A Willcock, S. %T An Insight Into the Delivery of a Palliative Approach in Residential Aged Care The General Practitioner Perspective %B Journal of Applied Gerontology %D 2009 %C United States %I Sage Publications, Inc. %V 28 %N 3 %P 395-405 %@ 0733-4648 %X %Z FOR Codes: 1117 %0 Journal Article %~ Pubmed %A Willcock, Simon M %T Getting back into the emergency department: diversifying general practice while relieving emergency medicine workforce shortages. %B Medical Journal of Australia %D 2008 %V 189 %N 2 %P 113-4 %@ 0025-729X %X New medical graduates expect to work in an environment that allows scope for flexibility and change across a career in medicine. Recruitment to general practice is adversely affected by its perceived limited scope of practice. Training in procedural and hospital skills is not difficult to access for general practice trainees, but complex and inconsistent credentialling criteria and protectionist attitudes among some specialist colleges mean that many skilled general practitioners are unable to utilise the full range of their skills in clinical practice. The discipline of emergency medicine is also experiencing difficulty in recruiting trainees. The employment of skilled GPs in emergency departments (including metropolitan departments) could improve vocational satisfaction for GPs and emergency physicians, and possibly also improve patient outcomes and flow through the emergency department. %Z FOR Codes: 1117 %0 Journal Article %~ Pubmed %A Nash, Louise %A Daly, Michele %A Johnson, Maree %A Coulston, Carissa %A Tennant, Chris %A van Ekert, Elizabeth %A Walter, Garry %A Willcock, Simon %A Walton, Merrilyn %T Personality, gender and medico-legal matters in medical practice. %B %D 2008 %V 17 %N 1 %P 19-24 %@ 1440-1665 %X The aim of this paper was to explore the relationship between the personality traits of Australian General Practitioners (GPs) and their gender, work practice arrangements, and history of medico-legal matters. %Z FOR Codes: 110319 %0 Journal Article %~ Pubmed %A Nash, Louise %A Daly, Michele %A Johnson, Maree %A Walter, Garry %A Walton, Merrilyn %A Willcock, Simon %A Coulston, Carissa %A van Ekert, Elizabeth %A Tennant, Chris %T Psychological morbidity in Australian doctors who have and have not experienced a medico-legal matter: cross-sectional survey. %B Australian & New Zealand Journal of Psychiatry %D 2007 %V 41 %N 11 %P 917-25 %@ 0004-8674 %X OBJECTIVE: To describe the differences in psychological morbidity between Australian general practitioners (GPs) who have experienced a medico-legal matter and those who have not. METHODS: A total of 1,499 GPs were initially invited to participate in the study. Two hundred and sixty requested not to participate, with 1,239 subsequently being sent a survey. There were 566 respondents (45.7% response rate to survey). There were two sources of data. First, a cross-sectional survey sought demographic information, personality traits via the Eysenck Personality Questionnaire (EPQ), history of a medico-legal matter with any medical defence organization, and measures of psychological morbidity, including the General Health Questionnaire (GHQ), Sheehan Disability Scale (SDS), and Alcohol Use Disorders Identification Test. Second, information was extracted from the United Medical Protection database on medico-legal matters. RESULTS: Fifty-nine per cent of respondents to the survey reported ever having a medico-legal matter, with 13% having a current medico-legal matter. Those with a current matter reported increased levels of disability (in work, social or family life) and higher prevalence of psychiatric morbidity (45% vs 27% GHQ 'case identification' rates), compared to those with no current matter. Those respondents with a history of past medico-legal matters reported increased levels of disability (SDS) and depression subscores (GHQ). Male respondents drank significantly more alcohol than female respondents, and male respondents with current or past medico-legal matters had significantly higher levels of alcohol use than male respondents with no experience of medico-legal matters. CONCLUSIONS: Doctors who have current and past medico-legal matters have a higher level of psychological morbidity. The study design was unable to distinguish cause or effect. A longitudinal study is planned to investigate this. The findings have significant implications for medical training, doctor support systems and medical insurance groups. %Z FOR Codes: 110319 %0 Journal Article %~ Pubmed %A Nash, Louise %A Curtis, Bradley %A Walton, Merrilyn %A Willcock, Simon %A Tennant, Christopher %T The response of doctors to a formal complaint. %B %D 2006 %V 14 %N 3 %P 246-50 %@ 1039-8562 %X This pilot study investigates the psychological impact on doctors of a complaint to the New South Wales Health Care Complaints Commission and the doctor's perception of legal risk. Doctors who received a complaint were sent a set of questionnaires embracing psychological variables and their perceptions of legal risk. The response rate was 60%. Thirty-eight per cent of respondents met screening criteria for psychiatric disorder. There was, however, minimal functional impairment of work, social or family life. Respondents scored highly on altruism, but at the same time were 'tough minded'. The questionnaire to assess the doctor's perception of legal risk appeared to have acceptable construct validity but showed that doctors still misunderstand medico-legal risk. Psychiatric morbidity rates of our sample were comparable with other Australian medical samples. This small sample appeared to cope with the stress of a complaint better than those reported in other studies. %0 Journal Article %~ Pubmed %A Kefford, Carolyn H %A Trevena, Lyndal J %A Willcock, Simon M %T Breaking away from the medical model: perceptions of health and health care in suburban Sydney youth. %B Medical Journal of Australia %D 2005 %V 183 %N 8 %P 418-21 %@ 0025-729X %X OBJECTIVES: To identify perceptions of health, health concerns, and health service needs among young people in a suburb of Sydney, New South Wales. DESIGN: Qualitative study using focus groups. SETTING: Berowra, a geographically isolated suburb on the outskirts of Sydney, between December 2002 and April 2003. PARTICIPANTS: 40 Berowra residents aged 14-24 years, recruited from two local government high schools (two groups), a local youth drop-in centre (one group), and the community, through advertising at the youth centre, local schools and church groups (one group). RESULTS: Focus group findings were classified into four broad themes. 1: Personal safety is a primary health concern. Berowra needs more recreational facilities to prevent drug and alcohol use related to boredom. 2: Health is more about quality of life than disease and illness. 3: Most health information comes from sources other than health providers. Health education must enable young people to make wise choices for the future. 4: Access to health services is of concern. More education is required on how Medicare works. Young people need to trust their service provider and will only see a doctor if they perceive themselves to be severely ill. Young people value meeting general practitioners in the school and community setting and not just in the doctor's consulting room. CONCLUSIONS: Young people desire a whole lifestyle approach to health rather than the traditional model based on diagnosis and disease. Health information needs to be accessible anonymously, and healthy lifestyles need to be promoted throughout the whole community, using youth workers and sporting leaders as role models. %0 Journal Article %~ Pubmed %A Willcock, Simon M %A Daly, Michele G %A Tennant, Christopher C %A Allard, Benjamin J %T Burnout and psychiatric morbidity in new medical graduates. %B Medical Journal of Australia %D 2004 %V 181 %N 7 %P 357-60 %@ 0025-729X %X OBJECTIVE: To determine the prevalence of psychiatric morbidity and burnout in final-year medical students, and changes in these measures during the intern year. DESIGN: Prospective longitudinal cohort study over 18 months, with assessment of psychiatric morbidity and burnout on six occasions. PARTICIPANTS: All 117 students in the first graduating cohort of the University of Sydney Graduate Medical Program were invited to participate in the study; 110 consented. OUTCOME MEASURES: Psychiatric morbidity assessed with the 28-item General Health Questionnaire and burnout assessed with the Maslach Burnout Inventory. RESULTS: The point prevalence of participants meeting criteria for psychiatric morbidity and burnout rose steadily throughout the study period. CONCLUSIONS: Internship remains a stressful time for medical graduates, despite initiatives to better support them during this period. The implications for the doctors themselves and for the communities they serve warrant further attention, including programs specifically aimed at reducing the rate of psychological morbidity and burnout during internship. %0 Journal Article %A Sullivan, EA %A Willcock, SM %A Ardzejewska, K %A Slaytor, EK %T A pre-employment programme for overseas-trained doctors entering the Australian workforce, 1997-99 %B Medical Education %D 2002 %C 9600 Garsington Rd, Oxford, England, Ox4 2Dg %I Blackwell Publishing Ltd %V 36 %N %P 614-621 %@ 0308-0110 %X %0 Journal Article %A Daly, MG %A Willcock, SM %T Examining stress and responses to stress in medical students and new medical graguates %B Medical Journal Of Australia %D 2002 %C Level 1, 76 Berry St, Sydney, Australia, 2060 %I Australasian Med Publ Co Ltd %V 177 %N %P S14-S15 %@ 0025-729x %X %0 Journal Article %~ Pubmed %A Llewellyn-Jones, R H %A Baikie, K A %A Castell, S %A Andrews, C L %A Baikie, A %A Pond, C D %A Willcock, S M %A Snowdon, J %A Tennant, C C %T How to help depressed older people living in residential care: a multifaceted shared-care intervention for late-life depression. %B International psychogeriatrics / IPA %D 2001 %V 13 %N 4 %P 477-92 %@ 1041-6102 %X OBJECTIVE: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. SETTING: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). PARTICIPANTS: The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents whowere eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. INTERVENTION DESCRIPTION: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) training for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. CONCLUSIONS: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed residents are substantial.