An innovative Australian doctors’ health service: using systems therapy to work with individual medical leaders in an acute public health setting

Abstract

Objective To describe an innovative doctors’ health service (Professional Support Unit) utilising systems therapy to support individual medical leaders across an Australian local public health district. Method Therapeutic interventions were informed by systems theory, the study of social systems, coherent entities with hierarchical orders united by organising relations of rules, roles, structures and alliances. Systems therapy addresses these relations to effect change. Working with leaders individually was based on the premise of effecting change in the system by changing part of the system, particularly the ‘decider subsystem’ of the medical lead. Results Support was provided to 30 medical leaders (50% of potential cohort). All but five self-referred with zero dropouts. Referrals snowballed gradually and exponentially following psychoeducation sessions normalising struggling and seeking help. Diversity of themes presented or emerging included requests for: (i) psychological support for lead/family, or staff/family; (ii)didactic sessions regarding impairment, ageing doctor, performance management and mental health first aid for doctors; (iv) anger management; (v) difficult staff; and (vi) being undermined or placed in untenable positions. Interventions were accordingly diverse and tailored. A vulnerable-resilience model was developed with practical tips. Conclusions Supporting medical leaders using therapeutic interventions grounded in systems theory may go towards addressing organisational duty of care to maintain safe work systems.