Physicians have dedicated their lives to caring for others, but far too often, that dedication comes at the expense of taking care of themselves. Sandra Frazier, MD, medical director of the Physician Resource Office, wants doctors to know they have a place to come for confidential help. The UAB Health System started the program just a year ago, and Frazier is still trying to get the word out to area physicians that the office exists. She also wants to make clear that the office is open to all physicians, not just UAB employees. “This office is dedicated to physician health and well being,” she explains. “We see practicing doctors, residents, medical students, dentists and dental students. We also see PhDs and PhD students. We are here for all these people throughout the state; it’s not just a UAB service. We see doctors with things like stress, burnout, depression, maybe even substance abuse or malpractice stress. Anything that we can help a physician or physician-in-training with, that’s what we’re designed to do. We offer counseling here, or if they prefer to see another counselor in the area, we have a network of therapists who work well with professionals, and we can refer them to an outside source. “Joint Commission really stresses addressing physicians’ health,” she continues. “It also stresses how important patient safety is. If your caretaker is not healthy, it’s a patient safety issue. The UAB Health System, as the training center for doctors, decided this would be a valuable service for all physicians and physicians-to-be in the state. We offer the service for any professional that needs our service.” She became interested in the issue of physicians’ health several years ago, and when she proposed the idea of this office to the UAB Health System, they agreed the time was right. “It’s important to take care of our caregivers,” she says. “We are dedicated to helping doctors take care of themselves. We encourage doctors to ask for help if they need it. They’ll find someone objective to listen to them here. We understand what it’s like to be a doctor.” Physicians will also find that any services they receive through PRO are completely confidential. “We don’t keep hospital records,” explains Frazier. “I have personal, private notes that I keep in my office. None of this goes into the computer system at UAB. We even have an anonymous billing system so we can’t track who comes to the office.” There are some limits to confidentiality, she cautions. If a client is deemed to be harmful to himself or others, she is obligated to report him to the Alabama Physician’s Health Program, but they don’t report to the board or the licensing agency. And they don’t contact employers without the written permission of the client. Of course, some physicians are referred, and in those cases communication may be necessary with the person who mandated that the physician receive help, but the client signs a form that recommendations are all that will be shared, and they see everything that is sent about their case. Frazier hopes to see doctors before the problem is bad enough for employers to notice. “Some people are mandated to come, but we really are encouraging self-referral,” she says. “We’re trying to get doctors to say, “It’s okay to say I need help,’ and to do it earlier rather than later. Our message is, ‘You’ve chosen a stressful career; there’s going to be times when it’s rocky.’” When a physician comes to the PRO, he or she will first meet with Frazier for an hour or two. Frazier makes recommendations that may range from behavior change to counseling. “I may just say, ‘Here’s a great book to read,’” she says. “I saw a doctor recently that was getting burned out and irritable. People were starting to ask what was wrong with him. He came over and we talked about strategies. I suggested he try some behavior modification, and then let me know how he was doing. I didn’t think he needed therapy. My suggestion may involve counseling; it may involve reading; it may involve exercise. We may suggest some classes the doctor can take.” The key, she stresses, is for doctors to recognize that they may have a problem and to ask for help early. “It’s like anything in this life,” she says. “The earlier you intervene in a problem process, the better the prognosis. All we do is make recommendations. They can take them, or leave them.” She certainly hopes that the doctors will take more of their recommendations than not, however. “This is my passion. I choose to do this because I love it,” she says. “I love seeing people get better.” July 2007