Physician heal thyself

The prevalence and consequences of stress associated with medical practice have been a subject of research and reflection for at least three decades. Despite enormous advances in medical care over that period, there is no evidence of a decline in the experience of stress or its sequelae among our medical colleagues.

This book is intended, as the name implies, as a self-help guide for practitioners. The authors are well credentialled and well versed in the literature relating to the topic, and the book is set out in a useful and readable format. The first sections deal with an explanation of the traditional stress construct, with remaining sections dealing with prevention and management strategies. These are presented as primary prevention (strategies for stress minimisation in the work environment), secondary prevention (coping strategies for situations in which stress can not be altogether eliminated), and tertiary prevention (stress management strategies for situations where stress is established and adversely affecting the practitioner’s life). The evidence for adverse psychoneuroimmunologic effects of chronic or recurrent stress is reviewed, and the book achieves a balance between behavioural, psychological and physical reasons for individual doctors to manage stress in their lives more effectively.

The academic underpinnings are presented in a clear and integrated style, and the practical strategies, while not new or revolutionary for readers, are a good summary of commonsense principles that medical practitioners routinely prescribe for their patients, but often neglect in their own lives. Although the British authors do not deal particularly with some current local stressors, including the indemnity insurance crisis and medicolegal concerns, the principles espoused are generic and the book is relevant to an Australian audience.

Simon M WillcockLecturer, Department of Academic Medicine Hornsby Hospital, NSW