1. Resilience Barnsley VTS Trainers’ Workshop 18 March 2015

2. Why is ‘Resilience’ needed?

3. Dodgy raw material According to the RCGP, the personality of doctors is characterised by: Compulsivity Perfectionism Self-criticism

4. Many are already nuts GPs who feel themselves ‘stressed’– 48% Hospital Anxiety & Depression (HAD) scale: Anxiety, borderline or worse– 55% Depression, borderline or worse– 27% GP suicide (SMR)162 (M) 193 (F) Wives of GPs 400 GPs who have sought help because of work-related stress – 22%

5. Is Anxiety Inevitable in General Practice?

6. Very probably: Uncertainty Professional duty vs. demands (& life/work conflict) Vulnerable patients Juggling the ‘Stakeholders’ Was the NHS ever not in crisis?

7. Coping with Uncertainty

8. Sources of Uncertainty: Priorities Diagnosis Management Review GP factors Structural factors ‘How am I driving?’ - isolation

9. How we work Hypothetico-deductive problem solving, ‘guess and test’ Uncertainty of evidence Too much and too little evidence Uncertainty of biology, ‘Cartesian dualism’

10. Key points Uncertainty is inevitable in medical practice, and particularly in general practice Uncertainty generates anxiety Strategies to combat anxiety you might use in your patients also apply to you

11. Take-home message (it’s not all doom and gloom) Your ability to cope with uncertainty will improve with: time, experience, arrogance.