Doctors as second victims<\/p>\n
Fortunately, this concept of\u00a0\u2018second victims\u2019<\/a> as ‘healthcare providers involved in an unanticipated adverse patient event, medical error or patient related injury…[who become]…traumatized by the event\u2019 is now fairly well-researched and understood. Such research does not detract from the primary victims \u2014 the patients and their families \u2014 but bolsters the health system and the care we provide.\u00a0Distressed and unwell doctors<\/a> are not functioning at their best; and their suffering alone is enough justification for action.\u00a0<\/p>\n Staff peer support programs<\/a> offer a systemic solution, having their origins in\u00a0vanguard organisations<\/a> in the US. These early programs now have evidence of\u00a0improved emotional state<\/a> and\u00a0return-to-work outcomes<\/a>. Such programs have spread globally, and increasingly we are seeing them here in Australia and New Zealand. Based on\u00a0early research<\/a>, staff peer support provides an extra intervention between the informal support we provide each other, and the professional support provided by trained mental health clinicians. Embedded within\u00a0Restorative and Just Culture principles<\/a>, operationalised staff peer support reminds us that many people are harmed in adverse events, and aims to heal those harms without blame or retribution.<\/p>\n Staff peer support programs have shown evidence of\u00a0improved emotional state and\u00a0return-to-work outcomes (PeopleImages \/ Shutterstock).<\/p>\n Colleague care<\/p>\n Colleague Care<\/a> is our Sydney Local Health District all-staff peer support program, open to all thirteen thousand staff in our District in recognition that it is not just doctors or even just clinicians who are impacted by adverse events. This program, piloted briefly before COVID-19 but now running sustainably since 2022, is only possible due to the dedicated funding of a doctor wellbeing team, MDOK (Medical Doctor OK). Resourcing such a team ensures that wellbeing initiatives, often driven by enthusiastic and committed staff, remain sustainable in the long-term, rather than faltering when individual clinicians move on.<\/p>\n Colleague Care models itself on\u00a0common principles<\/a> found across staff peer support programs nationally and internationally. Our scope is to support staff after adverse events, which can range from near misses, medication errors and difficult CERS responses, to sentinal events, unexpected deaths, staff injury and legal matters. We train trusted and experienced staff to become \u2018peer responders\u2019. Any staff member can access the program without a referral, finding details on the intranet and reaching out to peer responders directly. The interaction is non-clinical \u2014 it is two colleagues spending time together, a ‘friendly ear’, sharing of lived experiences of adverse events, and what might be helpful to move on, including linking to other services.\u00a0<\/p>\n Confidentiality and trust in the program has been essential, and the program sits within the wellbeing team, separate from clinical governance, line management and human resources. Whilst de-identified data is collected, no notes or records are kept of people accessing the program. Running on fractional staffing, we are fortunate to have a coalition of exceptional humans supporting the program in addition to their usual roles \u2014 medical educators providing the training, psychologists supervising our peers, and of course, our generous peer responders, many of whom have had a negative experience themselves in an adverse event, and wish only to prevent this for others.<\/p>\n A growing uptake in Colleague Care<\/p>\n Programs like this take time to build\u00a0trust and awareness<\/a>, and we have seen over the past three years a slow but growing uptake. We know that approximately 31% of our program use comes from doctors \u2014 a close match to their workforce proportion, and a sign of the program\u2019s acceptability.\u00a0Current data<\/a> shows the most common reason for doctors to use the program is legal reasons (52%), followed by other serious events (\u2018Harm-score 1 or 2\u2019) (18%) and patient complaints (9%). The number of catch-ups can vary, but with a median of two, for just over an hour total, one can imagine two cups of coffee; the first to debrief the shock of the incident, and the second to prepare or debrief for the investigation process. Hearteningly, over 70% of staff who utilise the program go on to access other supports, with unions, defence organisations, legal teams, and private mental health clinicians or GPs being the most common. Unsurprisingly, doctors are less likely to access other supports compared to peers.<\/p>\n Staff peer support programs function as more than just a formalised buddy system. They complement rather than replace other supports. They allow a conversation about what can go wrong in healthcare, reminding colleagues they are not alone when it does happen. As much as we should try to avoid adverse events, we need to normalise that these things will happen. Such programs skill us to check in with our impacted colleagues, rather than being complicit in their isolation through silence.\u00a0<\/p>\n As hospitals have rightly allocated resources and time to investigating and avoiding adverse events, hopefully a new paradigm further brings systemic support for the doctors and other clinicians impacted as well.<\/p>\n Dr Sarah Michael is the Director of Psychological Wellbeing with the MDOK Program<\/p>\n The Every Doctor, Every Setting (EDES) Framework<\/a> and Action Plan<\/a> are Australia\u2019s national approach to strengthening the health, wellbeing, and psychosocial safety of doctors and medical students across all career stages and work settings.<\/p>\n Led by the National Doctors Health and Wellbeing Leadership Alliance (NLA)<\/a>, EDES provides both a shared framework and a practical action plan to drive change at individual, organisational, and system levels. \u00a0Since 2023, EDES has been supporting the medical sector to move from commitment to implementation though leadership, practical tools and real work examples.<\/p>\n The EDES Insight+ Series highlights initiatives that align with the EDES showcasing how organisations and individuals are translating EDES priorities into meaningful, on the ground action across diverse medical settings.<\/p>\n To learn more about the EDES Framework and Action Plan, or to explore how your work aligns with EDES, visit www.everydoctoreverysetting.org.au<\/a>.<\/p>\n This program is funded by the Australian Government Department of Health, Disability and Ageing.<\/p>\n The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the\u00a0MJA\u00a0or\u00a0InSight+\u00a0unless so stated.\u00a0<\/p>\n Subscribe to the free\u00a0InSight+\u00a0weekly newsletter\u00a0here<\/a>. It is available to all readers, not just registered medical practitioners.\u00a0<\/p>\n![\"2519117943\"](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2026\/05\/2519117943.png\")
<\/p>\n![\"](\"https:\/\/cdn.craft.cloud\/019da4e9-f79c-70fd-9f88-624918b9686f\/assets\/EDES_Aigns_with_badge_navy-1024x1024.avif\"){kind=icon}
<\/p>\n