Great Minds: It's time to shift the social contract between doctors and patients

Plus, some good news stories from around NZ [NZ Herald]( [Matt Heath] Matt Heath Happiness Editor Hi {NAME} Welcome to part three of our Great Minds newsletter. Last week, I Zoomed with Occupational Physician Dr David Beaumont as part of a [Herald Premium article]( on doctors and burnout. I wanted to share the interview with you today, along with some feel-good stories and more from our [Great Minds series](. We also sat down with Toni Street to talk about [the inspiration behind her new wellbeing podcast](. The podcast features Kiwis from all walks of life and what they’re doing to achieve their wellbeing goals, from fitness to parenting to mental health. You can [check out the first episodes here](. Dr Beaumont, are New Zealand doctors happy? I don’t think so at the moment. Doctors are not good at looking after their own health. Largely because they’re compassionate and there are huge demands on their time and their expertise. I think they were stretched to breaking point even before the pandemic. Why does it matter from a patient’s perspective if their doctor is happy? There’s clear evidence that happy, healthy doctors give better care to their patients than unhappy, unhealthy doctors. I think what pushes doctors to breaking point is the principle that people expect doctors to fix patients. The system expects that too. So when it doesn’t work, doctors get blamed. We forget the responsibility for our own health rests with us. If a doctor gives treatment for type 2 diabetes and that doesn’t control the diabetes, we should be saying, “what is that person doing to make the lifestyle changes necessary to actually improve that health and how can the system support them to do that”? For doctors, there is unwritten collusion within the system that doctors take full responsibility for people’s health. So you’re saying doctors are expected to fix patients, and that’s not always possible, which is stressful for the doctor? The idea that doctors fix people is built on a false premise. We come to expect to go to a doctor with a huge problem and say “fix me’. Whereas even if I’ve got a chest infection and the doctor prescribes antibiotics, all the antibiotics are doing is supporting my own immune system to heal me. Everything that we do is healing ourselves. All a doctor does is create the circumstances for healing. It’s okay if there is a clear pathological process happening that we can address, but in something like 50 per cent of cases presented there is no overt pathological process, the problem is psychosocial in nature. There is nothing that modern medicine can do to treat it and therefore medically unexplained symptoms, such as chronic pain, chronic fatigue are poorly managed by the system as they take time and they take multidisciplinary processes, which are resource consuming. So people with these conditions do feel let down and often angry. There is a wrong emphasis as far as I’m concerned. So we should go to the doctor looking to work with them on our health? It needs to be a partnership, a collaboration. We have the opportunity in New Zealand to look at the whole healthcare system in a collaborative way. Patients say they want more autonomy. A whole-person approach. I work on a Te Whare Tapa Whā̄ model, which is health in every domain of our lives. Physical, mental health, family and spiritual. I think this should be provided by the system for all of us. So when I work with my clients, I spend time with them working through all four pillars and look at where the gaps are and what they need to do to actually take control of their health. And you weren’t taught to do this as a doctor? I was taught health is the absence of disease. Which is just totally wrong. The absence of a negative doesn’t make a positive. Better to ask how we find the positives to actually make change in people’s lives and health. The modern definition of health is the ability to control our lives. Health is the ability to adapt and self-manage in the face of life’s challenges. It needs to be an empowerment model so that people realise they can take control of their lives. They need the education and the health literacy to do that and that’ exactly where doctors and healthcare should sit in helping people to achieve that. Good News - Uplifting stories from around NZ ['Kan do it': Meet the Kiwi grandfather, almost blind and deaf, who built his own home]( [Meet the Kiwi grandfather, almost blind and deaf, who built his own home]( Herald photojournalist Mike Scott headed to Ngāruawāhia to meet Brian Gubb as part of the Aotearoa Photojournalism Workshop. [Read more >]( [Grit and determination: Whanganui team complete 84km ultramarathon fundraiser]( [Grit and determination: Whanganui team complete 84km ultramarathon fundraiser]( Eighteen weeks after the idea was hatched, five Aerowork Whanganui workers set out from Pipiriki. [Read more >]( [Local Focus: Life lessons from Axel - aged 10]( [10-year-old already a dab hand at fishing - and life lessons]( Axel Goldsbury is helping feed his family using survival skills he learned online. [Read more >]( More from Great Minds [Hamish and Kyle on getting a good night's sleep]( [Hamish and Kyle on getting a good night’s sleep]( Psychotherapist Kyle MacDonald and Nutters Club co-host Hamish Williams talk mental health and navigating the challenging parts of life. [Read more >]( [Debbie Ngarewa-Packer - reconnecting to our roots can help us grow into the best we can be]( [Debbie Ngarewa-Packer - reconnecting to our roots can help us grow into the best we can be]( The uniqueness of Māori means not one methodology can fix our system overnight. [Read more >]( [Bay of Plenty DHB mental health units operating over capacity]( [Bay of Plenty DHB mental health units operating over capacity]( Seclusion areas were used for patients to sleep in in ‘extreme cases’. [Read more >]( [NZ Herald]([NZ Herald]( [Facebook]( [Instagram]( [Twitter]( [NZME] You are receiving this email because you are opted-in receive to NZ Herald updates. To manage your email preferences, [click here](. 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