In most cases, looking after palliative care patients is an extremely satisfying experience for the GP, and one which is valued by the patient and their family.
However, sometimes palliative care can be challenging. Issues that may be hard for GPs to deal with include:
- Clinical anxiety, if there is a perception that a diagnosis was missed or delayed
- Difficulty in switching from a curative to palliative approach
- Feelings of reluctance to take on complex problems because of the time constraints of general practice
- Difficulty dealing with clinical uncertainty
- Feelings of clinical helplessness if unable to completely relieve the distress of the patient or family, or feeling that an outcome was unacceptable
- Being involved in caring for a dying friend, colleague, or family member
- Caring for a patient with whom one identifies in some way.
In a busy general practice setting it is common for GPs to “soldier on” despite a level of distress. However, accumulating stressors can lead over time to burnout, which affects the GP's own wellbeing and relationships, their workplace and their colleagues, and may reduce the quality of the care they can provide.
Useful strategies for professional self-care include:
- Recognising that all doctors will sometimes be troubled by difficult cases
- Sharing care with others, or referring on, if there are “boundary issues” or strong feelings involved
- Accepting the limits of the care that can be provided within the constraints of a busy general practice, and not setting unrealistic expectations – sharing care may be helpful here
- Discussing a difficult case with a trusted colleague or a member of the palliative care team – this can be very reassuring, even quite some time later.
Return to GP Home page
This page was created on 26 May 2009 and is due for review in May 2011.*