Sources of Support and Advice
Where to start? Illness and disability impact on so many different aspects of life. Two doctors with the same illness or disability may have wildly diverse needs. The needs of a new lower limb amputee may be considerably different to those of a person who has been a lifelong wheelchair user. Needs also vary with time, and are dependent, amongst others, on an individual’s stage of life; personal support network; stage of training or employment and financial circumstances. Try not to make assumptions, and don’t allow others to transfer their own assumptions and preconceptions to your situation. Don’t be afraid to voice your opinions, concerns, frustrations…… and be prepared to continually re-evaluate with your changing circumstances.
This may all seem very daunting and isolating. Attempting to address all areas of difficulty at once is a bewildering prospect, both physically and emotionally.
It would be an impossible task for us to provide an exhaustive list to cover every potential individual circumstance, but here are a few suggestions to get you started.
Whether as a result of an acute accidental injury or lifelong degenerative condition, the realisation that an illness, impairment or disability has implications for life in medical practice is almost inevitably unwelcome.
There is no right or wrong way to react to a diagnosis. So, anger, frustration and feeling confused are normal responses. However, sooner or later, there is the need to start reinstating perspective. It is possible to do this by one’s self, but why re-invent the wheel? Here’s some quick steps for starters. For additional information, have a look at our specific pages.
Information
It’s difficult to tread the line between Doctor and Patient - difficult for yourself and difficult for the team that are treating you. Well rehearsed questions often disappear upon sitting in the patient’s chair. So, our advice is:
- Be inquisitive
- Ask questions
- Make lists
- Trawl Medline / Google…….
- Seek second, third, fourth opinions
- Turn yourself into an expert about your medical condition / impairment
- Use your new found expertise to help yourself plan, and to assist in dealing with uncertainty
Your Relationships
Don’t be surprised if your relationships are tested. Partners, friends, work-colleagues…… everyone else is also trying to construct their own interpretation of the impact of your illness / disability.
Helplines, Charitable Organisations & Self-help Groups
Help lines may be of use for a number of reasons:
- Sometimes it’s helpful to have the experiences / support / advice of a completely independent person.
- Some find it easier to talk to a complete stranger, rather than “burden” their partner / friends / colleagues with their worries.
Don’t forget the tried-and-tested national sources of support. For information gathering purposes, consider both medicine-specific and disease/impairment-specific organisations. Different organisations can help answer different types of questions, and can have widely differing perspectives and approaches to tackling challenges.
Self-help organisations offer the chance for you to communicate with other individuals in a similar position to yourself. Again, some are doctor related; some are orientated towards specific diseases / conditions; some are even specific enough to be medic and disease/impairment related.
Charitable organisations can be foreboding. As always, some are more approachable and more helpful than others. Don’t forget locally based organisations – there is often a more personal manner, tailored more specifically to your individual circumstances, and you may well find a more enthusiastic willingness to help.
If you’re finding information hard to find, consider also trying:
- BMJ Chronic Illness Matching Scheme – there may be fewer people, but there may just be someone going through the same as you.
- If you feel you are being discriminated against, the BMJ has a web-site where you can seek support and comfort.
If at first you don’t get the answers you are looking for, keep trying. Tempting though it is to become disheartened, try not to. Someone, somewhere can help – it’s just finding that right person.
| Organisation | Contact Details |
|---|---|
| Alcoholics Anonymous | Tel: 08457 697 555 |
| Association of Disabled Professionals | Web: www.adp.org.uk |
| Association of Medical Professionals with Hearing Loss | Web: www.amphl.org |
| BMJ Chronic Illness Matching Scheme | Web: www.bmjcareers.com/ chill |
| BMJ – are you being discriminated against? | Web:www.bmjcareers.com/ discrimination |
| British Doctors and Dentists Group | Tel:020 7487 4445 |
| Carers Line | Tel:0808 808 7777 |
| Cruse Bereavement Care | Tel: 0870 167 1677 |
| Deaf Professionals Network | Web:www.deafprofessionals.com |
| DIAL UK (Disability Information and Advice Line) | Tel: 01302 310123 |
| Disabled Living Foundation Helpline |
Tel: 0845
130 9177 Textphone: 020 7432 8009 Web:www.dlf.org.uk |
| Doctors Supportline | Tel:0870 765 0001 |
| Doctors Support Network |
Tel:0870
321 0642 Web:www.dsn.org.uk |
| Drinkline | Tel: 0800 917 8282 |
| Narcotics Anonymous |
Tel:020
7730 0009 Web:www.ukna.org |
| RADAR (Royal Association for Disability and Rehabilitation) |
Tel:
020 7250 3222 Textphone:020 7250 4119 |
| Release (drugs and legal advice for users, families and friends) | Tel:0845 450 0215 |
| RNIB (Royal National Institute for the Blind) |
Tel: 020 7388 1266 Web:www.rnib.org.uk |
| RNID (Royal National Institute for the Deaf) | Web:www.rnid.org.uk |
| Samaritans |
Tel:08457
90 90 90 Web:Samaritans.org |
| Sick Doctors Trust |
Tel:0870
444 5163 Web:www.sick-doctors-trust.co.uk/ |
| Victim Support Line |
Tel:0845
30 30 900 Textphone:020 7896 3776 |
If none of the above seem appropriate, try “The Telephone Helplines Directory”. It contains contact details for all helplines that are members of the Telephone Helplines Association (this is a voluntary membership). Directories can be viewed at local libraries or on-line at www.helplines.org.uk
Counselling Services
Just a hunch, but as a medic, I’d suspect you are a highly motivated and independent individual who is disconcerted with the thought of asking someone else for help. Don’t be.
Your GP can arrange counselling on your behalf – however, there is often a considerable wait.
- If you choose to seek support independently, you may wish to contact ‘The UK Council for Psychotherapy’ or ‘UK Register of Counsellors’. Their members are professionally qualified, and either organisation can provide contact details of practitioners local to you.
- If you prefer not to meet face-to-face, try the BMA Counselling Service.
| Organisation | Contact Details |
|---|---|
| BMA Counselling Service |
Tel:0645
200 169 Web:www.bma.org.uk |
| National Counselling Service for Sick Doctors |
Tel:0870
241 0535 Web:www.ncssd.org.uk |
| The UK Council for Psychotherapy |
Tel:020
7436 3002 Web:www.UKCP.org.uk |
| UK Register of Counsellors |
Tel:0870
443 5232 Fax:0870 443 5161 |
For doctors in training, employment and training are inextricably linked, and many issues overlap both fields. To achieve specific post-grad qualifications, specific jobs are required, desired and sought – even if the link between that “must-have” job and your end-career post are tenuous.
Training
You may discover that the combination of your particular impairment / illness plus a career in Medicine had not been considered possible by Deaneries / Professional Bodies. This does not necessarily mean that it is not possible – only that no one has thought about it before. It does mean that it will be up to you to prove that your combination of disability and career choice is viable – if you wish to accept that challenge.
Research
- Identify your interests, abilities and aspirations
- Identify the training / job requirements
- Do you meet the criteria already?
- Could you meet the criteria?
- Could you meet the criteria if reasonable adjustments were in place?
Be pro-active - bite the bullet and construct a list of potential difficulties that you can envisage – anything you can think of. It isn’t a pleasant task, but if you’ve already addressed the issue, no-one can surprise you with a “problem”. Some examples:
- travelling to work
- physical barriers to mobilising safely around the building
- difficulty with manual dexterity required for a practical procedure
- difficulty with using standard computer equipment…….
Challenge your own preconceptions. Are the difficulties on your list actual? Or, having exposed yourself to a difficulty, did you find that it wasn’t a problem after all?
Devise your own solutions to your difficulties:
- Is working from home feasible?
- Can someone give you a lift to work?
- Is public transport an option?
- Can Access to Work (see below) assist?
- Are there alternative easier routes that are accessible and appropriate?
- Could barriers be removed with installation of ramps / handrails / lifts vs. stairs / effective lighting ……
- Do you need to use the specific equipment that is causing difficulty?
- Are there alternative methods to perform the procedure using different equipment?
- Would an assistant be helpful?
- Do you have to perform the procedure?
- Could IT adaptations be useful? – flat screen monitors enhance clarity; specific software eg. screen magnification or speech output software; ergonomic keyboard / mouse ……
It’s far easier for a Deanery, Trust or Royal College to say “yes” to a coherent plan if you have spent the considerable time and effort answering all of their questions before they have even thought of them.
Deanery
There should be advice and support available here. Some Deaneries are beginning to appoint specific members of staff, but with the increasing numbers of medical students with disabilities entering the profession, this is an area that will have to expand.
Standard training programmes may not be appropriate.
- It may be that certain jobs on a rotation are more difficult to undertake. It may be necessary to ‘mix-and-match’ jobs on an individual basis.
- Flexible training could be considered if full-time work proves difficult.
- Supra-numary positions might be a possibility. This may allow full participation in service and training…. but without the responsibilities of being an essential staff member.
Should a change in career prove preferable, there should be ways and means of negotiating transition to alternative specialities or training.
Royal Colleges
The Royal Colleges are now subject to the Disability Discrimination Act 1995, and as qualification bodies, must therefore ensure that they do not discriminate against disabled doctors.
Each Royal College sets specific entry requirements for post-graduate examinations and specialist training programmes.
You and your appropriate College may wish to negotiate
- Inform the College of your disability / illness / impairment
- Inform the College of the difficulties resulting from your illness / disability
- Provide the College with alternative suggestions:
- Will they sanction an alternative post as contributing towards your training?
- Consider what “special” arrangements would suit you in order for you to undertake examinations? ….. extra time? an amanuensis? large print papers? accessible examination hall?
Identify a specific individual within the College – and stick to them. Phone, e-mail, write……. Be persistent. See our Career Development: Postgraduate Training page for useful contacts.
Your Employer
Your contract
- Find out what you are entitled to in terms of sick-leave : duration, payment – full / half pay……
- Keep in touch
- Provide regular sick-notes
- Inform those that need to know…… the consultant / GP partners with whom you are working; your Deanery; your Occupational Health physician; your own GP; Personnel Department
- It’s disheartening sequentially telling everyone – particularly when there is uncertainty surrounding diagnosis, prognosis, prospects of returning to work etc. – but get it over and done with and try to move onwards and stay positive.
- Beware and be paranoid. Some unscrupulous employers have a tendency to be incredibly unhelpful in the hope that you’ll find everything too much to bare and that their “problem” (i.e. you) will disappear. Hang on in there. Don’t give them the satisfaction.
- Get yourself familiar with the Disability Discrimination Act and The Disability Rights Commission.
- Use them.
Disability Advisor
This is an individual who is employed within an organisation to assess, co-ordinate needs and ensure that disabled employees have every necessary adaptation. Some are employed full-time in this capacity, whilst others (usually in smaller companies) perform the task on a part-time or ad-hoc basis. Sadly, not available everywhere - not even in every NHS Trust.
Try and identify someone within your organisation and enlist their support.
Occupational Health Physician
Be open and honest. Don’t be tempted to paint a picture that is rosier than reality. You are going to need to be able to function in your employee capacity. Don’t bend the truth in order to get back to work earlier than you are actually ready - you’ll have to be able to cope. If the Occupational Health physician doesn’t know everything, they’re not in a position to ensure your safety and wellbeing, nor that of your patients.
Don’t be surprised if you’re a new challenge for the Occupational Health physician, and they may well have little/no experience in dealing chronically ill / disabled doctors.
Don’t be afraid to ask to be referred to someone who does have prior experience in your particular area of need – even if it means going out of area.
Why bother?
- They can co-ordinate on your behalf
- Provide an impartial ear in whose direction you may scream when things are going pear-shaped
- a few well-worded and well-directed letters can make all the difference in ensuring your ability to continue practicing medicine.
Access to Work (AtW)
Access to Work is a UK wide scheme administered via your regional Jobcentre Plus office.
AtW aims to assist individual disabled people to meet the cost of help they require to do a specific job – help that a non-disabled person doing the same job would not need. An Access to Work Advisor will conduct an interview with you and establish the help, support and further specialist assessments that you might need in order to be able to be employed in a specific role. Support is provided on an individual basis.
There is scope for assistance with aids and equipment, personal help, alterations to the physical environment and assistance with transportation.
AtW may require specialist reports from other professionals before agreeing support e.g. someone who specialises in assessing the IT needs of visually impaired individuals.
The percentage funding available from AtW varies according to the total cost of assistance required and whether the client is unemployed, newly appointed, or in longterm employment.
Contact addresses for local offices are available from the Access to Work Website.
Additional Considerations
This is only a briefest of guides to other sources of help and advice:
Social Services
If you become registered disabled, a social worker will be assigned to you.
They can assist:
- ·in establishing whether you are entitled to any benefits
- ·completing application forms
- ·(occasionally – and only if the other party consents) establishing contact with others in a similar position to yourself
Rehabilitation Officers
- Can assist with assessment of the impact of your disability / illness on your daily living.
- Can suggest adaptations that might help.
Occupational Therapy
- Can assist with assessment of the impact of your disability / illness on your daily living.
- Can suggest adaptations that might help.
- ·If adaptations to your home are suggested (and you want to proceed), they can assist with application to your local council for installation of the adaptations
Blue badge scheme
If mobility is difficult, contact your local council to see whether you could benefit from receipt of a Disabled Person’s Car Badge – don’t worry if you don’t drive, the badge follows you and can be used in the car of whomever is driving you.
Utilities
- Contact your suppliers – some provide discounted services to disabled or chronically ill individuals
- Contact your council – you may be entitled to a reduction in Council Tax if you can prove that you require extra rooms in your home as a result of your disability.
Your Finances
Being disabled or chronically ill is not healthy for your bank balance. Being out of work; having your hours (and banding supplements) confined; being unable to undertake locums etc. etc. all take their toll. Then, of course, there are the costs that you have to bare because of your illness or disability – equipment costs, prescription charges, travel costs……. Here are a few considerations:
- Mortgages and insurance policies
- Get them while you can. Harsh, I’m afraid, but true.
- Being chronically ill or disabled can seriously adversely affect your ability to arrange mortgages, life assurance, critical illness cover, and even travel insurance.
- You may find yourself being refused a mortgage or insurance cover, or being charged a premium.
- Be aware of exclusion criteria.
Tax Credits
You may be entitled to tax credits e.g. Blind persons tax allowance.
Benefits
- Statutory Sick Pay
- Incapacity Benefit
- Income Support
- Industrial Injuries
- Disablement Benefit
- Criminal Injuries Compensation
- Disability Living Allowance………
Help with Health Costs
Prescription charges, travel to hospital appointments, sight test, spectacles / contact lenses, wigs etc are all additional costs that can be encountered due to illness or disability. They’re particularly unwelcome when unable to work, and sick-leave payment has ceased.
The leaflet HC11 Help with Health Costs is available from:
- Your local post office
- Some hospital departments
- Or, on-line at www.doh.gov.uk/nhscharges/hc11.htm
If you are not entitled to free prescriptions – consider whether a pre-payment certificate is a better option. Application forms and current charges are obtainable from pharmacies and post offices.
Your optician will be able to inform you if you are entitled to reduced or free sight tests and prescription spectacles or contact lenses.
Additional Sources of Financial Assistance
The Royal Medical Benevolent Fund may be able to provide assistance to doctors and their families where illness, disability or impairment has impinged on income.
| Organisation | Contact Details |
|---|---|
| Benefits Agency Enquiry Line |
Tel:0800
882200 For hearing / speech impaired people: 0800 243355 Web:www.dss.gov.uk |
| Disabled Persons Tax Credit Information Line |
Tel:0845
605 5858 For hearing / speech impaired people: 0845 608 8844 |
| Disability Benefits Unit |
Tel:0845
712 3456 For hearing / speech impaired people: 0845 722 4433 |
| Help with Health Costs | Web:www.doh.gov.uk/ nhscharges/hc11.htm |
| Royal Medical Benevolent Fund (RMBF) |
Tel: 020
8540 9194 Fax: 020 8542 0494 Web: www.rmbf.org |
Try also your local County Council and Citizens Advice Bureau