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Faces of AMA: Dr Mary Wyatt
Promoting the work-health connection
“Why are you a member of AMA?
I do feel that AMA has protected me. I have been able to speak out because I am part of an organisation, I have felt backed by the organisation, for example in the workers’ compensation area, and they have not been backward in coming forward.”
Dr Mary Wyatt has never been one for easy options, or taking the obvious path. She did her remote elective in the highlands of Papua New Guinea, and says that although she had to be careful “it was amazing medicine”.
“It was difficult medicine: malaria, TB, and fairly advanced surgical and obstetric problems.” She relished the experience so much she was able to extend her rotation to three months.
“After graduating I ran away from Victoria. I felt that the big hospital health system was too political and bureaucratic, so I did my training in Darwin.” Dr Wyatt then spent three years overseas in Abu Dhabi, in UAE, and KwaZulu, in South Africa. Dr Wyatt happened upon occupational medicine, and liked it. She had considered surgery, but felt the demands of time – with a young family – would make that impossible. She laughs, “I also had trouble putting on eye makeup so thought perhaps surgery wasn’t right for me!”
Work in an occupational medicine practice combined with study felt manageable. “It is a fascinating field. And I feel that I made absolutely the right choice. I can choose the amount of work I do, it is a very broad field that combines medicine with business and many opportunities to move out of the four walls of the consulting suite.
As occupational physicians we go to a lot of workplaces, see how things work and deal with employers and policy makers. I’ve been to factories to see how beer bottles are made (in large volumes!), how mushrooms are grown, and how Hansard is recorded.”
“When people ask what I do and I tell them I’m an occupational physician they often have no idea what it means. I tell them I am a doctor who specialises in work and health, and the ways that work affects health, and vice versa.” The week is busy with seeing patients, working to influence policy, in workplaces and at a broader system level, and trying to get better quality information to those at the coalface. I talk to CEOs about reducing work and health, and issues such as reducing absenteeism. Occupational physicians also deal with situations such as toxic chemical release – such as mercury or chromium.”
Dr Wyatt is part of a team, which she says is the best team she has ever worked in, steering policy through the Australasian Faculty of Occupational and Environmental (AFOEM). AFOEM has recently released its Position Statement, Realising the health benefits of work. This has been followed up with a Consensus Statement. www.healthbenfitsofwork.org
“I don’t believe that return to work is being dealt with well in many situations. The results are not improving. According to the results of the latest Return to Work Monitor, the national survey on return to work, the help employees say they get is not increasing over time. There has been some improvement in return to work this year, but that seems to be a bounce-back from the problems we saw because of the global financial crisis.
“For employers it is often an issue of cost – some manage their staff well, but for others their way of dealing with their workforce is tough and there is an adversarial approach. If an employee doesn’t get back to work, they will stay on the system for a few years. More often than not, they move off the compensation system, but then into another system. They may have a common law claim, go onto a disability pension, or apply for benefits through their super fund. It is effectively long-term disability.”
“When people ask what I do and I tell them I’m an occupational physician they often have no idea what it means. I tell them I am a doctor who specialises in work and health, and the ways that work affects health, and vice versa.” The week is busy with seeing patients, working to influence policy, in workplaces and at a broader system level, and trying to get better quality information to those at the coalface. I talk to CEOs about reducing work and health, and issues such as reducing absenteeism. Occupational physicians also deal with situations such as toxic chemical release – such as mercury or chromium.”
Dr Wyatt is part of a team, which she says is the best team she has ever worked in, steering policy through the Australasian Faculty of Occupational and Environmental (AFOEM). AFOEM has recently released its Position Statement, Realising the health benefits of work. This has been followed up with a Consensus Statement. www.healthbenfitsofwork.org
“I don’t believe that return to work is being dealt with well in many situations. The results are not improving. According to the results of the latest Return to Work Monitor, the national survey on return to work, the help employees say they get is not increasing over time. There has been some improvement in return to work this year, but that seems to be a bounce-back from the problems we saw because of the global financial crisis.
“For employers it is often an issue of cost – some manage their staff well, but for others their way of dealing with their workforce is tough and there is an adversarial approach. If an employee doesn’t get back to work, they will stay on the system for a few years. More often than not, they move off the compensation system, but then into another system. They may have a common law claim, go onto a disability pension, or apply for benefits through their super fund. It is effectively long-term disability.”
“Peoples’ expectations have changed over the last twenty years. It’s much less acceptable to treat people badly at work; but in general workplaces are way behind where they need to be. If we can change employers understanding, it can help them and their staff. There is now ample evidence that an engaged and happy workforce is more productive. Think of your own experiences.
“As a group, what workers say is that it is their doctor that helps most. Actually, what makes the difference is whether they perceive their employers as having helped them return to work. It is the perception of help or hindrance that matters.”
“In compensation systems there is what we call the ‘toxic dose’. The worker may ring their claims officer twice and not hear back. They may feel they are not respected, just a number, perhaps no-one from the workplace calls either. When these sorts of things happen a few times the worker starts to give up, as many doctors do, because the process is just too hard. Workers suffer isolation and depression when they are off work, and their lives often become inwardly focused and negative.”
Dr Wyatt sees that doctors have a role as advocates for patients, and for systemic change. “Doctors should articulate the issues where possible. If they articulate these then they wouldn’t be pushed aside. The more we can voice the issue, the more we will be heard.”
“We all want to contribute, really, don’t we? This is an opportunity to do that. We are in a fortunate position. If I go into a workplace I have a level of credibility because I am a doctor, so I can influence. I can go in and talk to a managing director and with credibility we are more likely to be able to affect change.”
She urges doctors to rely on their own judgment, to explain their reasoning to patients, and influence them. “Consumerism has changed things, even in medicine; people are now more likely to speak up. The downside to this is that doctors may tend to be more compliant with patient demands. It is a significant issue. They are given more time off than they need, there is a rise in opiate use, doctors are less willing to say ‘this isn’t working’. They may order unnecessary scans, even if there is clinically no reason, because the patient expects there will be investigations. And often this can do more harm than good. Overtreatment is a big issue globally.”
Even for Dr Wyatt, finding the work/health balance is difficult. “It is really very easy to work too hard.” Her best remedy is to escape: to sun, warmth, beaches and fishing.
“But really, I have no regrets. The only other thing I would have loved to have been was a singer, even though I can’t sing!”
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