Two words with many implications – for the doctor undergoing remediation and reintegration AND for the team to which the doctor is returning. Both need care and attention whatever the original reason for the remediation.

Being away from work when it’s not for a holiday, isn’t easy and coming back to work when you have been away for retraining; remediation or because of a suspension is anxiety provoking.

What do I say to my colleagues? How much do they know? What will they ask? What has changed while I’ve been away? How will I re-establish my position with them?

While a doctor is away colleagues are likely to have had to take on extra work to manage their absent colleague’s workload. Depending on the reason the colleague has been absent they may not have spoken to the returning colleague for some time and interactions can be awkward even without previous relationship tensions. So not only is it important for the returning doctor to focus on any facets of clinical practice that may have been found to be in need of improvement but s/he needs to attend to the relationships in the team and the interpersonal dynamics too.

The returning doctor needs to be clear what they will say to their colleagues about their absence – saying nothing isn’t helpful. Unless there is an appropriate degree of openness, rumour and speculation will fill the void. Team members may make the wrong assumptions about their colleague’s absence and this can taint attitudes and dilute the chances of successful reintegration.

The team’s concerns should be heard too – what do they feel about the doctor’s return, what are their views of the relationships between themselves and the doctor and what are their hopes and fears for his/her return?

What accommodations and adjustments will need to be made by the doctor and his/her colleagues? All these issues need careful consideration and “a sink or swim” approach and “just get on with it” isn’t in anyone’s best interests – least of all the patient! Taking account of the facts, feelings and opinions of all concerned in this matter shows due respect and a duty of care for everyone.

by Dr. Megan Joffe