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The level of performance a person is capable of attaining is dependent on finding the right balance between tension and support. Nowhere is this truer than in medicine, where high performance is expected and can literally be the difference between life and death.

No tension with no support creates a sense of apathy: excessive support alone can create complacency. Without urgency, determination and drive – why get out of bed in the morning?

On the other hand, high tension without adequate support creates high levels of stress, which we know can compromise performance.

In today’s environment, tension is on the rise: most doctors are working in increasingly challenging environments and few experience a proportionate increase in support. But access to support that matches the level of stress in the job is what is needed if we, as doctors, are to maximise our potential and do the best we can for patients.

most doctors are working in increasingly challenging environments and few experience a proportionate increase in support

A year ago we wrote in Casebook about the cause and effect of stress in medicine (“The pressure point”, Casebook 19(3)). The evidence is there to show that being involved in an adverse event, being sued for negligence, or having your professional conduct or competence brought into question is a source of the most severe tension for healthcare professionals. It is also associated with an increased risk of a second or third event. This issue of Casebook features many case reports that reflect these stressful situations.

At MPS we understand how important it is that the support we provide matches the tension caused by these events – it is at the core of what we do.

Dr Stephanie Bown
Editor-in-chief

Disclaimer: All information in this issue is correct at time of publishing (September 2012).