Mears et al (Psychiatric Bulletin, July 2004, 28, 251-253) advocate that consultants should work in ‘progressive roles’ in order to combat occupational stress. This role includes a low accumulation of patients from other members of the multidisciplinary team, scope for delegation, time to respond to emergencies, taking a low level of direct referrals, and feeling support from and reliance upon other team members. Consultants working in such a role are more positive and less stressed.
However, there is nothing in the methodology to indicate that the numbers of supporting team members were considered in the analysis. Surely, all of the above factors may relate pretty directly to the number and quality of other members of one's team, and without sufficient multidisciplinary colleagues it is rather difficult to envisage consultants surviving in the suggested ‘progressive’ role. In the absence of such data, and of any consideration of team sizes, the paper's recommendations appear fairly vacuous.
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