Doctors as patients: postal survey examining consultants and general practitioners adherence to guidelines
Most senior doctors (both general practitioners and consultants) rarely go to see their primary care doctor and for many (over 70 per cent) prescribing for themselves and their families is the norm, according to a study published in this week's BMJ. What is needed to address doctor's health problems, say the authors from the University of Kent, is access to a "doctor's doctor", possibly based in the local hospital, who could also look after other NHS staff and their families; an occupational health service for general practitioners (GPs) and regular health check ups for all doctors.
Professor Malcolm Forsythe and colleagues studied the personal use of health services of over 1150 GPs and consultants in south east England, in accordance with the BMA guidelines on the ethical responsibilities of doctors towards themselves and their families. The study, say the authors, was conducted in the context of a current picture of GPs and senior hospital doctors with high levels of stress, anxiety and depression who take little time off work for illness but who, when they are off work, tend to be off for long periods.
Forsythe et al found that even though most (96 per cent) doctors were registered with a GP they very rarely used their services. The team also found that doctors were very reluctant to take time off work due to illness and that this was particularly true of GPs and female doctors. Despite their findings the authors also report that doctors expressed support of the BMA guidance on their responsibilities to their own health and that of their families.
The authors suggest that one of the reasons doctors are unlikely to consult their own GP is because of difficulties of getting to see them. They also say that with the high levels of psychosocial problems among doctors, visiting their GP or local occupational health service may not be perceived by doctor patients as the appropriate confidential setting for consultation.
Forsythe et al conclude that there is a need for the provision of a dedicated general practitioner service for doctors and their families, as well as an ‘out of area' (ie not within the same workplace) service, particularly for the treatment of psychosocial problems and substance misuse. They say that these changes together with provision of a consultant led occupational service to cover all NHS staff, may improve compliance with the ethical guidelines covering this area.
Contact:
Professor Malcolm Forsythe, Professorial Fellow in Public Health, Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent Email:J.M.Forsythe-2@ukc.ac.uk