Being a doctor. Being a patient.
I recently heard that one of my friends – a medical resident, had developed pneumonia and had to be admitted to hospital for a week of intravenous antibiotics. She had been working long hours on a stressful rotation and as a result had not been sleeping or eating particularly well. She began to notice a pain in her chest, shortness of breath and hot and cold flushes, but chose to ignore the symptoms. It was only when she had a near collapse that she sought help.
Her story did not surprise me. I myself waited almost ten days before booking an appointment to see a GP for extreme lethargy, progressively worsening moist cough and shortness of breath. When I finally had the appointment, I realized how uncomfortable I felt being the person sitting in the patient’s chair. I did not like waiting 40 minutes in the waiting room for my appointment. I particularly disliked the examination process and having someone else auscultate my chest. The whole experience felt strange and somehow ‘not-quite-right’. I was not used to being in this position. On talking to other medical staff – it was the same. Doctors do not like being patients.
The British Journal of General Practice in 2008 performed a systematic review investigating doctors’ access to health care and the barriers they faced. One of the key barriers to accessing healthcare was: ‘embarrassment’. Davidson and Schattner found that 71% of doctors described themselves as embarrassed when seeing another doctor. While ‘embarrassment’ is a broad term, the studies reviewed described this as:
- general discomfort with the patient role
- concern that the treating doctors might think they were over-reacting to a trivial illness
- concern (embarrassment) that they should not impose upon another doctor’s time, especially if the illness was a trivial one
- discomfort in exposing self to peers personally and emotionally
- feeling like a failure as should be able to cope
- mental health issues
Other barriers listed included lack of time to see a doctor, costs involved, trying to find the ‘right’ doctor to see, confidentiality, fear of loss of control, self-treatment, and inside knowledge into the limitations of the health system. While much needs to be done to overcome many of these barriers, it is reassuring to know that there is now greater awareness about these issues. Health promotion is being taught at the university level to medical students with the emphasis on looking after one’s own physical and mental health and not falling into the thinking patterns listed above – i.e. feeling ‘embarrased’ to seek help. At the hospital level, systems are being established for providing support to stressed and ill doctors. On a national level, programs such as the Beyond Blue Doctor’s mental health program and the General Practice Registrars Australia helpline are now available. It may also be worthwhile establishing a GP database listing GP’s that are willing to care for doctors as patients. With greater awareness of these issues and better support services in place, hopefully doctors can become more comfortable assuming the patient role and taking care of their own health.
Kay M, Clavarino A, Doust J. Doctors as patients: a systematic review of doctors’ health access and the barriers they experience. Br J Gen Pract. 2008 July 1; 58(552): 501–508.