Physician, Heal Thyself: a Qualitative Study of Physician Health Behaviors

• Published in: Academic psychiatry Vol. 38; no. 1; pp. 19 - 25
• Main Authors: George, Susan, Hanson, Janice, Jackson, Jeffrey L.
• Format: Journal Article
• Language: English
• Published: New York Springer New York 01.02.2014; Springer Nature B.V
• Subjects: Adult; Attitude to Health; Burnout; Coding; Confidentiality; Emergency medical care; Empirical Report; Employment Potential; Fear; Female; Grounded Theory; Guidelines; Health Behavior; Health Services Accessibility - standards; Humans; Interrater Reliability; Interviews; Male; Medical Education; Medical records; Medical Services; Medicine; Medicine & Public Health; Mental Health; Narcotics; Pain; Patients; Physicians; Physicians - psychology; Preventive medicine; Psychiatry; Qualitative Research; Semi Structured Interviews; Sexually Transmitted Diseases; Structured Interviews; Substance Abuse; Surgery; Teaching Methods; Transcripts (Written Records); Self-care; Physicians; Barriers to care
• ISSN: 1042-9670; 1545-7230
• DOI: 10.1007/s40596-013-0014-6

Objective The authors explore how physicians perceive their own health and barriers to healthcare, as well as what might motivate their behavior. Methods This qualitative study uses semi-structured interviews of a purposive sampling of physicians, both staff and housestaff, from Walter Reed Army Medical Center and the Medical College of Wisconsin. Transcripts of interviews that probed attitudes and behaviors towards self-care were coded independently by two reviewers using grounded theory qualitative methods. Results The authors conducted 28 interviews until no new themes emerged. Common barriers to healthcare included inadequate time, fear of consequences, and concern about confidentiality, particularly for stigmatizing diseases identified as mental health problems, chronic pain, substance abuse, and sexual dysfunction. Common behaviors included neglecting one's health, minimizing symptoms, self-diagnosing, and a strong desire not to burden colleagues. Participants were split into those who felt it was fine to self-medicate and others who avoided it. Participants proposed solutions for identified problems, including building time into schedules for self-care, monitoring electronic medical record access to make providers accountable, obtaining care at other institutions, and working to change the culture around healthcare for physicians. Conclusions All participants in this study perceived significant unresolved issues pertaining to self-care. Physicians commonly neglect their own care and experience barriers to care, some self-generated and some systems based. The results and suggested interventions provide fodder for future research.