Interventions to improve physicians' well-being and patient care.

Concerns about the quality of medical care provided by health services appear to be increasing. Deficits in care are frequently found to be associated with stress and with the apparent lack of recognition of psychological problems when they occur in doctors. This paper looks briefly at the levels and sources of stress, depression and alcoholism in doctors, and the relationship of these to the care they provide. It goes on to use the research findings on causation to propose a system of organisational and individual primary and secondary interventions to address these psychological problems. The paper focusses upon a longitudinal study which follows up 314 medical students over 11 years, but also uses other relevant recent literature to discuss the issues that arise.