R Tyssen1. 1. Institutt for medisinske atferdsfag Universitetet i Oslo Postboks 1111 Blindern 0317 Oslo. reidar.tyssen@basalmed.uio.no
Abstract
BACKGROUND: Though there are several narratives written by doctors who have experienced personal illness and a troublesome patient-role, few have described the particular problems for the doctor who meets a patient who is also a colleague. MATERIAL AND METHODS: Relevant literature that describes this particular doctor-patient relationship is reviewed. RESULTS: Psychological factors that obstruct the doctor's role are often caused by negative counter-transference reactions. Feelings of inferior professional competence, over-identification, and being too sociable are some pitfalls for the caring doctor. Organisational obstacles are "corridor consultations" and deficiencies in occupational health services and primary health care services for patients who are physicians themselves. They are often treated differently from other patients when admitted to hospital. Doctor-patients tend to deny their own symptoms and to be shameful and reluctant to accept the role of patient. They often have fears about confidentiality and may diagnose themselves and also self-prescribe. This may lead to deficient care-seeking. Some practical advice concerning taking care of doctor-patients is given. INTERPRETATION: Doctor-patients should be met in the same way as other patients, but all medical students and doctors should be aware of the particular obstacles and pitfalls in this special doctor-patient relationship.
BACKGROUND: Though there are several narratives written by doctors who have experienced personal illness and a troublesome patient-role, few have described the particular problems for the doctor who meets a patient who is also a colleague. MATERIAL AND METHODS: Relevant literature that describes this particular doctor-patient relationship is reviewed. RESULTS: Psychological factors that obstruct the doctor's role are often caused by negative counter-transference reactions. Feelings of inferior professional competence, over-identification, and being too sociable are some pitfalls for the caring doctor. Organisational obstacles are "corridor consultations" and deficiencies in occupational health services and primary health care services for patients who are physicians themselves. They are often treated differently from other patients when admitted to hospital. Doctor-patients tend to deny their own symptoms and to be shameful and reluctant to accept the role of patient. They often have fears about confidentiality and may diagnose themselves and also self-prescribe. This may lead to deficient care-seeking. Some practical advice concerning taking care of doctor-patients is given. INTERPRETATION: Doctor-patients should be met in the same way as other patients, but all medical students and doctors should be aware of the particular obstacles and pitfalls in this special doctor-patient relationship.