Self-reported health care over the past 10 years: a survey of general practitioners.

To investigate how and where doctors receive their health care, 275 general practitioners were given a questionnaire about their health care in the previous 10 years; responses were received from 247 doctors (90%). Thirty nine per cent of the subjects were registered with a general practitioner who was independent of them. All but one of the remainder were registered with a practice partner, close friend or relative. Whatever the relationship of the subjects with their own general practitioner, personal health problems were managed to a great extent by themselves. Most (84%) of the medication taken in the previous five years had been self-prescribed and one third of medical investigations had been self-initiated. Over half of the general practitioners studied had seen a specialist about their health in the preceding 10 years; 51% had referred themselves. A 'jury' of seven general practitioners compared the subjects' referrals to a specialist with the care that would be expected for a non-general practitioner patient. Where the jury reached agreement, 68% of referrals were thought to have been appropriate; self-referrals were significantly more likely to be thought inappropriate (P less than 0.05); and self-treatment prior to self-referral to a specialist was considered inappropriate in 78% of cases. The amount of self-prescribed medication and frequency of consultation was the same, whatever relationship the subject held with the general practitioner. This study shows that most general practitioners manage their own health care. The question of whether this is always appropriate is raised and the provision of an occupational health service for general practitioners is discussed.