Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study

Objective To explore general practitioners' perceptions of the effects of their profession and training on their attitudes to illness in themselves and colleagues. Design Qualitative study using focus groups and indepth interviews. Setting Primary care in Northern Ireland. Participants 27 general practitioners, including six recently appointed principals and six who also practised occupational medicine part time. Main outcome measures Participants' views about their own and colleagues' health. Results Participants were concerned about the current level of illness within the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal illness and engaging in health screening. Embarrassment in adopting the role of a patient and concerns about confidentiality also influenced their reactions to personal illness. Doctors' attitudes can impede their access to appropriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrangements of the practice were cited as reasons for working through illness and expecting colleagues to do likewise. Conclusions General practitioners perceive that their professional position and training adversely influence their attitudes to illness in themselves and their colleagues. Organisational changes within general practice, including revalidation, must take account of barriers experienced by general practitioners in accessing health care. Medical education and culture should strive to promote appropriate self care among doctors.