What does your doctor do when he or she is sick? Surprisingly, when it comes to their own health, doctors face many of the same struggles their patients do. You would think that because they are acting members of the medical establishment they would have easy access to health insurance, but they don’t. Some might have a group plan available as employees of a large medical association or hospital, but otherwise, doctors are on their own just like every other self-employed adult in the US. In addition, they can face job-related pressures that make them prime candidates for their own crisis intervention.
My friend Dr. H. tells me that stress is an issue at the moment. “The media has been calling it physician burn-out, but I hate that term because it implies that there is something wrong with us quite separate from stresses we’re put under.” The stresses are quite enough unto themselves. Payers (insurance companies), regulators and other interest groups have used the computer to control what doctors can and cannot do, and they’re left trying to make it all work. Doctors contend daily with poorly designed software, poor communication between offices and a health care system under constant fire. Frustrated MDs don’t even know who to complain to. They have no union to protect or support them. But there is a glimmer of hope: “At least the media is beginning to report it and the federal government is making efforts to reduce the burden of computer documentation, albeit too little, too late.”
Working at speed as a doctor is tough. Physicians are required to respond when there is a need, and many of the health issues that would be a minor glitch for a person with a stable job can jeopardize a doctor’s ability to function when they are required to drop everything and run at a moment’s notice. The result of this erratic schedule can be vision problems, accidents and alcohol or mental health issues. An additional problem is that patients don’t stop getting sick and needing medical care when their doctor is down with the flu. Physicians are still, to a degree, responsible for making sure their patients get seen. For those who are part of a big medical system, this is somewhat less of a problem. But doctors with their own practice can’t just call a temp agency and ask them to send someone over – it is their personal responsibility to find a capable replacement. The life of a doctor is not one that everyone comes through unscathed. Dr. H always smiles when he hears about a doctor retiring from practice on his or her own terms in their late 60s: “You made it!!” he thinks.
But isn’t there some advantage for doctors when it comes to getting health care? Dr. H. admits that there are. “We do get sick with everything that everyone else gets, but truthfully, it is a real honor to be able to call your favorite doctor up and get seen quickly.” A down side? “Several times, doctors that I knew treated me, and may have even treated me extra carefully, but they didn’t do what I thought should have been done.” The up side is that having a thorough understanding of what is happening is very comforting when a doctor is facing health issues. Illness can be very frightening for a lay person. Ironically, as doctors get more and more specialized, once they are outside of their own specialities they become effectively in the same position as that of the average patient. And although many doctors allow their closest colleagues to treat them, ethically, physicians are not supposed to treat family members or close friends. It is a fine line to walk, in a profession where maintaining impartiality is essential.
Dr. H realizes that his patients take comfort, the same way he does, in knowing as much about their condition as possible. I asked if some people flipped out when they were told an unpleasant truth; do they really want to know? Dr. H was emphatic. ”EVERYONE wants to know. After years of experience you learn that patients accept bad news better than most would think, especially if the doctor tells the patient what the next step is or what the options are and educates them. If you take the easy way out and don’t tell patients difficult information in a timely manner, and they find out later on that you kept information from them, your credibility is gone. Patients like information, they like the truth; live and learn. Of course, you have to be sensitive when talking about bad news, and that’s where experience helps.”
Can a doctor’s personal experience in health influence the advice that he gives his patients? Dr. H laughed. “Well, they say a patient must drink more than his doc to be considered an alcoholic. So, yes – we all come into caring for patients with our own backgrounds, which definitely colors our decisions … within the guidelines of practice.”
Live and learn.