Doctors as patients: postal survey examining consultants and general practitioners adherence to guidelines

Objectives To examine the adherence by senior NHS medical staff to the BMA guidelines on the ethical responsibilities of doctors towards themselves an d their families. Design Postal semistructured questionnaire. Setting Four randomly selected NHS trusts and three local medical committee s in South Thames region. Subjects Consultants and principals in general practice. Main outcome measures Personal use of health services. Results The response rate was 64% (724) for general practitioners and 72% ( 427) for consultants after three mailings. Most (1106, 96%) respondents wer e registered with a general practitioner, although little use was made of t heir services. 159 (26%) general practitioners were registered with a gener al practitioner in their own practice and 80 (11%) admitted to looking afte r members of their family. 73 (24%) consultants would never see their gener al practitioner before obtaining consultant advice. Most consultants and ge neral practitioners admitted to prescribing for themselves and their family . Responses to vignettes for different health problems indicated a general reluctance to take time off, but there were differences between consultants and general practitioners and by sex. Views on improvements needed include d the possibility of a "doctor's doctor," access to out of area secondary c are, an occupational health service for general practitioners, and regular health check ups. Conclusion The guidelines are largely not being followed, perhaps because o f the difficulties of obtaining access to general practitioners outside wor king hours. The occupational health service should be expanded and a genera l practitioner service for NHS staff piloted.