Interventions to improve physicians' well-being and patient care

Concerns about the quality of medical care provided by health services appe ar to be increasing. Deficits in care are frequently found to be associated with stress and with the apparent lack of recognition of psychological pro blems when they occur in doctors. This paper looks briefly at the levels an d sources of stress, depression and alcoholism in doctors, and the relation ship of these to the care they provide. It goes on to use the research find ings on causation to propose a system of organisational and individual prim ary and secondary interventions to address these psychological problems. Th e paper focusses upon a longitudinal study which follows up 314 medical stu dents over 11 years, but also uses other relevant recent literature to disc uss the issues that arise. (C) 2000 Elsevier Science Ltd. All rights reserv ed.