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 t heir profession and training on their attitudes to illness in themselves an d colleagues. Design Qualitative study using focus groups and indepth interviews. Setting Primary care in Northern Ireland. Participants 27 general practitioners, including six recently appointed pri ncipals and six who also practised occupational medicine part time. Main outcome measures Participants' views about their own and colleagues' h ealth. Results Participants were concerned about the current level of illness with in the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal ill ness and engaging in health screening. Embarrassment in adopting the role o f a patient and concerns about confidentiality also influenced their reacti ons to personal illness. Doctors' attitudes can impede their access to appr opriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrang ements of the practice were cited as reasons for working through illness an d 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, inclu ding revalidation, must take account of barriers experienced by general pra ctitioners in accessing health care. Medical education and culture should s trive to promote appropriate self care among doctors.