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Vries C, Flurey CA. 'Do I cry or just carry on': A story completion study of healthcare professionals' anticipated responses to experiencing chest pain. J Health Psychol 2024:13591053231221400. [PMID: 38282370 DOI: 10.1177/13591053231221400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Healthcare professionals may experience barriers to seeking healthcare that differ from the general population. We explored healthcare professionals' anticipated responses to experiencing chest pain following a period of stress using qualitative story completion method with healthcare professionals (n = 44). Data were analysed using reflexive thematic analysis, which identified three themes: '"Do I cry or just carry on?": A Culture of Suffering in Silence' identified worries that expressing health concerns would be perceived as weakness, with potential impact on career opportunities. Participants also described self-diagnosis and self-medication rather than help-seeking. '"Me? Have a panic attack?": Psychosomatic Shame' suggested mental health issues may be ignored due to stigma. '"We definitely don't take care of ourselves": Prioritising Pressures of Multiple Responsibilities over Self-care' identified real or perceived pressures to de-prioritise their health. Future research should explore the design of confidential, time efficient support for healthcare professionals that tackle cultural norms and barriers to self-care.
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Mark Anderson D, Diris R, Montizaan R, Rees DI. The effects of becoming a physician on prescription drug use and mental health treatment. JOURNAL OF HEALTH ECONOMICS 2023; 91:102774. [PMID: 37451143 DOI: 10.1016/j.jhealeco.2023.102774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 05/16/2023] [Accepted: 05/26/2023] [Indexed: 07/18/2023]
Abstract
There is evidence that physicians disproportionately suffer from substance use disorder and mental health problems. It is not clear, however, whether these phenomena are causal. We use data on Dutch medical school applicants to examine the effects of becoming a physician on prescription drug use and the receipt of treatment from a mental health facility. Leveraging variation from lottery outcomes that determine admission into medical schools, we find that becoming a physician increases the use of antidepressants, anxiolytics, opioids, and sedatives. Increases in the use of antidepressants, anxiolytics, and sedatives are larger among female physicians than among their male counterparts.
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Affiliation(s)
- D Mark Anderson
- Department of Agricultural Economics and Economics, Montana State University, NBER, United States; IZA - Institute of Labor Economics, Bonn, Germany.
| | - Ron Diris
- Department of Economics, Leiden University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Raymond Montizaan
- Research Centre for Education and the Labour Market, Maastricht University, the Netherlands; IZA - Institute of Labor Economics, Bonn, Germany
| | - Daniel I Rees
- Department of Economics, Universidad Carlos III de Madrid, Spain
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Jonsson P, Christiansen F, Brulin E. The association between self-treatment and mental health among Swedish physicians. Occup Med (Lond) 2023; 73:243-248. [PMID: 37210591 PMCID: PMC10292679 DOI: 10.1093/occmed/kqad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Despite a high prevalence of mental health problems among physicians, the rate of help-seeking behaviour is low. Instead, physicians tend to self-treat. This can have a negative impact on individual physicians and society. AIMS The aim was to explore the relationship between self-rated depression, the use of psychotropic medication, and the extent of self-treatment across gender and hierarchical position among Swedish physicians. In addition, the aim was to investigate whether social support can buffer against self-treatment. METHODS This study draws on data from the Longitudinal Occupational Health for Health Care in Sweden 2021 study, comprising a representative sample of physicians. Descriptive statistics and logistic regressions were carried out. RESULTS The present study showed that approximately 60% of the physicians using narcotic or non-narcotic psychotropic medication were self-prescribing. Male and more senior physicians self-treated to a greater extent. Physicians without depression were self-treating to a greater extent than those with depression. Those who used non-narcotic psychotropic medication intermittently were more likely to self-treat than those who used these medications regularly. The frequency of use was insignificant in relation to self-treatment with narcotic psychotropic medication. No buffering effect from social support at work was found. CONCLUSIONS Self-treatment was common among physicians in Sweden, particularly among those who reported mild or no symptoms of depression. This may have negative long-term effects on an individual level and for Swedish health care at large.
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Affiliation(s)
- P Jonsson
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
| | - F Christiansen
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
| | - E Brulin
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet, Stockholm 113 65, Sweden
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Doctors' experience of becoming patients and its influence on their medical practice: A literature review. Explore (NY) 2019; 16:145-151. [PMID: 31843394 DOI: 10.1016/j.explore.2019.10.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/14/2019] [Accepted: 10/20/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Doctors' illness experiences can deeply influence not only their perceptions of illness and roles but also their medical practice. Researchers and doctors have sought to understand what happens when doctors become patients. However, currently, literature reviews focused exclusively on their illness experiences are lacking. This review examines academic literature and combines it with illness narratives (i.e., pathographies) written by doctors to elucidate the unknown about doctors' experiences and its subsequent influence on medical practice. METHODS An electronic search of the databases Academic Search Complete, Google Scholar, PubMed, ProQuest, and Ichushi-Web was conducted using relevant keywords. The literature reviewed included studies that described doctors' illness experiences or doctors' perspectives on their experiences of being patients. RESULTS Previous studies showed that doctors' disease prognoses are generally better than or similar to those of patients belonging to the general population. However, doctors' documented illness experiences are multi-dimensional and have several common themes. These include the concept of the 'medical self' (behaving as a doctor despite being a patient) and 'role reversal' (the doctor adjusting to the patient role). The other elements of their experiences include barriers to health care, self-treatment and self-doctoring, presenteeism, and 'wounded healers' (those who can heal others using the wisdom from their illness experiences). Most previous literature has omitted the sociocultural and historical dispositions of doctors and their biomedical perspectives of their own afflictions, even though these strongly impact their illness experiences. CONCLUSION Further research that re-contextualises the meaning of illness for doctors is necessary.
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Work and mental health in doctors: A short review of Norwegian studies. Porto Biomed J 2019; 4:e50. [PMID: 31893247 PMCID: PMC6924981 DOI: 10.1097/j.pbj.0000000000000050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/08/2019] [Indexed: 12/02/2022] Open
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Mahmood JI, Støen Grotmol K, Tesli M, Vaglum P, Tyssen R. Contextual Factors and Mental Distress as Possible Predictors of Hazardous Drinking in Norwegian Medical Doctors: A 15-Year Longitudinal, Nationwide Study. Eur Addict Res 2017; 23:19-27. [PMID: 27832645 DOI: 10.1159/000452442] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 10/09/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND We have previously identified long-term individual predictors of hazardous drinking in doctors, but longitudinal studies on contextual factors (work and life stress) and mental distress being independently linked to hazardous drinking over the first 15 years of a medical career are lacking. METHODS Two nationwide cohorts of Norwegian doctors (n = 1,052) from all 4 Norwegian universities were surveyed in their final year of medical school (1993/1994 and 1999) (T1), and 4 (T2), 10 (T3), and 15 (T4) years later. Hazardous drinking was measured using a validated 9-item version of the Alcohol Use Disorder Identification Test. Work-related and other predictors were analysed using generalized estimating equations. RESULTS Ninety percent (947/1,052) responded at least once, and 42% (450/1,052) responded at all 4 time points. Hazardous drinking was reported by 16% at T1, 14% at T2 and T3, and 15% at T4. Life events (p = 0.009) and mental distress (p = 0.002) were adjusted predictors of hazardous drinking, in addition to male gender, no religious activity, drinking to cope with tension, and low conscientiousness. CONCLUSIONS Doctors' work-related stress was not linked to hazardous drinking, but life events, mental distress, and drinking to cope were. Prevention should target mental distress and drinking to cope with tension.
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Affiliation(s)
- Javed Iqbal Mahmood
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Chiou SJ, Kung PT, Naessens JM, Huang KH, Chang YC, Wang YH, Tsai WC. Do physicians with diabetes have differences in dialysis use and survival than other patients with diabetes. Diabetes Res Clin Pract 2014; 105:382-90. [PMID: 25088403 DOI: 10.1016/j.diabres.2014.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/10/2014] [Accepted: 07/05/2014] [Indexed: 11/24/2022]
Abstract
AIMS To assess whether the increased knowledge and resources available to physicians led to differences in dialysis and survival rates between physicians and non-physician patients with diabetes. METHODS All newly diagnosed (1997-2009) type 2 diabetes patients aged ≥35 years from the National Health Insurance Program of Taiwan database were included. After propensity score matching (1:10), we estimated the relative risk of dialysis and death using Cox proportional hazards model adjusted for demographic characteristics and comorbidities. RESULTS Physicians with diabetes were more likely to start dialysis than general patients, with a 48% increased hazard risk (HR) (P=0.006). Physicians with diabetes had significantly lower risk of death (HR: 0.88; P=0.025). However, those requiring dialysis had a non-significant increased risk of death (HR: 1.19). There was an increased HR for death in older physicians (HR: 1.81; P<0.001) and those with cancer or catastrophic illness. The HR of dialysis (7.89; P<0.0001) increased dramatically with increasing Charlson Comorbidity Index scores. CONCLUSIONS Physicians with DM survived longer than other patients with diabetes, likely benefiting from their professional resources in disease control and prevention. Nonetheless, they displayed no advantage from their medical backgrounds compared with the general patients if they developed end stage renal disease.
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Affiliation(s)
- Shang-Jyh Chiou
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, No. 89, Nei-Chiang Street, Taipei 10845, Taiwan, ROC; Department of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, ROC
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, ROC
| | - James M Naessens
- Division of Health Care Policy and Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, United States
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC
| | - Yu-Chia Chang
- Department of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung 41354, Taiwan, ROC
| | - Yueh-Hsin Wang
- Department of Health Services Administration, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC
| | - Wen-Chen Tsai
- Department of Health Services Administration, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC.
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Braquehais MD, Lusilla P, Bel MJ, Navarro MC, Nasillo V, Díaz A, Valero S, Padrós J, Bruguera E, Casas M. Dual diagnosis among physicians: a clinical perspective. J Dual Diagn 2014; 10:148-55. [PMID: 25392289 DOI: 10.1080/15504263.2014.929331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Co-occurrence of mental disorders and substance use disorders (dual diagnosis) among doctors is a cause of serious concern due to its negative personal, professional, and social consequences. This work provides an overview of the prevalence of dual diagnosis among physicians, suggests a clinical etiological model to explain the development of dual diagnosis in doctors, and recommends some treatment strategies specifically for doctors. The most common presentation of dual diagnosis among doctors is the combination of alcohol use disorders and affective disorders. There are also high rates of self-medication with benzodiazepines, legal opiates, and amphetamines compared to the general population, and cannabis use disorders are increasing, mainly in young doctors. The prevalence of nicotine dependence varies from one country to another depending on the nature of public health policies. Emergency medicine physicians, psychiatrists, and anaesthesiologists are at higher risk for developing a substance use disorder compared with other doctors, perhaps because of their knowledge of and access to certain legal drugs. Two main pathways may lead doctors toward dual diagnosis: (a) the use of substances (often alcohol or self-prescribed drugs) as an unhealthy strategy to cope with their emotional or mental distress and (b) the use of substances for recreational or other purposes. In both cases, doctors tend to delay seeking help once a problem has been established, often for many years. Denial, minimization, and rationalization are common defense mechanisms, maybe because of the social stigma associated with mental or substance use disorders, the risk of losing employment/medical license, and a professional culture of perfectionism and denial of emotional needs or failures. Personal vulnerability interacts with these factors to increase the risk of a dual diagnosis developing in some individuals. When doctors with substance use disorders accept treatment in programs specifically designed for them (Physicians' Health Programs), they show better outcomes than the general population. However, physicians with dual diagnosis have more psychological distress and worse clinical prognosis than those with substance use disorders only. Future studies should contribute to a better comprehension of the risk and protective factors and the evidence-based treatment strategies for doctors with dual diagnosis.
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Affiliation(s)
- María Dolores Braquehais
- a Integral Care Program for Sick Doctors, Galatea Clinic, Galatea Foundation , Col·legi Oficial de Metges de Barcelona , Barcelona , Spain
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Montgomery AJ, Bradley C, Rochfort A, Panagopoulou E. A review of self-medication in physicians and medical students. Occup Med (Lond) 2011; 61:490-7. [PMID: 21727179 DOI: 10.1093/occmed/kqr098] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a culture within medicine that doctors do not expect themselves or their colleagues to be sick. Thus, the associated complexities of self-diagnosis, self-referral and self-treatment among physicians are significant and may have repercussions for both their own health and, by implication, for the quality of care delivered to patients. AIMS To collate what is known about the self-treatment behaviour of physicians and medical students. METHODS The following databases were searched: PubMed, PsychInfo, EBSCO, Medline, BioMed central and Science Direct. Inclusion criteria specified research assessing self-treatment and self-medicating of prescription drugs among physicians and/or medical students. Only peer-reviewed English language empirical studies published between 1990 and 2009 were included. RESULTS Twenty-seven studies were identified that fitted the inclusion criteria. Self-treatment and self-medicating was found to be a significant issue for both physicians and medical students. In 76% of studies, reported self-treatment was >50% (range: 12-99%). Overall, only one of two respondents was registered with a general practitioner or primary care physician (mean = 56%, range = 21-96). Deeper analysis of studies revealed that physicians believed it was appropriate to self-treat both acute and chronic conditions and that informal care paths were common within the medical profession. CONCLUSIONS Self-treatment is strongly embedded within the culture of both physicians and medical students as an accepted way to enhance/buffer work performance. The authors believe that these complex self-directed care behaviours could be regarded as an occupational hazard for the medical profession.
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Affiliation(s)
- A J Montgomery
- Department of Education and Social Policy, University of Macedonia, Egnatia Street 156, Thessaloniki 54006, Greece.
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Margaretten ME, Tierney LM, Dhaliwal G. Clinical problem-solving. A hard diagnosis. N Engl J Med 2009; 361:613-7. [PMID: 19657126 DOI: 10.1056/nejmcps0804137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Mary E Margaretten
- Division of Rheumatology, University of California, San Francisco, San Francisco, CA 94118, USA.
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Chen JY, Tse EYY, Lam TP, Li DKT, Chao DVK, Kwan CW. Doctors' personal health care choices: a cross-sectional survey in a mixed public/private setting. BMC Public Health 2008; 8:183. [PMID: 18505593 PMCID: PMC2429910 DOI: 10.1186/1471-2458-8-183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 05/28/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among Western countries, it has been found that physicians tend to manage their own illnesses and tend not have their own independent family physicians. This is recognized as a significant issue for both physicians and, by extension, the patients under their care, resulting in initiatives seeking to address this. Physicians' personal health care practices in Asia have yet to be documented. METHODS An anonymous cross-sectional postal questionnaire survey was conducted in Hong Kong, China. All 9570 medical practitioners in Hong Kong registered with the Hong Kong Medical Council in 2003 were surveyed. Chi-square tests and logistic regression models were applied. RESULTS There were 4198 respondents to the survey; a response rate of 44%. Two-thirds of respondents took care of themselves when they were last ill, with 62% of these self-medicating with prescription medication. Physicians who were graduates of Hong Kong medical schools, those working in general practice and non-members of the Hong Kong College of Family Physicians were more likely to do so. Physician specialty was found to be the most influential reason in the choice of caregiver by those who had ever consulted another medical practitioner. Only 14% chose consultation with a FM/GP with younger physicians and non-Hong Kong medical graduates having a higher likelihood of doing so. Seventy percent of all respondents believed that having their own personal physician was unnecessary. CONCLUSION Similar to the practice of colleagues in other countries, a large proportion of Hong Kong physicians self-manage their illnesses, take self-obtained prescription drugs and believe they do not need a personal physician. Future strategies to benefit the medical care of Hong Kong physicians will have to take these practices and beliefs into consideration.
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Affiliation(s)
- Julie Y Chen
- Family Medicine Unit, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, PR China
| | - Eileen YY Tse
- Family Medicine Unit, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, PR China
| | - Tai Pong Lam
- Family Medicine Unit, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, PR China
| | - Donald KT Li
- Family Medicine Unit, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, PR China
| | - David VK Chao
- Family Medicine Unit, The University of Hong Kong, 3/F Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, PR China
- Department of Family Medicine and Primary Health Care, United Christian Hospital, G/F, Block G, 130 Hip Wo Street, Kwun Tong, Kowloon, Hong Kong, PR China
| | - Chi Wai Kwan
- Department of Statistics and Actuarial Science, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong, PR China
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Lusilla P, Gual A, Roncero C, Bruguera E, Marcos V, Valero S, Casas M. Dual diagnosis in inpatient physicians: prevalence and clinical characteristics. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/17523280701724189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tyssen R. Health problems and the use of health services among physicians: a review article with particular emphasis on Norwegian studies. INDUSTRIAL HEALTH 2007; 45:599-610. [PMID: 18057803 DOI: 10.2486/indhealth.45.599] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This paper provides an overview of recent Norwegian and international research into physicians' health problems and their use of health services, with a particular focus on more recent studies relating to The Norwegian Physicians' Survey. The review suggests that physicians' physical health is similar to the general population, although female physicians tend to be in better health than other women. Some mental disorders such as depression and suicide appear to be more prevalent. Mental health problems are known to be associated with low work control (autonomy), time pressure and demanding patients. There is little difference between the genders early in their career, but more female than male physicians seem to experience problems later on. Physicians seldom take sick leave, and tend to make less use of primary health care and some screening facilities. Self-treatment is common -- even for mental problems. American impaired physician programmes have demonstrated high recovery rates (70-80%), and increasing emphasis is now being placed on psychiatric diagnoses. As certain mental disorders appear to be common among physicians, specialist psychiatric services should be made more accessible for this group. A low-threshold facility for seeking help with such problems has recently been developed in Norway (the Villa Sana Resource Centre).
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Affiliation(s)
- Reidar Tyssen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Hem E, Stokke G, Tyssen R, Grønvold NT, Vaglum P, Ekeberg Ø. Self-prescribing among young Norwegian doctors: a nine-year follow-up study of a nationwide sample. BMC Med 2005; 3:16. [PMID: 16242034 PMCID: PMC1276798 DOI: 10.1186/1741-7015-3-16] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2005] [Accepted: 10/21/2005] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-prescribing among doctors is common, but no longitudinal studies have documented this issue. We studied the self-prescribing behaviour among young Norwegian physicians and the predictors of self-prescribing. METHODS We conducted a nationwide, prospective and longitudinal study following young Norwegian physicians from internship through the subsequent nine years using three postal questionnaires. Chi-square tests and logistic regression models were applied. RESULTS About 54% of the physicians in their fourth and ninth postgraduate years had self-prescribed medication at least once during the previous year. Among those who had used prescription medication during the previous year, about 90% had self-prescribed. Self-prescribing behaviour did not differ significantly between men and women, or according to the type of work at any time. The most frequently self-prescribed medications were antibiotics (71%-81%), contraceptives (24%-25%), analgesics (18%-21%), and hypnotics (9%-12%). Those who had needed treatment for mental problems had self-prescribed hypnotics and sedatives to a greater extent than the others. Being male, having self-prescribed during internship, somatic complaints, mental distress, subjective health complaints, and not having sought help from a general practitioner, were significant adjusted predictors of self-prescribing in the ninth postgraduate year. CONCLUSION The level of self-prescribing among young Norwegian physicians is relatively high, and this behaviour is established early in their professional lives. Although self-prescribing is acceptable in some situations, physicians should seek professional help for illness. Efforts to inculcate more rational help-seeking behaviour should probably start in medical schools.
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Affiliation(s)
- Erlend Hem
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
| | - Guro Stokke
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
| | - Reidar Tyssen
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
| | - Nina T Grønvold
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
| | - Per Vaglum
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
| | - Øivind Ekeberg
- Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, University of Oslo, PO Box 1111 Blindern, NO-0317 Oslo, Norway
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