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The physician's disease: The impact of medical knowledge on personal illness

Published online by Cambridge University Press:  27 February 2007

JEFFREY P. TUTTLE
JEFFREY P. TUTTLE
Affiliation:
Department of Psychiatry, University of Kentucky, Lexington, Kentucky
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Abstract

Objective: When physicians confront a personal illness of a serious nature, they may discover that the transition to the sick role is challenging, and the inability to relinquish their stethoscope may cause undo anxiety. The physician–patient relationship is intrinsically asymmetrical, and the role of the physician is to regulate the amount of information patients need in order to become educated about their illness and to make informed decisions about their treatment plan. This article explores the challenges in the physician–patient relationship when the patient is also a physician.

Methods: This article is a literature review of publications involving the unique challenges physician–patients experience when suffering from serious personal illness.

Results: The medical knowledge physician–patients harbor has the potential to complicate their ability to cope with difficult or terminal diagnoses. Paradoxically, knowledge about a condition may fuel anxiety instead of alleviating the fear associated with the unknown. Medical knowledge therefore may entail a certain loss of innocence, and physicians are often unable to revert to being “mere” patients. Furthermore, managing this anxiety in physician–patients may prove to be challenging to the treating physician.

Significance of results: From a medical perspective, physician–patients need to be addressed like any other patient. Psychologically, however, these patients are unique, and the specific challenges their education and experience bring into the consultation room needs to be explicitly addressed.

Keywords

LymphomaPhysician–patient relationshipPhysician illnessPsycho-oncologyCancer anxiety
Type
REVIEW ARTICLE
Information
Palliative & Supportive Care , Volume 5 , Issue 1 , March 2007 , pp. 71 - 76
Copyright
© 2007 Cambridge University Press

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References

REFERENCES

Allibone, A. (1990). Who treats the doctor? Practitioner, 234, 984–987.Google Scholar
Allibone, A., Oakes, D., & Shannon, H.S. (1981). The health and health care of doctors. The Journal of the Royal College of General Practitioners, 31, 728–734.Google Scholar
American Medical Association. (1993). E-8.19: Self-treatment or treatment of immediate family members. AMA Code of Medical Ethics. http://www.ama-assn.org/ama/pub/category/2498.html
Aoun, H. (1992). From the eye of the storm, with the eyes of a physician. Annals of Internal Medicine, 116, 335–338.Google Scholar
Bennet, G. (1997). All doctors are problem doctors. Doctors must admit that they are human. British Medical Journal, 314, 1908.Google Scholar
Bone, R.C. (1996). A personal experience with SIRS and MODS. Critical Care Medicine, 24, 1417–1418.Google Scholar
Bowes, D. (1984). The doctor as patient: An encounter with Guillain-Barre syndrome. Canadian Medical Association Journal, 131, 1343–1348.Google Scholar
British Medical Association. (2004). Ethical responsibilities in treating doctors who are patients. BMA Medical Ethics Committee. Revised March 2004. Guidance from the Ethics Department: Ethical responsibilities in treating doctors who are patients. http://www.bma.org.uk/ap.nsf/content/doctorspatients.
Bunker, J.P. & Brown, B.W., Jr. (1974). The physician–patient as an informed consumer of surgical services. New England Journal of Medicine, 290, 1051–1055.Google Scholar
Bynder, H. (1967). How does ailing MD pick a doctor? Medical World News. Nov 24.
Cockerham, W.C., Creditor, M.C., Creditor, U.K., et al. (1980). Minor ailments and illness behavior among physicians. Medical Care, 18, 164–173.Google Scholar
The doctor as patient. (1972). Medical World News, 13, 56–65.
Edelstein, E.L. & Baider, L. (1982). Role reversal: When doctors become patients. Psychiatria Clinica, 15, 177–183.Google Scholar
Ellard, J. (1974). The disease of being a doctor. Medical Journal of Australia, 2, 318–323.Google Scholar
Ende, J., Kazis, L., & Moskowitz, M.A. (1990). Preferences for autonomy when patients are physicians. Journal of General Internal Medicine, 5, 506–509.Google Scholar
English, T.L. (1991). A piece of my mind. Skeptical of skeptics. JAMA, 265, 964.Google Scholar
Fromme, E. & Billings, J.A. (2003). Care of the dying doctor: On the other end of the stethoscope. JAMA, 290, 2048–2055.Google Scholar
Glass, G.S. (1975). Incomplete role reversal: The dilemma of hospitalization for the professional peer. Psychiatry, 38, 132–144.Google Scholar
Gold, N. (1972). The doctor, his illness and the patient. The Australian and New Zealand Journal of Psychiatry, 6, 209–213.Google Scholar
Hamama-Raz, Y., Zahava, S., & Ohry, A. (2000). Fear of personal death among physicians. Omega, 41, 139–149.Google Scholar
Horn, M.O. (1999). The other side of the bed rail. Annals of Internal Medicine, 130, 940–941.Google Scholar
Kane, A.C. & Hogan, J.D. (1985). Death anxiety in physicians: Defensive style, medical specialty, and exposure to death. Omega, 16, 11–21.Google Scholar
Keoun, B. (1996). Doctors with cancer struggle to define split role. Journal of the National Cancer Institute, 88, 1616–1617.Google Scholar
Kirsch, M. (1996). When a doctor is a patient. American Journal of Gastroenterology, 91, 1299–1300.Google Scholar
Lipsett, D.R. (1975). The doctor as a patient. Psychiatric Opinion, 12, 20–25.Google Scholar
Mandell, H.N. & Spiro, H.M. (1987). When Doctors Get Sick. New York: Plenum Medical Book Co.
Marzuk, P.M. (1987). When the patient is a physician. New England Journal of Medicine, 317, 1409–1411.Google Scholar
Meissner, W.W. & Wohlauer, P. (1978). Treatment problems of the hospitalized physician. International Journal of Psychoanalytic Psychotherapy, 7, 437–467.Google Scholar
Mullan, F. (1985). Seasons of survival: Reflections of a physician with cancer. New England Journal of Medicine, 7(4), 270–273.Google Scholar
Osmond, H. & Siegler, M. (1977). Doctors as patients. Practitioner, 218, 834–839.Google Scholar
Parsons, T. (1975). The sick role and the role of the physician reconsidered. The Milbank Memorial Fund Quarterly, 53, 257–278.Google Scholar
Philips, J.B. (1983). Caring for other physicians. New England Journal of Medicine, 308, 1542–1543.Google Scholar
Pullen, D., Lonie, C.E., Lyle, D.M., et al. (1995). Medical care of doctors. Medical Journal of Australia, 162, 481, 484.Google Scholar
Rabin, D., Rabin, P.L., & Rabin, R. (1982). Occasional notes. Compounding the ordeal of ALS: Isolation from my fellow physicians. New England Journal of Medicine, 307, 506–509.Google Scholar
Rosvold, E.O. (2002). Physicians in Illness and Health: An Epidemiological Study on Health and Illness Behaviour among 19th and 20th Century Norwegian Physicians. Oslo: Institute of General Practice and Community Medicine, University of Oslo.
Scally, G. (1996). Physicians can't heal themselves. Lancet, 347, 1059.Google Scholar
Schneck, S.A. (1998). “Doctoring” doctors and their families. JAMA, 280, 2039–2042.Google Scholar
Silagy, C. (2001). A view from the other side. A doctor's experience of having lymphoma. Australian Family Physician, 30, 547–549.Google Scholar
Spiro, H.M. & Mandell, H.N. (1998). When doctors get sick. Annals of Internal Medicine, 128, 152–154.Google Scholar
Spiro, J.H., Roenneburg, M., & Maly, B.J. (1978). Teaching doctors to treat doctors: Medical peer counseling. Journal of Medical Education, 53, 997.Google Scholar
Srivastava, R. (2006). A piece of my mind. Doctors need doctors too. JAMA, 295, 866–867.Google Scholar
Stoudemire, A. & Rhoads, J.M. (1983). When the doctor needs a doctor: Special considerations for the physician–patient. Annals of Internal Medicine, 98, 654–659.Google Scholar
Tierney, W.M. & McKinley, E.D. (2002). When the physician-researcher gets cancer: Understanding cancer, its treatment, and quality of life from the patient's perspective. Medical Care, 40(6 Suppl.), 20–27.Google Scholar
Vaillant, G.E., Sobowale, N.C., & McArthur, C. (1972). Some psychologic vulnerabilities of physicians. New England Journal of Medicine, 24, 372–375.Google Scholar
Viner, E.D. (1994). A physician's personal experience of critical illness. Trends in Health Care, Law & Ethics, 9, 43–45, 42.Google Scholar
Weintraub, W. (1964). “The VIP syndrome”: A clinical study in hospital psychiatry. Journal of Nervous and Mental Disease, 138, 181–193.Google Scholar
White, R.B. & Lindt, H. (1963). Psychological hazards in treating physical disorders of medical colleagues. Diseases of the Nervous System, 24, 304–309.Google Scholar