Getting sick is human, but paradoxically doctors are not at all clear when they are the ones who get sick. In general, they have difficulty seeing themselves as patients and self-medicate at the first symptoms, they go to a colleague between corridors, instead of asking for a fixed appointment, they do poor monitoring of their pathological process and many will work despite their bad condition .
ICU doctors attend to a Coronavirus patient. EFE/Juan Carlos Cárdenas/Archive
This reality is reflected in the following percentages: 90% of professionals self-medicate in banal processes and 60% turn to another colleague informally, as indicated in the report “Ill is Human: when the patient is the doctor” .
Presented at General Council of Official Medical Associations (CGCOM), the study is part of a 5-year investigation that has aimed to understand the process of making doctors sick.
Led by Aragon Bioethics Research Group (GIBA-IIS Aragon), has had the collaboration of the Foundation for Social Protection (FPSOMC) and the Chair of Professionalism and Clinical Ethics of the University of Zaragoza and the College of Doctors of Zaragoza.
“Since we entered the Faculty of Medicine we are taught how to care for others, but we have never been given the tools to take care of ourselves and it is essential that we think of self-care as an essential part of the quality of care we provide and as an essential part also in the safety of our patients”.
This is how the doctor expressed it Manuela García Romero, second vice president of the General Council of Medical Associations (CGCOM), when presenting this report which, in his opinion, “is key to continue contributing to detect and eliminate this resistance that can cause the professional’s illness to eventually become complicated and run through alternative circuits”.
“When the doctor is sick, a role conflict arises: being the patient when we have been trained to diagnose, treat and care puts us on the other side of the table, in an unlearned scenario”, he considered for his part María Pilar Astier, family doctor and technical advisor for quality and safety of the Catalan Institute of Health.
Therefore, he added, the immediate reaction is to try to solve the health problem by yourself: self-diagnosis and self-treatment. When the process is prolonged, make corridor consultations with colleagues so that sometimes the diagnoses are delayed and the follow-ups are not done in an organized way”.
“We are not trained to diagnose and treat, and we do not assume our role as a patient. This possibility is not taught at university and then time is not taken to consider this circumstance throughout professional life, as we are oriented to care for our patients”.
The research has emerged from three perspectives: the experience of the professional who falls ill; the experience of those who attend it; and the opinion of all medical professionals who at some point in their lives have been or may be sick or become doctors of colleagues who get sick, be doctors of doctors. It also considers the gender perspective.
And the tendency to go to work when sick is a way to express our responsibility towards patients and colleagues. And when we ourselves are doctors of other doctors, we recognize the difficulty that this entails and is reflected in different ethical and clinical problems that arise in communication, information, follow-up…”, point out from the research team.
The doctor, a bad patient: facts and feelings
In fact, they have found that 90% of professionals self-medicate in banal processes about their own health and that when these processes are no longer so mild, but have a certain seriousness, the majority, 60%, resort to a another colleague, a professional colleague, and they do it, moreover, in a completely informal way, between corridors.
In this sense, they have emphasized the importance of having a health reference, because in fact 50% of active medical men do not have or do not know their family doctor and 1/3 of women do not either.
The report also highlights that 20% of resident doctors self-medicate with anxiolytics or hypnotics without any consultation or evaluation by another colleague.
Regarding presenteeism and among resident doctors who have been practicing for a very short time, up to 70% had come to work sick.
“Doctors feel that they have the responsibility to always go to the workplace even when they are sick so as not to harm their colleagues or overload them and not to feel that they are abandoning their patients”, they stated.
Among the strategies they have proposed for the future, they highlight the need to sensitize the population in general, professionals and health institutions about the process of doctors falling ill and involving the institutions in the detection of occupational risk factors that affect the health of doctors.
In the personal interviews carried out for the study, the MIR resident doctors have expressed this reality as follows: “when a doctor is sick, with knowledge, the anxiety comes not only from the diagnosis but because you know a little more about the prognosis…”
“I had a moment of weakness, so to speak, when I saw myself alone, with this diagnosis and that I was admitted, that I had to take medication for a few months, the first night alone there in the hospital… so yes, the the feeling that invaded me above all is that of loneliness and fear…”
Throughout all the phases of his “grief” process (fear, denial…), the practitioner experiences numerous emotions that have to do not only with the vulnerability universally associated with the disease, but with his personality, identity and conflict of role…
The interviewees frequently speak directly or indirectly of denial, understanding this as the difficulty in accepting the reality of the disease in all its aspects: the possibility of receiving a serious diagnosis, treatment recommendations, diminishing abilities to carry out their usual work .
And in this report professionals with an already established career reflect it: “It took a few months until I was aware of it, the people around me noticed it, but I didn’t realize that I needed help and I was trying to give it to myself alone without seeking any help….. “ .
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