In 2012, researchers Dr. Domeyer-Klenske and Dr. Marcy Rosenbaum released the results of their study on how doctors would treat fellow doctors as patients. The study entitled When Doctor Becomes Patient: Challenges and Strategies in Caring for Physician-Patients, focused on the challenges in doctor-patient relationships when the patient is likewise a doctor. Although apparently not having received much traction in the international research community, this study is the first of its kind and gave some interesting insights.
Researchers gathered 29 respondents, 15 of whom were practicing family medicine and the other 14 being general practitioners. Methods involved semi-structured interviews which asked about these doctors’ experiences in doctoring doctors.
The challenges to the dynamics of the relationship proved to be as follows:
1 – Maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend
Respondents felt that boundaries were not recognized in the relationship. These revolving around the three key features of physician, colleague, and friend. Respondents had a difficult time separating relationships from their patients which often manifested in patients’ reluctance to discuss difficult, emotional topics.
2- Avoiding assumptions about patient knowledge and health behaviors
Some physician-patients carry themselves with the knowledge and bearing of a physician and this assumption proved to be a difficult challenge for respondents. These patients would often explain the complaint themselves, monitored their own symptoms, scheduled their own visits, and reportedly presumed to know the next steps to be taken. Going both ways, physicians and patients reportedly felt that the other was assessing their performance in a way.
3- Managing physician-patients’ access to informal consultations, personal test results, and opinions from other colleagues
Another new dynamic discovered in the relationship is that of ‘curbside communication’. Where regular patients would set appointments and communicate formally, doctor-patients would engage in more informal forms of communication such as approaching the respondents during social events, through email, or simply in the hallway. While some physicians found this to be helpful in that it helps the process move faster, others consider it a hindrance to healthcare as it bypasses qualitative protocol. Many doctor-patients referred themselves and had unique access to information and opinions from other doctors which provided for a new dynamic altogether.
The study continues on to discuss the three strategies that researchers suggest as to better improve the relationship. These will be discussed in the next installment of this series: Doctoring for Doctors.
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