"Doctor, Heal Thyself?" is the title of a new study led by a Yale researcher which suggests that many physicians seem to live by this motto, because they are unlikely to see a doctor on a regular basis.
Approximately one in three physicians surveyed did not have a regular source of care (RSOC). The researchers also found that medical specialty and beliefs about control of health outcomes were directly linked to whether or not a physician sought regular care. The study further found that not having a RSOC had a significant negative impact on use of preventive services several years later.
"It was somewhat surprising to find that about one-third of the physicians in our sample did not have a doctor themselves," says Dr. Cary Gross, assistant professor of internal and general medicine at the School of Medicine and principal investigator on the study. "This is a much higher proportion than has been estimated for the general population. Even in a sample of people who likely had excellent access to care, use of RSOC and preventive services was suboptimal."
In the study, published in the Archives of Internal Medicine, Gross and his colleagues tried to ascertain specific beliefs that were associated with RSOC use. They found that physicians who were "fatalistic," indicating that their health was ultimately controlled by chance rather than by the actions of themselves or their physicians, were significantly less likely to have a RSOC.
Medical specialty also appeared to have a significant impact on use of RSOC in the sample. Internists, pathologists, surgeons and physicians in other specialties were significantly more likely to have no RSOC than pediatricians.
"Physicians are an unusual population to study because they can access health services themselves, without having a personal physician," says Gross. "Even so, our data suggests that physicians without a RSOC were far less likely to receive preventive services six years later."
These new findings are consistent with earlier studies that report 35% to 56% of physicians do not have a personal physician. But Gross says these cross-sectional studies did not investigate why some doctors did not have a RSOC, or whether there was an adverse impact on health care.
Although many patients look to their physicians for advice about medical care, little is known about the use of RSOC among physicians. Gross and colleagues at Johns Hopkins University looked at 915 physicians who graduated from the Johns Hopkins School of Medicine between 1948 and 1964. They assessed RSOC in a 1991 survey, and use of cancer screening tests and the influenza vaccine was assessed in 1997. In the 1997 survey, respondents were asked whether they had received various tests and whether they were performed to investigate specific signs or symptoms or for asymptomatic screening. Thirty-five percent of respondents had no RSOC.
Gross' colleagues on the study included Lucy A. Mead, Daniel E. Ford and Michael J. Klag of the Welch Center for Prevention, Epidemiology and Clinical Research at the Johns Hopkins School of Medicine, and the Johns Hopkins School of Hygiene and Public Health.
-- By Karen Peart
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