Self-doctoring: a qualitative study of physicians with cancer

Abstract

Background: Self-doctoring is providing oneself care normally delivered by a professional caregiver. Expert authors warn physicians not to self-doctor, yet cross-sectional studies document that physicians frequently do. Explanations for this disparity remain speculative.

Objective: To better understand the circumstances when physicians did and did not doctor themselves and the reasoning behind their actions.

Design: Qualitative semistructured interview study of 23 physician-patients currently or previously treated for cancer.

Results: Participants had multiple opportunities to doctor themselves (or not) at each stage of illness. Only 1 physician recommended self-doctoring, although most reported having done so, sometimes without realizing it. Participants' approaches to their own health care created a continuum ranging between typical physician and patient roles. Participants emphasizing their physician role approached their health care as they would approach the care of their own patients, preferring convenience and control of their care to support from professional caregivers. Participants emphasizing their role as patient approached their health care as they thought a patient should, preferring to rely less on their own abilities and more on their providers, whose support they valued. Most participants balanced both roles depending on their experiences and basic issues of trust and control. Importantly, subjects at both ends of the continuum reported unanticipated pitfalls of their approach.

Conclusion: Our findings showed that participants' health care-seeking strategies fell on a continuum that ranged from a purely patient role to one that centered on physician activities. Participants identified problems associated with overdependence on either role, suggesting that a balanced approach, one that uses the advantages of both physician and patient roles, has merit.