title: Doctors as patients: postal survey examining consultants and general practitioners adherence to guidelines.
abstract: OBJECTIVE
  To examine the adherence by senior NHS medical staff to the BMA guidelines on the ethical responsibilities of doctors towards themselves and their families.
  
  
  METHODS
  Postal semistructured questionnaire.
  
  
  METHODS
  Four randomly selected NHS trusts and three local medical committees in South Thames region.
  
  
  METHODS
  Consultants and principals in general practice.
  
  
  METHODS
  Personal use of health services.
  
  
  RESULTS
  The response rate was 64% (724) for general practitioners and 72% (427) for consultants after three mailings. Most (1106, 96%) respondents were registered with a general practitioner, although little use was made of their services. 159 (26%) general practitioners were registered with a general practitioner in their own practice and 80 (11%) admitted to looking after members of their family. 73 (24%) consultants would never see their general practitioner before obtaining consultant advice. Most consultants and general practitioners admitted to prescribing for themselves and their family. Responses to vignettes for different health problems indicated a general reluctance to take time off, but there were differences between consultants and general practitioners and by sex. Views on improvements needed included the possibility of a "doctor's doctor," access to out of area secondary care, an occupational health service for general practitioners, and regular health check ups.
  
  
  CONCLUSIONS
  The guidelines are largely not being followed, perhaps because of the difficulties of obtaining access to general practitioners outside working hours. The occupational health service should be expanded and a general practitioner service for NHS staff piloted.
authors.affiliation: Centre for Health Services Studies, George Allen Wing, University of Kent, Canterbury, Kent CT2 7NF. J.M.Forsythe-2@ukc.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Forsythe
authors.forename: M
authors.initials: M
authors.lastname: Calnan
authors.forename: B
authors.initials: B
authors.lastname: Wall
mesh_terms: D001291:Attitude of Health Personnel; D003253:Consultants / Q000706:statistics & numerical data*; D004739:England; D004992:Ethics, Medical; D005192:Family Health; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D009786:Occupational Health Services / Q000706:statistics & numerical data; D010548:Personal Health Services / Q000706:statistics & numerical data*; D010821:Physicians, Family / Q000592:standards* / Q000706:statistics & numerical data*; D013222:State Medicine / Q000592:standards