"Post-residency disease" and the medical self: identity, work, and health care among doctors who become patients.
Doctors who become patients due to serious illnesses face many challenges related to issues of identity, work, and professionalism. In-depth interviews with such doctors reveal the complex ways in which illness threatens identity in these professionals. In comparison with "medical student's disease," these doctors now exhibit "post-residency disease"-minimizing physical symptoms that are in fact present, leading to decreases in care sought. Doctors often feel they are somehow invulnerable to disease and have to remain strong, not burdening others. Many describe themselves as "workaholics," which can prove to be a double-edged sword, posing problems as well as providing benefits. This professional commitment could interfere with preventive health behaviors and with "practicing what they preach." Some view their illness with their "medical self" - as if they were a physician observing another patient rather than themselves. These doctors often support their approach by choosing a colleague as a doctor who will not challenge them, thereby establishing a "denial system" as opposed to a support system. These doctor-patients confront difficult issues of how much their physicianhood is an identity or an activity, illustrating the intricate relationships and tensions between work, identity, professionalism, and health in contemporary medicine.
Klitzman
Robert
R
Department of Psychiatry, Center for Bioethics, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. rlk2@columbia.edu
D003717:Denial, Psychological; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D010815:Physician Impairment / Q000523:psychology; D010819:Physician's Role / Q000523:psychology*; D010817:Physician-Patient Relations; D012179:Retirement; D012649:Self Concept; D012803:Sick Role; D012933:Social Identification; D013997:Time Factors; D035502:Trust; D014937:Work / Q000523:psychology