When doctor becomes patient: challenges and strategies in caring for physician-patients.
OBJECTIVE
The current study was aimed at exploring the challenges that arise in the doctor-patient relationship when the patient is also a physician and identifying strategies physicians use to meet these challenges. No previous research has systematically investigated primary care physicians' perspectives on caring for physician-patients.


METHODS
Family medicine (n=15) and general internal medicine (n=14) physicians at a large Midwestern university participated in semi-structured interviews where they were asked questions about their experiences with physician-patients and the strategies they used to meet the unique needs of this patient population. Thematic analysis was used to identify common responses.


RESULTS
Three of the challenges most commonly discussed by physician participants were: (1) maintaining boundaries between relationships with colleagues or between roles as physician/colleague/friend, (2) avoiding assumptions about patient knowledge and health behaviors, and (3) managing physician-patients' access to informal consultations, personal test results, and opinions from other colleagues. We were able to identify three main strategies clinicians use in addressing these perceived challenges: (1) Ignore the physician-patient's background, (2) Acknowledge the physician-patient's background and negotiate care, and (3) Allow care to be driven primarily by the physician-patient.


CONCLUSIONS
It is important that primary care physicians understand the challenges inherent in treating physicians and develop a strategy with which they are comfortable addressing them. Explicitly communicating with the physician-patient to ensure boundaries are maintained, assumptions about the physician-patient are avoided, and physician-patient access is properly managed are key to providing quality care to physician-patients.
University of Iowa, USA. aedomeyer@gmail.com
Amy
A
Domeyer-Klenske
Marcy
M
Rosenbaum
D004645:Empathy / Q000941:ethics; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D005791:Patient Care / Q000941:ethics* / Q000379:methods; D010817:Physician-Patient Relations / Q000941:ethics*; D058007:Physicians, Primary Care / Q000941:ethics / Q000523:psychology*; D011787:Quality of Health Care / Q000941:ethics; D014481:United States