title: Physicians caring for physicians: the perspective of the primary care physician.
abstract: OBJECTIVE
  How physicians provide longitudinal primary care to physician-patients (ie, physicians as patients) has not been well studied. The potential challenges of providing care to physician-patients include maintaining professional boundaries and adhering to practice guidelines. The objective was to explore the differences in identifying how physicians perceive caring for physicians-patients in the longitudinal setting versus caring for other patients in the general population.
  
  
  METHODS
  The study consisted of focus groups, followed by quantitative survey. Participants were primary care physicians (internal medicine and family medicine) at an academic multispecialty group practice. Thematic analysis of focus groups informed the development of the survey.
  
  
  RESULTS
  In focus groups, participants identified several benefits, challenges, and differences in caring for physician-patients versus the general population. When these findings were explored further by quantitative survey, participants noted differences in care regarding chart documentation protocols, communication of results, and accommodation of schedules. They agreed that there were benefits to providing care to physician-patients, such as believing their work was valued and discussing complex issues with greater ease. There also were challenges, including anxiety or self-doubt. Participants also agreed on the following strategies when caring for this population: make recommendations based on evidence-based medicine, follow routine assessment and examination protocols, follow routine scheduling and communication protocols, recommend the same follow-up visit schedule, and define boundaries of the relationship.
  
  
  CONCLUSIONS
  Physicians perceive caring for physician-patients as different and rewarding, although some find that it provokes anxiety. Many are willing to make concessions regarding scheduling and testing. With increasing experience, the anxiety decreased as did the need to follow protocols and maintain boundaries. Further investigation is needed to determine the impact of physician experience and training on the quality of care for physician-patients.
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Teng
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Butler
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Sarah
authors.initials: S
authors.lastname: Schramm
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: J Harry
authors.initials: JH
authors.lastname: Isaacson
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Craig
authors.initials: C
authors.lastname: Nielsen
authors.affiliation: From the Department of Internal Medicine, Quantitative Health Sciences, Medicine Institute, and the Department of Bioethics, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Carmen
authors.initials: C
authors.lastname: Paradis
mesh_terms: D003657:Decision Making / Q000941:ethics; D004645:Empathy / Q000941:ethics; D004992:Ethics, Medical; D005194:Family Practice / Q000941:ethics*; D005260:Female; D017144:Focus Groups; D006123:Group Practice / Q000941:ethics; D019538:Health Care Surveys; D006801:Humans; D007388:Internal Medicine / Q000941:ethics*; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000941:ethics; D058007:Physicians, Primary Care / Q000941:ethics* / Q000523:psychology; D011320:Primary Health Care / Q000941:ethics*; D012201:Reward; D014495:Universities