Doctors are said to make lousy patients. Now comes a study indicating that many docs avoid being patients altogether.
Researchers at Johns Hopkins School of Medicine decided to examine how well doctors took care of their health after previous studies suggested that doctors' bad habits--among them smoking and drinking--influence what they tell patients.
Using annual health surveys completed by graduates, they found that a surprising number of physicians--about one in three--had no regular source of care, even though they had ready access, were better educated and could more easily afford it than the average American. Of the 312 (out of 915 Hopkins grads) who didn't see a doctor regularly, 28% had no medical care, and 7% treated themselves (the authors suspect that figure is probably higher).
And these are the folks who tell us that good eating, exercise and regular checkups are the keys to a longer life. What's going on here?
Several factors may underlie some doctors' reluctance to see another doctor, said Dr. Michael J. Klag, director of the Hopkins study. They may be anxious because they know what can go wrong, they may worry about confidentiality in seeing an associate or they may simply self-diagnose, writing their own prescriptions and ordering their own tests, although that's not considered the best practice.
In other cases, doctors may not perceive any need to be examined, even though conditions such as high blood pressure, glaucoma and high cholesterol are silent. Klag said he knows of doctors who learn of their high cholesterol only by undergoing free screenings at the annual American Heart Assn. meetings.
But it's at the routine checkups that a primary care doctor can help break down a patient's natural reluctance to be tested for illnesses they may not want to think about.
"Very few people volunteer to have a colonoscopy," said Klag, interim chairman of Hopkins' department of medicine.
"A lot of primary care is educating people and convincing them to make changes in lifestyle or to undergo some tests they don't want to undergo," he said. "If you don't have that nudge, you don't get it done."
And if a third of doctors aren't getting such primary care, they, too, need to be educated.
The Hopkins researchers analyzed survey responses in 1991 from 915 medical graduates, 91% of whom were men. Their average age was 61. The researchers also studied 1997 surveys for indications about use of preventive care services.
