Doctor as patient: “There should be a care circuit”

We are born and we die. In this process that makes up life, we also get sick. Almost every, more than 95%, we have some health problem, as reflected in the ‘Global Study of the burden of disease’ in the period 1999-2013. And before them we all look for a treatment to cure ourselves or at least to maintain an acceptable quality of life. No one is spared from getting sick, not even doctors, be it a cold, a mental health problem or a heart disease.

In this sense, according to the report ‘Getting sick is human, when the patient is the doctor’ presented by the Bioethics Research Group of Aragon (GIBA-IIS Aragon) and the General Council of Official Colleges of Physicians (CGCOM) a few months ago, points out that doctors tend to perform self-diagnosis and self-treatment, resort to ‘corridor consultations’, choosing the doctor they want to treat them.

“We look for the doctor either because of the relationship we have with him or because of his prestige,” says Dr. Enrique Arrieta

“It’s something very frequent,” admits the Dr Antonio Blanco, coordinator of our Bioethics and Professionalism Working Group of the Spanish Society of Internal Medicine (SEMI). He has seen it in the corridors, in the hospital dining rooms. “Eating with a neurologist you start talking about the headaches you have. Or you ask the dermatologist about a mole that has appeared on you, ”he adds. In general, serious pathologies are not asked in the corridor, and the doctor is usually chosen out of confidence. “We look for the doctor either because of the relationship we have with him or because of his prestige,” says the Dr. Enrique Arrieta member of the Communication Working Group of the Spanish Society of Primary Care Physicians (Semergen).

Self-diagnosis is also common. “In a relatively mild process such as a cold, if there are no warning signs (high fever, fatigue, etc.) you seek symptomatic relief,” says Dr. Arrieta. “In a catarrhal process, self-diagnosis is something common in all patients, we know the symptoms and if there are no alarm data, the strange thing is to consult someone,” adds Dr. Blanco. Only in cases where the situation worsens do they go to the doctor, and that is when part of the conflict appears, who to turn to? How to manage attention?


“The ideal would be to go to the occupational health doctor. I understand that the corridor consultation has its functionality, its value, but it also has its setbacks”, says Dr. Blanco. The CGCOM report states that “as we ourselves are doctors for other doctors, we recognize the difficulty that this situation entails in our attitude in the consultation and triggers ethical and clinical problems”. “I have ever been consulted by a co-worker and I have not felt very comfortable. You wonder if someone with more experience will trust you, and you have to do a medical examination delving into the personal sphere with issues that you would not normally deal with ”, admits Dr. Blanco. He himself consulted his colleagues about an allergic process that was causing him doubts, and now he points out that perhaps the doctor who treated him did not feel comfortable. “A doctor-patient conflict is generated that sometimes we are not aware of,” he admits.

“I don’t put them in the consultation time, if they are already tight, incorporating another patient will make them spend less time and less attention”

The Dr. Carolina Maicas, Specialist physician in the Cardiology Area of ​​the University Hospital of Toledo, she has had several doctors as patients. “Our specialty causes a little respect from colleagues from other specialties. So when they arrive with chest pain or tachycardia, they put themselves in your hands”. The main problem is, within the existing waiting list, when do I see the partner? “Each doctor has his own form of him. I I do not put them within the consultation time, if they are already tight, adding another patient will cause you to spend less time and attention on them. I always make an appointment with them sooner or later, losing time for studies and other hospital activities”.

Dr. Maicas went to the ER one Saturday when she had an acute visual problem. “When they saw me I introduced myself as a partner. The subsequent revisions were initially regulated, but then they tell you that when you have a gap, you go over. In that sense, doctors fail. You are leaving it because you are busy, you don’t have time for anything, you don’t find yourself anymore, and It takes longer to go to the revisions ”. Doctors are also affected by the same problems as other patients. “It has to do with waiting lists or bureaucracy (for example, the need for a flyer to perform an X-ray)”, says Dr. Arrieta.


Faced with this situation, in corridor consultations and non-regulated consultations, different strategies are opened to improve sick doctor care. “I think that doctors can be bad patients because our knowledge and our experience have made us aware of the complications and risks of the different pathologies, and what we seek is to get out of uncertainty as soon as possible. As the health system currently stands, I see it as difficult, but I think that the most effective thing is to have some kind of preferred “circuit”, or with a reference professional (as was the case in hospitals until not long ago where there was a gynecologist who was the one who treated the nurses and the rest of the workers)”, proposes Dr. Arrieta.

In this sense, Dr. Maicas points out that one of the main barriers is that in the end there is a group of patients who are healthcare or their own close relatives and who end up consulting you. “The waiting lists present in some specialties greatly complicates the situation”, he points out. It is true, he continues, “that specialties such as Internal Medicine have professional reference personnel who are not so much at the foot of the canyon and can channel and manage these consultations. But in specialties such as Cardiology we manage ourselves as we can”.

At the moment the circuits do not exist. For example, initiatives such as the Comprehensive Care Program for the Sick Doctor (PAIME), of the Illustrious Official College of Physicians of Madrid (icomem) aimed at physicians with mental disorders and addictive behaviors that may interfere with their professional practice, who receive comprehensive and confidential care.

“It would be important have a circuit to avoid injustices with patients on waiting lists, which, as the literature points out, is different between poor patients and rich patients. It may be because part of society with a higher educational level knows how to find the tricks of the system and, based on this hypothesis, doctors and health professionals could also be ‘bypassing’ the waiting lists, and we should be aware of this and change it ”, concludes Dr. Blanco.

Because health we all need…

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