Doctors' experiences when treating doctor-patients: a scoping review

Claire J Hutton; Margaret Kay AM; Penny Round; Chris Barton

doi:10.3399/BJGPO.2023.0090

Doctors' experiences when treating doctor-patients: a scoping review

BJGP Open. 2023 Dec 19;7(4):BJGPO.2023.0090. doi: 10.3399/BJGPO.2023.0090. Print 2023 Dec.

Authors

Claire J Hutton¹, Margaret Kay AM², Penny Round³, Chris Barton⁴

Affiliations

¹ Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia claire.hutton1@monash.edu.
² General Practice Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
³ School of Curriculum Teaching and Inclusive Education, Faculty of Education, Monash University, Melbourne, Australia.
⁴ Department of General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Abstract

Background: To work effectively, doctors need to look after themselves. They often delay seeking medical care for a range of reasons. Once they do, there is evidence that the doctors treating them ('treating doctors') can struggle to provide optimal care.

Aim: To examine existing literature on what is currently known about experiences for treating doctors, in particular GPs, when their patient is also a doctor.

Design & setting: A scoping review of articles written in English.

Method: Using the JBI methodological framework for scoping reviews, five databases (MEDLINE, PsycINFO, CINAHL [Cumulative Index to Nursing & Allied Health], Google Scholar, and Scopus) were searched from the database start date until 31 December 2022. Qualitative and quantitative studies reporting the treating doctor's experience, guidelines for treating doctors, expert opinion articles, and editorials were included. Grey literature was considered, searching the first 10 pages of two Google searches.

Results: Forty-eight articles from eight countries met inclusion criteria, of which 12 were research studies. The main areas of focus were as follows: affective responses, which included anxiety about being criticised, concern about upsetting the doctor-patient, and discomfort regarding the acknowledgement that doctors get sick; relational factors, which included boundary issues, over-identifying with the doctor-patient, treating them as a colleague rather than a patient, and role ambiguity; confidentiality, which incorporated both affective and relational aspects; and influence of medical culture and socialisation on dynamics between treating doctor and doctor-patient. These findings have been distilled into a list of key suggestions for the treating doctor.

Conclusion: Doctors can find treating doctor-patients anxiety-provoking and challenging. The sources of this discomfort are multifaceted, and more empirical research is needed to better understand and address the complex relationship between treating doctor and doctor-patient.

Keywords: general practitioners; physicians, family; physicians, practice patterns; physician–patient relations; physician’s role.