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PubMed · 10477473

Trusting under pressure.

L M Thomas
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Abstract

This essay explores the idea that it is possible for a patient to feel ill at ease with a health care professional, even though there is no active ill will on the part of the professional. Noting that the relationship between the patient and the health care professional, especially in the case of the physician, is an asymmetrical one, I suggest that it is incumbent upon professionals to take extra steps to insure that the patient feels at ease in the staff-patient encounter, notwithstanding the good will that health professionals may be assumed to have toward patients generally.

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Attitude to HealthBlack PeopleEthics, MedicalHumansHypertensionMinority GroupsPrejudiceProfessional-Patient RelationsProfessional Patient RelationshipJournal Article

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L M Thomas. 1999. Trusting under pressure.. https://pubmed.ncbi.nlm.nih.gov/10477473/

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Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study.

OBJECTIVE: To explore general practitioners' perceptions of the effects of their profession and training on their attitudes to illness in themselves and colleagues. DESIGN: Qualitative study using focus groups and in depth interviews. SETTING: Primary care in Northern Ireland. PARTICIPANTS: 27 general practitioners, including six recently appointed principals and six who also practised occupational medicine part time. MAIN OUTCOME MEASURES: Participants' views about their own and colleagues' health. RESULTS: Participants were concerned about the current level of illness within the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal illness and engaging in health screening. Embarrassment in adopting the role of a patient and concerns about confidentiality also influenced their reactions to personal illness. Doctors' attitudes can impede their access to appropriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrangements of the practice were cited as reasons for working through illness and expecting colleagues to do likewise. CONCLUSIONS: General practitioners perceive that their professional position and training adversely influence their attitudes to illness in themselves and their colleagues. Organisational changes within general practice, including revalidation, must take account of barriers experienced by general practitioners in accessing health care. Medical education and culture should strive to promote appropriate self care among doctors.

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