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Physicians as Patients: Barriers to Primary Care Access Encountered by Physicians

Editor's note: This is a corrected version of the article previously published.

URMI PATEL, MD
BECKY LOWRY, MD
MEGAN HILES, MD, MBA

FPM. 2025;32(4):21-25.

Author disclosures: no relevant financial relationships.

Regular access to primary care is key to health and well-being, even for physicians.

In 2022, the U.S. surgeon general issued an advisory defining physician burnout as an urgent public health issue.1 The advisory recommended prioritizing care-seeking strategies and basic health habits for physicians. One such habit is regularly following up with a primary care physician.

Physicians face both individual and systemic barriers to seeking primary care. This article examines the literature on physicians’ access to primary care physicians, identifies common barriers, and offers potential solutions.

KEY POINTS

  • Prioritizing care-seeking strategies and basic health habits is a key part of reducing burnout, and it includes physicians receiving regular care from a primary care physician.
  • Physicians face systemic barriers to seeking primary care, including lack of time and concerns about confidentiality.
  • Starting during training, physicians should be encouraged to practice self-care behaviors, should establish care with a primary care physician, and should be taught how to support their medical colleagues as patients.

WHY PHYSICIANS NEED THEIR OWN PHYSICIAN

Regular access to a primary care physician can improve physician wellness by ensuring that any physical and mental health issues are being addressed in a timely fashion. Currently, more than 300 physicians die by suicide each year, and many more suffer from depression and anxiety.2 The COVID-19 pandemic led to an increase in mental health and substance use visits among physicians, contributing to an increased need for access to mental health services.3 Yet, among physicians who identified as having depression, only 25% considered getting help and only 2% received it.4

Integrating mental health into primary care can have significant benefits.5 A Department of Veterans Affairs study showed that integration led to decreased rates of mental health specialty use.6 At a time when there is a high prevalence of mental health diagnoses and a shortage of mental health providers, integration improves access to mental health care.7 In addition, chronic work-related stress makes physicians more vulnerable to certain physical conditions, such as impaired cognitive function, heart disease, and type 2 diabetes.1 However, physicians frequently minimize or downplay their experience of stress.7 Without a primary care physician, physicians as patients risk trivializing their symptoms, over-treating in some cases, and self-treating without proper documentation, leading to gaps in care.8

LITERATURE ON PRIMARY CARE USAGE BY PHYSICIANS

Dr. Patel is a resident physician at McLaren Family Medicine Residency (Rural Training Track), Petoskey, Mich.

Dr. Lowry is an internal medicine physician and chief wellness officer at the University of Kansas Health System and professor at the University of Kansas Medical Center, Department of Internal Medicine, Kansas City, Kan.

Dr. Hiles is an internal medicine physician and director of the Wellness and Prevention Clinics at National Jewish Health, Department of Medicine, Denver, Colo.

Send comments to fpmedit@aafp.org, or add your comments to the article online.

Author disclosures: no relevant financial relationships.

  1. 1.Murthy VH. Addressing Health Worker Burnout: The U.S. Surgeon General's Advisory on Building a Thriving Health Workforce. U.S. Public Health Service; 2022. https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf
  2. 2.Sigsbee B, Bernat JL. Physician burnout: a neurologic crisis. Neurology. 2014;83(24):2302-2306.
  3. 3.Myran DT, Cantor N, Rhodes E, et al. Physician health care visits for mental health and substance use during the COVID-19 pandemic in Ontario, Canada. JAMA Netw Open. 2022;5(1):e2143160.
  4. 4.Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374(9702):1714-1721.
  5. 5.Funk M, Saraceno B, Drew N, Faydi E. Integrating mental health into primary healthcare. Ment Health Fam Med. 2008;5(1):5-8.
  6. 6.Leung LB, Yoon J, Escarce JJ, et al. Primary care-mental health integration in the VA: shifting mental health services for common mental illnesses to primary care. Psychiatr Serv. 2018;69(4):403-409.
  7. 7.Riley R, Spiers J, Chew-Graham CA, et al. “Treading water but drowning slowly”: what are GPs' experiences of living and working with mental illness and distress in England? A qualitative study. BMJ Open. 2018;8(5):e018620.
  8. 8.Ooi K. A doctor in the house: ethical and practical issues when doctors treat themselves and those they are close to. Asian Bioeth Rev. 2018;10(1):3-19.
  9. 9.Gross CP, Mead LA, Ford DE, Klag MJ. Physician, heal thyself? Regular source of care and use of preventive health services among physicians. Arch Intern Med. 2000;160(21):3209-3214.
  10. 10.Rhodes E, Kendall C, Talarico R, et al. Primary care physician use and frequency of visits among physicians in Ontario, Canada. JAMA Netw Open. 2022;5(8):e2227662.
  11. 11.Ko DT, Chu A, Austin PC, et al. Comparison of cardiovascular risk factors and outcomes among practicing physicians vs. the general population in Ontario, Canada. JAMA Netw Open. 2019;2(11):e1915983.
  12. 12.Berk J, Mills B, Varma S. Physician, heal thyself: health maintenance behaviors among physicians. Tex Med. 2014;110(12):e1.
  13. 13.Davidson SK, Schattner PL. Doctors' health-seeking behaviour: a questionnaire survey. Med J Aust. 2003;179(6):302-305.
  14. 14.Uallachain GN. Attitudes towards self-health care: a survey of GP trainees. Ir Med J. 2007;100(6):489-491.
  15. 15.George S, Hanson J, Jackson JL. Physician, heal thyself: a qualitative study of physician health behaviors. Acad Psychiatry. 2014;38(1):19-25.
  16. 16.Morishita M, Iida J, Nishigori H. Doctors' experience of becoming patients and its influence on their medical practice: a literature review. Explore. 2020;16(3):145-151.
  17. 17.Kahn KL, Goldberg RJ, DeCosimo D, Dalen JE. Health maintenance activities of physicians and nonphysicians. Arch Intern Med. 1988;148(11):2433-2436.
  18. 18.Ahmad A. Managing physician fatigue. Gastrointest Endosc Clin N Am. 2021;31(4):641-653.
  19. 19.Agrawal A. Physician heal thyself. Indian Heart J. 2018;70(5):756-757.
  20. 20.Forsythe M, Calnan M, Wall B. Doctors as patients: postal survey examining consultants' and general practitioners' adherence to guidelines. BMJ. 1999;319(7210):605-608.
  21. 21.Klitzman R. “Post-residency disease” and the medical self: identity, work, and health care among doctors who become patients. Perspect Biol Med. 2006;49(4):542-552.
  22. 22.Taylor AK, Kingstone T, Briggs TA, et al. “Reluctant pioneer”: a qualitative study of doctors' experiences as patients with long COVID. Health Expect. 2021;24(3):833-842.
  23. 23.McFadden T, Simon C, Kobeissi B, Gerin-Lajoie C. Physicians' access to primary care: results from the Canadian Medical Association National Physician Health Survey. Can J Ophthalmol. 2020;55(3 Suppl 1):27-28.
  24. 24.Thompson WT, Cupples ME, Sibbett CH, Skan DI, Bradley T. Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study. BMJ. 2001;323(7315):728-731.
  25. 25.Wessely A, Gerada C. When doctors need treatment: an anthropological approach to why doctors make bad patients. BMJ. 2013;347:f6644.
  26. 26.Kay M, Mitchell G, Clavarino A, Doust J. Doctors as patients: a systematic review of doctors' health access and the barriers they experience. Br J Gen Pract. 2008;58(552):501-508.
  27. 27.Nakagawa K, Yellowlees PM. The physician's physician: the role of the psychiatrist in helping other physicians and promoting wellness. Psychiatr Clin North Am. 2019;42(3):473-482.
  28. 28.Wilf-Miron R, Kagan I, Saban M. Health behaviors of medical students decline towards residency: how could we maintain and enhance these behaviors throughout their training. Isr J Health Policy Res. 2021;10(1):13.
  29. 29.Domeyer-Klenske A, Rosenbaum M. When doctor becomes patient: challenges and strategies in caring for physician-patients. Fam Med. 2012;44(7):471-477.
  30. 30.Krall EJ. Doctors who doctor self, family, and colleagues. WMJ. 2008;107(6):279-284.
  31. 31.Avinger AM, McClary T, Dixon M, Pentz RD. Evaluation of standard-of-care practices among physicians who treat other physicians: a qualitative study. JAMA Netw Open. 2022;5(10):e2236914.
  32. 32.Bird S. Doctors as patients. Aust Fam Physician. 2008;37(4):256-257.
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