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Personal Health Care of Residents: Preferences for Care Outside of the Training Institution

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Abstract

Objective

The personal health care issues of residents are important but have received minimal study. Available evidence suggests that residents experience difficulties obtaining care, partly related to both the demands of medical training and concerns about confidentiality and privacy.

Methods

A self-report survey was distributed in 2000–2001 to advanced residents at the University of New Mexico Health Sciences Center. Questions related to personal health and health care attitudes, behaviors, preferences, and experiences, and vignettes related to personal illness and treatment. Here the authors report findings regarding preferences for obtaining health care “at” versus “outside” of one’s training institution.

Results

Data from 141 residents are presented. A substantial minority of residents had obtained care outside of their institution in the preceding year. Residents expressed concerns about their medical privacy and confidentiality related to obtaining care within their own institution, including concerns about being seen by other residents or by past or future attendings. Women expressed more concern than did men on numerous issues, as did residents in primary care versus specialty training. Residents expressed a preference for care outside the training institution when taking into account confidentiality and prevention of embarrassment; care at their own institution was preferred when considering expense and scheduling. Outside care was more strongly preferred for more stigmatizing illnesses (e.g., mental health-related). Most residents felt poorly informed regarding their personal health care confidentiality rights and did not know whether their institution had confidentiality policies regarding residents who develop physical or mental health problems.

Conclusion

Residents worry about confidentiality and privacy when deciding where to obtain personal medical care. Trainees’ concerns are relevant to crafting policies on resident health care. Programs should strive to inform residents thoroughly about policies and rights pertaining to personal health care.

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References

  1. Rosen IM, Christie JD, Bellini LM, et al: Health and health care among housestaff in four U.S. internal medicine residency programs. J Gen Intern Med 2000; 15: 116–121

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Levey RE: Sources of stress for residents and recommendations for programs to assist them. Acad Med 2001; 76: 142–150

    Article  CAS  PubMed  Google Scholar 

  3. Thomas NK: Resident burnout. JAMA 2004; 292: 2880–2889

    Article  CAS  PubMed  Google Scholar 

  4. Dyrbye LN, Thomas MR, Shanafelt TD: Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med 2006; 81: 354–373

    Article  PubMed  Google Scholar 

  5. Cohen JS, Patten S: Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Med Educ 2005; 5: 21

    Article  PubMed Central  PubMed  Google Scholar 

  6. Ratanawongsa N, Wright SM, Carrese JA: Well-being in residency: a time for temporary imbalance. Med Educ 2007; 41: 273–280

    Article  PubMed  Google Scholar 

  7. Papp KK, Stoller EP, Sage P, et al: The effects of sleep loss and fatigue on resident-physicians: a multi-institutional, mixed-method study. Acad Med 2004; 79: 394–406

    Article  PubMed  Google Scholar 

  8. Shanafelt TD, West C, Zhao X, et al: Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med 2005; 20: 559–564

    Article  PubMed Central  PubMed  Google Scholar 

  9. Shanafelt TD, Bradley KA, Wipf JE, et al: Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002; 136: 358–367

    Article  PubMed  Google Scholar 

  10. West CP, Huschka MM, Novotny PJ, et al: Association of perceived medical errors with resident distress and empathy: a prospective longitudinal study. JAMA 2006; 296: 1071–1078

    Article  CAS  PubMed  Google Scholar 

  11. Dyrbye LN, Thomas MR, Shanafelt TD: Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc 2005; 80: 1613–1622

    Article  PubMed  Google Scholar 

  12. Bellini LM, Shea JA: Mood change and empathy decline persist during three years of internal medicine training. Acad Med 2005; 80: 164–167

    Article  PubMed  Google Scholar 

  13. Collier VU, McCue JD, Markus A, et al: Stress in medical residency: status quo after a decade of reform? Ann Intern Med 2002; 136: 384–390

    Article  PubMed  Google Scholar 

  14. Schwartz JS, Lewis CE, Clancy C, et al: Internists’ practices in health promotion and disease prevention: a survey. Ann Intern Med 1991; 114: 46–53

    Article  CAS  PubMed  Google Scholar 

  15. Lewis CE, Clancy C, Leake B, et al: The counseling practices of internists. Ann Intern Med 1991; 114: 54–58

    Article  CAS  PubMed  Google Scholar 

  16. Roberts LW, Warner TD, Lyketsos C, et al: Perceptions of academic vulnerability associated with personal illness: a study of 1,027 students at nine medical schools. Collaborative Research Group on Medical Student Health. Compr Psychiatry 2001; 42: 1–15

    Article  CAS  PubMed  Google Scholar 

  17. Roberts LW, Warner TD, Carter D, et al: Caring for medical students as patients: access to services and care-seeking practices of 1,027 students at nine medical schools. Collaborative Research Group on Medical Student Healthcare. Acad Med 2000; 75: 272–277

    Article  CAS  PubMed  Google Scholar 

  18. Brotherton SE, Etzel SI: Graduate medical education, 2005–2006. JAMA 2006; 296: 1154–1169

    Article  CAS  PubMed  Google Scholar 

  19. Fogel SP, Sneed JR, Roose SP: Survey of psychiatric treatment among psychiatric residents in Manhattan: evidence of stigma. J Clin Psychiatry 2006; 67: 1591–1598

    Article  PubMed  Google Scholar 

  20. Daugherty SR, Baldwin DC Jr, Rowley BD: Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions. JAMA 1998; 279: 1194–1199

    Article  CAS  PubMed  Google Scholar 

  21. Christie JD, Rosen IM, Bellini LM, et al: Prescription drug use and self-prescription among resident physicians. JAMA 1998; 280: 1253–1255

    Article  CAS  PubMed  Google Scholar 

  22. Klitzman R: Improving education on doctor-patient relationships and communication: lessons from doctors who become patients. Acad Med 2006; 81: 447–453

    Article  PubMed  Google Scholar 

  23. Safran DG, Miller W, Beckman H: Organizational dimensions of relationship-centered care: theory, evidence, and practice. J Gen Intern Med 2006; 21: S9–15

    Article  PubMed Central  PubMed  Google Scholar 

  24. Association of American Medical Colleges: Education Doctors to Provide High Quality Medical Care. A Vision for Medical Education in the United States. Report of the Ad Hoc Committee of Deans. Washington, D.C., AAMC, 2004

    Google Scholar 

  25. Frank E, Hedgecock J, Elon LK: Personal health promotion at US medical schools: a quantitative study and qualitative description of deans’ and students’ perceptions. BMC Med Educ 2004; 4: 29

    Article  PubMed Central  PubMed  Google Scholar 

  26. Dabrow S, Russell S, Ackley K, et al: Combating the stress of residency: one school’s approach. Acad Med 2006; 81: 436–439

    Article  PubMed  Google Scholar 

  27. Broquet KE, Rockey PH: Teaching residents and program directors about physician impairment. Acad Psychiatry 2004; 28: 221–225

    Article  PubMed  Google Scholar 

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Correspondence to Laura Weiss Roberts M.D., M.A..

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Dunn, L.B., Moutier, C., Hammond, K.A.G. et al. Personal Health Care of Residents: Preferences for Care Outside of the Training Institution. Acad Psychiatry 32, 20–30 (2008). https://doi.org/10.1176/appi.ap.32.1.20

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  • DOI: https://doi.org/10.1176/appi.ap.32.1.20

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