Do you have your own doctor, doctor? Tackling barriers to health care

Doctors are more at risk of mental ill-health than the general population.1 The risk of suicide is higher than the general population, especially among GPs, anaesthetists, and psychiatrists.2 Studies from North America suggest that 8–18% of doctors will be affected by drug or alcohol abuse during their lifetime.3 So the way that doctors do or don't access health care is important — for them, their families, their colleagues, and ultimately, for their patients. An article in this issue4 reviews the literature on health behaviours of doctors and the barriers they experience in accessing care. The review is timely in that the 2007 white paper, Trust, Assurance and Safety – the Regulation of Health Professionals in the 21st Century 5 proposed a strategy for improving the health of health professionals. This will include appropriate prevention and early intervention for health concerns, promoting easier uptake of services and assuring confidentiality. In 2006 the Chief Medical Officer6 recognised deficiencies in the provision of care to doctors impaired by mental health and addiction problems. In addition, the Department of Health published a report this year on mental ill health in doctors;7 this was a response to the inquiry8 into the suicide of a young psychiatrist with serious mental illness who received suboptimal care. Dating back to 1994, a variety of reports in the UK, from the Nuffield Trust,9,10,11 the General Medical Council (GMC),12 and the British Medical Association (BMA)13 have identified the particular health needs of doctors and the barriers they experience in accessing care. The review by Kay et al 4 notes that there is little …