Dr Kay’s
research has shown that treatment barriers exist because of the
patient-doctor’s embarrassment, a sense that to admit ill health is to
admit weakness, concern over lack of confidentiality, fear of mandatory
reporting and an expectation within the profession that doctors will keep
on working even while they are unwell[1].
The recent
Beyondblue National Mental Health Survey of Doctors and Medical Students
have backed her concerns in relation to mental health issues. It found
that, when it comes to seeing a doctor about a mental health problem, 37.4%
of the 40,000 doctors and 6,600 medical students surveyed identified
embarrassment as a barrier to help seeking. Concerns about privacy and
confidentiality and risks to registration were also ranked high as barriers
to treatment[5].
“We are measuring ourselves against
the model learned in medical school of the ideal patient, who walks in and
walks out without asking any questions. But sometimes doctors don’t
understand it’s not being a bad patient if you ask whether you have a brain
tumour,” Dr Kay says.
Consultations can also be fraught for the
treating doctor, especially if the doctor-patient doesn’t believe he or she
is practising good medicine or if the treating doctor doesn’t feel he or
she has total control, says Dr Kay.
Even whether to charge the
doctor-patient is an issue that needs to be negotiated to prevent
discomfort.
“Doctors do access care differently. For example, their
GP might tell them to see a surgeon but then not go on to organise things
for them as they would another patient. Follow-up is often missed and
patient-centered care is not always done when the patient is a doctor,” Dr
Kay says.