Physicians as Psychiatric Patients: Private Practice Experience

Psychiatric illnesses account for a considerable amount of the morbidity among doctors. Although no one knows the exact incidence, the treatment of emotionally ill doctors falls into the special province of the psychiatrist in private practice. Several significant early signs of emotional disturbance, particularly in the conduct of his profession, stand out; such as a hurried existence, self-doubts about the ordinary medical procedures, excessive tension when confronted with a difficult diagnostic problem, and gradual neglect of his practice. The most common long standing unhealthy life attitude was a morbid, self-sacrificing, driven existence, best described as masochism since it always exposed him to exploitation by others. Much delay was the general rule before a doctor got into therapy, even though therapy turned out satisfactorily in spite of stressful situational problems. While the types of disorders ran the gamut of the different diagnostic categories, the largest number had the diagnosis of personality disorder. Twice as many specialists as general practitioners made up this group. The treatment was largely outpatient psychotherapy. The cardinal principle in management consisted in treating the physician-patient, purposefully omitting the fact of his special medical education.