Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study

Objective: To explore general practitioners' perceptions of the effects of their profession and training on their attitudes to illness in themselves and colleagues. Design: Qualitative study using focus groups and indepth interviews. Setting: Primary care in Northern Ireland. Participants: 27 general practitioners, including six recently appointed principals and six who also practised occupational medicine part time. Main outcome measures: Participants' views about their own and colleagues' health. Results: Participants were concerned about the current level of illness within the profession. They described their need to portray a healthy image to both patients and colleagues. This hindered acknowledgement of personal illness and engaging in health screening. Embarrassment in adopting the role of a patient and concerns about confidentiality also influenced their reactions to personal illness. Doctors' attitudes can impede their access to appropriate health care for themselves, their families, and their colleagues. A sense of conscience towards patients and colleagues and the working arrangements of the practice were cited as reasons for working through illness and expecting colleagues to do likewise. Conclusions: General practitioners perceive that their professional position and training adversely influence their attitudes to illness in themselves and their colleagues. Organisational changes within general practice, including revalidation, must take account of barriers experienced by general practitioners in accessing health care. Medical education and culture should strive to promote appropriate self care among doctors.

Overlapping Notions of Self and Other: the Case of the Anabaptist Body

This paper examines the complex interrelations between notions of ͚“elf͛ and ͚Otheƌ͛ with regards to human bodies, taking as a case study the bodily experiences of Anabaptist Christians, both historically and in the present day. It first examines body practices and discourses through the lens of Anabaptist approaches to baptism and conscience and it relates these to the Foucauldian notion of care of the Self. It then looks at biopolitical relations between individuals and the state through an examination of oath-taking and anti-war protests. Finally, it discusses the roles of bodies and bodiliness in contemporary Anabaptist commemorative practices.