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Delaying Care, Avoiding Stigma: Residents' Attitudes Toward Obtaining Personal Health Care

Dunn, Laura B. MD; Green Hammond, Katherine A. PhD; Roberts, Laura Weiss MD, MA

Academic Medicine:
doi: 10.1097/ACM.0b013e31819397e2

Purpose: The authors sought to understand the health issues and care-seeking practices reported by residents and explored the extent to which fear of academic jeopardy, stigma, and being the subject of discussion by colleagues may affect residents' care-seeking.

Method: Residents at the University of New Mexico Health Sciences Center were surveyed in 2000–2001 regarding avoidance or postponement of obtaining necessary health care, responses of others to absences, and perceptions of jeopardy to training status if a supervisor learned of a specific condition. Responses were analyzed via repeated-measures MANOVA.

Results: Of 217 surveys, 155 were returned (71% response rate). Concerns with mental health, pain, minor infections, or relationship, sleep-related, fatigue, or gynecological/urological problems were expressed by 26% to 43% of residents. Concerns of potential jeopardy if a director or supervisor learned about personal health issues were strongest for problems with drugs/alcohol, moderately high for HIV, and moderate for mental health, eating-related problems, cancer, and STDs. Residents had sometimes avoided seeking care, and 18% had often avoided or delayed care-seeking; women delayed or avoided care more often than men. More frequent avoidance of seeking care was associated with poorer self-rated mental and physical health and greater health concerns.

Conclusions: Residents at times postpone or avoid seeking care. Time and scheduling difficulties influence the ability to obtain care. Perceptions of potential academic jeopardy, stigma, and reactions of colleagues may affect residents' attitudes and care-seeking. Further inquiry is essential to understand how extensively these factors may influence the well-being of residents.

Author Information

Dr. Dunn is associate professor, Department of Psychiatry & Department of Urology, University of California, San Francisco, San Francisco, California.

Dr. Green Hammond is a consultant, Ecosystem Modeling, Albuquerque, New Mexico.

Dr. Roberts is chairman and Charles E. Kubly Professor, Department of Psychiatry and Behavioral Medicine, and professor, Department of Population Health, Center for the Study of Bioethics, Medical College of Wisconsin, Milwaukee, Wisconsin.

Editor's Note: A commentary on this article appears on page 159.

Correspondence should be addressed to Dr. Roberts, 8701 Watertown Plank Road, Milwaukee, WI 53226; telephone: (414) 955-8990; fax: (414) 955-6299; e-mail: (

© 2009 Association of American Medical Colleges