Doctors admitted to a physicians' health program: A comparison of self-referrals versus directed referrals

Objective: To compare the profile of doctors with mental disorders admitted to a Physicians' Health Program (PHP) depending on their type of referral. Design: Retrospective chart review. Method: We analysed 1545 medical records of doctors admitted to the Barcelona PHP (PAIMM) from 1 February 1998 to 31 December 2012. Results: Most doctors (83.2%) were self-referred to the programme. Patients non-self-referred were older (x-=55 vs x -=49.6 years; t=6.96, p<0.01) than those self-referred and there were more men (68.3%) than women (45.8%; OR=0.39; 95% CI 0.29 to 0.52). Self-referrals were more frequent among patients with nonaddictive disorders (84.6% vs 15.4%; OR=4.52; 95% CI 3.23 to 28.45). Self-referred patients needed less inpatient admissions (16.8% vs30.9%; OR=2.22; 95% CI 1.63 to 3.01) and the length of their treatment episodes was shorter (x-=24.3 vs x - = 32.4 months; t=3.34; p<0.01). Logistic regression showed a significant model (χ2=67.52; df=3; p<0.001). Age, gender and diagnosis were statistically associated with type of referral to the programme. Conclusions: Type of referral to a PHP may be influenced not only by sick doctors' personal traits but also by each programme's design and how it is perceived by service users. Our findings should be taken into account when designing treatment and preventive interventions for this professional group.