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‘‘The Medical Self’’
Self-doctoring and Choosing Doctors
‘‘When am I a doctor, and when am I a patient?’’ Stuart asked. He and
others grappled with this question.
As their disease progressed, these physicians were finally forced to
acknowledge their illness in some way, but had to decide exactly how and
to what degree to do so. After all, they could treat themselves, order and
interpret their own lab tests, and prescribe medications—choosing drugs,
doses, and lengths of treatment. These capabilities could all help. Yet
such self-doctoring had limitations.
They also self-doctored in the contexts of dynamic doctor-patient and
doctor-colleague relationships that can shape these self-treatment deci-
sions. These ill physicians had to choose and interact with their own
doctors, but faced obstacles in doing so.
I found that most of these doctor-patients wrestled with questions of
whether they should self-prescribe, and if so, to what extent. They also
faced dilemmas in selecting doctors to treat them. Generally, they tried
to balance treating themselves and being treated by others, but wondered
how to establish such boundaries. In these matters, many thought they
were not wholly objective.
Several physicians described going within a few minutes from seeing
patients in a clinic to being seen as a patient. The physical contexts of
clinics and their own doctors’ offices also structured and shaped their
roles, informing how they behaved.
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