A large number of physicians work whilst having infections and other diseases. This behaviour might be harmful to the physicians themselves as well as to their patients and staff members.

Most physicians practise self-treatment when they are ill, and although they prefer to be treated by a physician they do not have personal ties to, many contact friends and colleagues when they need help from another physician.

Results. Of subjects with a heart attack, angina, stroke or diabetes 45% of men and 35% of women were taking a statin (P < 0.001). Of subjects with cardiovascular disease (CVD) or diabetes taking statins 61% of men and 40% of women achieved total serum cholesterol levels £5 mmol L )1 . The odds ratio for taking a statin was increased amongst subjects who also took antihypertensive drug(s) or acetylsalicylic acid, subjects with a family history of coronary heart disease (CHD) and women who had visited the general practitioner within the last year. Amongst presumed healthy subjects use of statins increased from about 1% in women aged 40-45 years, to 7% at age 60 and to 12% at age 75 whilst the corresponding figures for men were 3%, 8% and 9%, respectively. About 22% of men but <2% of women aged 60 who were not taking statins had a 10-year Framingham CHD risk score >20%. Determinants of statin use were similar to those amongst subjects with CVD or diabetes. Conclusion. People with CVD or diabetes remain undertreated with statins, women more so than men. Use of other preventive drugs, the family history and recent contact with the general practitioner were the most important determinants of statin use in primary and secondary prevention. Amongst healthy subjects aged 60 or 75 years women received statins disproportionately to their low CHD risk compared with men.

ObjectiveTo explore general practitioners’ (GPs) views on leadership roles and leadership challenges in general practice and primary health care.DesignWe conducted focus groups (FGs) with 17 GPs.SettingNorwegian primary health care.Subjects17 GPs who attended a 5 d course on leadership in primary health care.ResultsOur study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical and leadership role. GPs recognized the need to take on leadership roles in primary care, but their lack of leadership training and credentials, and the way in which their practices were organized and financed were barriers towards their involvement.ConclusionsGPs experience tensions between the clinical and leadership role and note a lack of leadership training and awareness. There is a need for a more structured educational and career path for GPs, in which doctors are offered training and preparation in advance.Key pointsLittle is known about doctors’ experiences and views about leadership in general practice and primary health care. Our study suggests that:There is a lack of preparation and formal training for the leadership role.GPs experience tensions between the clinical and leadership role.GPs recognize leadership challenges at a system level and that doctors should take on leadership roles in primary health care.

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