PERKS AND PITFALLS: THE EXPERIENCE OF PHYSICIAN ± PATIENTS WITH CANCER. E.K. Fromme 1 , R.S. Hebert 1 , J.A. Carrese 1 ; 1 Johns Hopkins University, Baltimore, MD PURPOSE: Physicians have been described as the`worst' patients. Despite this, several prominent medical journals routinely feature writings by physician patients about their illnesses. This qualitative study examined the experience of physician patients treated for cancer. METHODS: Physicians who had a previous diagnosis of cancer other than non-melanoma skin cancer were recruited by their oncologists or radiation oncologists. 24 physician subjects representing diverse spectra of race, age, specialty, career stage and practice setting were identified. Various disease stages and tumor types were represented, from incidentally identified carcinoma to imminently terminal metastatic carcinoma. Subjects participated in in-depth semistructured interviews lasting an hour and a half. Interview transcripts were independently coded by two readers and compared for agreement. Content analysis identified several major categories of themes. RESULTS: 5 themes representing experiences specific to physician patients are presented. (1) Trusting others to provide care presented a particular challenge to our physician subjects who were well aware of the potential for error and were used to being in control in the medical environment. Physician subjects ranged from total trust in their providers and a desire to`just be a patient' to getting care only in institutions where they had access to their own lab results and computerized records. (2) Physicians have the ability to doctor themselves, and our physician subjects varied in their willingness to do so. In one instance, a physician found himself ordering his CT scans, referring himself to specialists and administering his own chemotherapy. Others, unable to wait for their physicians, broke their own bad news by checking lab results. (3) Physicians with a serious illness are faced with a choice about disclosing their illness to colleagues. Our physician subjects who chose to do so elicited reactions ranging from strong support to total avoidance. (4) Similarly, physicians are faced with a choice about disclosing their illness to patients. Our physician subjects who chose to tell their patients reported that their patients often responded with interest and support, and that they used self-disclosure to facilitate some aspect of the medical encounter. (5) Our physician subjects perceived clear advantages as patients such as easier access to their records, better understanding of their conditions, and particularly prompt and supportive follow up by their care providers. CONCLUSION: Our physician subjects identified advantages and challenges in their experiences as patients with cancer. In some cases, their illnesses affected the way that they interacted with colleagues and patients, whereas their physician status affected the way that they interacted with their physicians and the health care system. The insights of these physician patients may be helpful to physicians who are seriously ill and to those who are currently healthy.