Increasing handicaps in hospital medicine: two point cross sectional study of golfing activity among doctorsBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7123.1656 (Published 20 December 1997) Cite this as: BMJ 1997;315:1656
- Correspondence to: Dr Eagles
Hospital consultants are often characterised by the media, and sometimes even by apparently well informed government ministers, as neglecting patients for private practice or the golf course. We investigated playing golf as a source of patient neglect.
Subjects, methods, and results
The study comprised a postal questionnaire of male medical graduates of 1977 from Aberdeen and Glasgow Universities. Subjects were surveyed about their golfing histories, including their golfing profile as a final year student and their recent golfing behaviour and aptitudes. Using general practitioners as a comparison group whom we presumed would be too stressed and overworked since government reforms1 to play much golf at all, we investigated the degree to which golf occupied the lives of hospital consultants.
The cohort comprised 134 subjects, the 52 male graduates of Aberdeen and the 82 male graduates of Glasgow whose addresses could be found in the medical directory of 1995. The overall response rate was 99/134 (74%). A significantly higher proportion of Aberdeen graduates responded (44/52 (85%) v 55/82 (67%); odds ratio 2.70 (95% confidence interval 1.04 to 7.21)), and more Aberdeen than Glasgow respondents had played golf as undergraduates (26/44 (59%) v 20/54 (37%); odds ratio 2.46 (1.01 to 6.05)).
Surprisingly, general practitioners were more likely to have played at university, to be current golfers, and to be members of golf clubs, and they currently played more often than consultants (1). When expected scores on a par 72 course as final year students and at the time of survey were compared, general practitioners' scores decreased by a mean of 3.9 (−1.0 to −6.8) while consultants' scores increased by a mean of 0.8 (−2.7 to 4.2).
Over recent years general practitioners have shouldered many of the tasks associated with government reforms, which are widely assumed to be the cause of stress, disillusionment, burnout, and early retirement.1 2 However, we found that many general practitioners played a lot of golf—a sport that we believe does nothing other than increase stress—and wonder whether golf might be the main culprit. People who play golf often should beware of developing overtraining syndrome, which is characterised by a “depressed psychological profile”3 and increased susceptibility to infection.4 A focal dystonia (popularly termed the yips) destroys the putting stroke in a quarter of people who play golf frequently, often with profound psychological consequences.5 These factors may impair health and insight to the extent that people seek early retirement with the hope of playing more golf and reducing stress, when exactly the opposite effect is likely to occur.
The association between golfing at university and becoming a general practitioner is puzzling. Do sporting habits and aptitudes influence career choice, or do golf and general practice draw on similar constitutional traits?
As graduates of Aberdeen University (JME) and of Glasgow University (GBR), so we could not agree on the reasons for the differences between our classmates' responses. Are Aberdeen graduates more energetic and dependable? Or are Glasgow graduates generally too industrious to play golf at university or to reply to frivolous questionnaires? Further research is required.
We conclude that hospital consultants seldom join golf clubs, do not play golf often, and their prowess deteriorates from that as undergraduates. While some might blame the introduction of compulsory audit, increased continuing medical education, the Calman changes, involvement in management, and general escalation in health service bureaucracy without meaningful increases in consultant numbers, it seems more likely to be due to engaging in large amounts of private practice or to laziness, or both. To avoid becoming as stressed as their colleagues in general practice, however, hospital doctors would do well to ignore the illusory allure of golf to which general practitioners have so sadly fallen prey.
We are grateful to all respondents and to Sybil McLeod for processing of the data. Katie Eagles, Jane Eagles, and Jennifer Affleck acted as clerical assistants.
Conflict of interests: JME and GBR are full time NHS consultants but have made every effort to report the findings objectively.