Abstract:

Doctors' health is a major problem for healthcare systems, and several surveys have been carried out in different countries to assess the situation. Yet information about doctors' health is limited, especially in Latin America. The problem is that many doctors find it difficult to admit that they are in trouble, that their work is stressful, or that they need help. Thus the aim of this paper is to explore how doctors view their health and the professional practice in relation with their health, through the analysis of the resources of appraisal in informal communication among them. We present a qualitative analysis of a corpus of texts from a discussion forum in which doctors from Spanish-speaking Latin America wrote about their health and profession. We aimed to answer the following questions: (1) How do doctors view and evaluate their professional practice? (2) Do doctors see their working conditions as a risk factor for their own health? (3) To what extent do doctors express positive or negative values in discussions about their work? (4) What do they evaluate in the discussion? (5) Who do they find are responsible for this situation: health systems, their patients or their colleagues? The analysis was conducted using the framework of Appraisal Theory within a Systemic Functional Linguistics (SFL) approach and focused on three main areas: "appraiser", "appraised" and "goals considered valuable" These were examined within the semantic domain of attitude, which includes assessments of human behaviour by reference to social norms (judgment), personal feelings (affect) and assessments of the value of objects, artefacts, happenings and states of affairs (appreciation). In all three areas, attitude was found to be largely negative. Most doctors were acutely aware of risks to their own health as well as of other professional problems, and only a few expressed happiness and satisfaction with their profession. The most interesting findings were the negative judgment of social esteem with regard to neglect of their own health and the judgment of social sanction with regard to the healthcare system, as a whole, and to senior colleagues, in particular. From the point of view of engagement, when doctors valued their work as hard and distressful, they showed a tendency to present the propositions as unproblematic, so they seemed to assume that their audience shared their position. But when they referred to the causes of doctors' illnesses, which implied judgments of social esteem of themselves and their colleagues, they tended to acknowledge alternative positions and they apparently aimed at persuading their audience to promote a change of situation. © 2010 Elsevier B.V.