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Why aren't physicians better blood donors?

Some of the regular donors at our hospital's blood center asked us an embarrassing question: "Why don't we ever see any doctors donating? They know better than anyone how important it is!"

It was a good point. Since physicians know firsthand that a good blood supply is vital, you might think they would be regular donors, right? Wrong--as we discovered after two minimally successful recruiting attempts among the medical staff. According to a follow-up survey we conducted, physicians rely on the same familiar set of excuses as the general public.

As background, it's important to note that our 320-bed hospital has a highly successful blood assurance program, constantly exceeding our needs. The donor center is centrally located in the clinical laboratory, and most staff physicians pass it daily. Donor hours run from 8 a.m. to 8 p.m., Monday through Friday. Physicians may call for an appointment and are processed without delay. In fact, we promise to get them in and out within 30 minutes.

The median age of our active medical staffers is less than 40 years. Prior to our special recruiting efforts, only two or three were regular donors. Others gave blood sporadically under special circumstances, such as for family or professional associates. More often than not, physicians did not replace blood used by their family members or themselves.

We determined to improve the track record by scheduling two Doctor Donor Weeks within a 12-month period. Both were highly publicized with posters placed conspicuously in locations like the physician lounge and dining room. We made announcements at medical staff meetings and sent each physician an individual written invitation. We asked them to call for appointments, but assured them they would be welcome at any time during routine donor hours.

The results were less than overwhelming. Only 13 physicians from our 189-member medical staff--just 7 per cent--gave blood during the first donor week, and only 3 per cent did so during the second week. Three other physicians gave blood at other times, so that within a 12-month period, just 12 per cent of the medical staff had donated.

Disappointed, we wondered how other recruiters had fared. A search of the literature turned up many articles on why people do or don't donate, but none that referred specifically to physicians. In one review of 60 articles on donor motivation published through 1975, various studies yielded similar finds. The principal deterrents seem to be lack of peer pressure to donate; fear (of needles, the sight of blood, rejection, negative reaction, or harmful effects on health); medical excuses; unpleasant prior experiences, such as physical reactions, impersonal treatment, or problems with phlebotomy or other aspects of collection; apathy or inertia; and inconvenience.

Another survey found little difference in the degree of social responsibility or general altruism between donors or non-donors, and reported peer pressure as the leading factor in persuading individuals to give blood. A third research team came to similar conclusions, but applied the term inertia instead of apathy to non-donors. Many non-donors recognize the need for blood, the researchers found, and many would donate if the correct conditions prevailed.

We wanted to learn the specific reasons why more of our physicians didn't donate, so we sent a questionnaire to each member of the active staff (Figure I). We asked whether the physician had donated within the past 12 months, and if not, why not. Fifty-four of our questionnaires were returned--a response rate of 29 per cent. The rate of return was highest among donor physicians, half of whom responded.

At first glance, the survey results suggest that health was the major constraint (Figure II). In fact, one might conclude that our medical staff on the whole was a pretty unhealthy group, since 45 per cent of the non-donors cited health as their reason. Several qualifying factors deserve attention, however.

First, non-donors with disqualifying conditions (history of hepatitis was the most common reason given) were probably more inclined to respond to the survey, since their explanation was valid and socially acceptable. Informal evidence suggests that some of these physicians don't really know if they are medically disqualified or not--and are not very anxious to find out.

Some, it not most, of the physicians on medication could be eligible if they were willing to discontinue their drug therapy briefly. Six physicians offered the lame excuse, "I need my blood," without referring to any underlying medical reason. Their standard response when questioned face to face was that they were so busy with their practices, they feared that donating would sap the energy needed to tend to their patients properly. They fell silent when asked why they couldn't donate on their days off.

Amazingly, almost 30 per cent of the non-donors checked off "fear" as one of their reasons for staying away from the blood center. Eight physicians cited fear of needles--a datum that would no doubt amuse their patients greatly. (We believe one doctor was pulling our leg when he claimed he fainted at the sight of blood.)

Seven physicians expressed fear of a donor reaction, the kind of response that is understandable from individuals who have had unpleasant experiences when donating in the past. We expected greater concern about being detected as a possible hepatitis carrier, since this reason was often mentioned in casual conversation. Only two responding physicians cited it, however.

Our remaining non-donor categories, inertia and other, covered the quarter of all non-donors with excuses unrelated to health or fear. The inertia group numbered only 15 physicians, or just one-fifth of the non-donors, but we suspect that, in reality, this was probably our largest group. After all, the staffers most indifferent or apathetic to the donor program were probably least likely to return their questionnaires--and we did not hear from 71 per cent of the medical staff.

Learning exactly why our physician donor weeks had not been more successful served as some consolation to the blood center staff. It also proved how stubborn are certain obstacles to the donor recruitment process, even within the medical community itself.

Of course, we realize that our physicians appreciate the importance of blood and blood procurement. And it may be the very success of our local blood assurance program that inhibits donations from busy clinicians. Perhaps they would respond more vigorously if there were constant or intermittent blood shortages. It would certainly be interesting to duplicate the efforts we have described here at a facility where blood shortages are common.

To sum up: Physicians, like everyone else, have vague and not always valid reasons relating to health, fear, and inertia for staying away from the blood donation couch. It's probable that a little peer pressure would help overcome some resistance, and we intend to keep encouraging our doctors, along with the rest of our hospital staff, to participate.
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Author:Umiker, William O.
Publication:Medical Laboratory Observer
Date:May 1, 1985
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