The Doctors Who Fear Disease Most: Health Anxiety Emerges as an Occupational Hazard for Healthcare Workers

Health anxiety, the excessive and persistent fear of illness that can grip a person even in the face of medical reassurance, has long been studied as a condition of the general public. A new scoping review published in BMC Health Services Research turns the lens around and asks a question that is both obvious in hindsight and startling in its implications: what happens when the people who spend their lives around disease begin to fear it for themselves? The study, led by Georgina M. Schlub of the University of Technology Sydney together with colleagues at the University of Sydney and the Children’s Cancer Institute, suggests that health anxiety among healthcare professionals may be far more common, and far more consequential, than the medical establishment has been willing to acknowledge.

The research team followed the PRISMA-ScR reporting guidelines, the accepted standard for scoping reviews, to map the existing literature on health anxiety in healthcare workers. Their search identified 35 peer-reviewed articles that met inclusion criteria, a body of evidence that on its face might seem modest for a workforce of millions worldwide. What is more striking is the temporal concentration of that evidence: 29 of the 35 studies were conducted during the Covid-19 pandemic. The pandemic, the authors argue, acted as a kind of natural experiment, thrusting healthcare workers into prolonged contact with a novel, deadly, and poorly understood pathogen while simultaneously flooding them with personal risk, moral distress, and the sight of unprecedented numbers of patients dying.

To move beyond a narrative summary, the researchers conducted an exploratory quantitative summary of the 19 studies that reported health anxiety data in a form suitable for pooling. The result was a combined estimate of health anxiety prevalence or severity among healthcare professionals, but the authors are careful, almost emphatic, about how that figure should be read. The between-study heterogeneity statistic, I-squared, came out at 99.8 percent, a value so extreme that it approaches the mathematical ceiling. In practical terms, this means the individual studies differed so profoundly in their populations, instruments, cutoffs, and contexts that any single pooled number is more of a signpost than a verdict. The team explicitly labels their estimate exploratory, a decision that reflects a growing sophistication in how systematic reviewers handle heterogeneous evidence rather than forcing false precision onto it.

Despite that heterogeneity, clear patterns emerged in the contributing factors. Health anxiety in healthcare professionals was associated with context-dependent variables including age, profession, gender, and broader sociodemographic characteristics. Younger workers, for instance, have repeatedly shown higher health anxiety scores in pandemic-era studies, a finding consistent with the general-population literature in which younger adults often report more illness-related worry. Professional role mattered as well, with frontline and direct-care occupations generally carrying greater exposure and, in several studies, greater anxiety. Gender differences appeared in multiple analyses, echoing the well-documented tendency for women to report higher health anxiety than men. None of these associations is deterministic, but together they sketch the outline of a workforce in which vulnerability to illness-related worry is unevenly distributed and shaped by the specific conditions of each worker’s job and life.

The conceptual heart of the paper is the authors’ use of the Cognitive Model of health anxiety as a framework for interpreting their findings. This model, rooted in cognitive-behavioural theory, holds that health anxiety is maintained by misinterpreting bodily sensations and health-related information as signs of serious disease, reinforced by safety behaviours such as repeated checking and reassurance seeking. The authors propose that elevated health anxiety in healthcare professionals may reflect processes consistent with vicarious trauma, the cumulative psychological impact of repeated exposure to the trauma of others. A nurse who has watched dozens of patients deteriorate from an infectious disease does not merely witness that trauma; the workplace ensures that the raw material of catastrophic health beliefs, the deteriorating patient, the abnormal scan, the sudden death, is a daily professional companion.

This framing has a certain explanatory elegance. Vicarious trauma has been extensively documented in professions such as emergency response, palliative care, and oncology, where it is understood to erode wellbeing, distort worldview, and contribute to burnout and post-traumatic stress. The cognitive model of health anxiety suggests a plausible mechanism by which such exposure could translate into illness anxiety specifically: the healthcare worker’s expert knowledge, normally a protective asset, becomes a double-edged sword. Knowing precisely how a constellation of symptoms can unfold into a fatal disease may make benign bodily sensations harder to dismiss, not easier. A headache is no longer just a headache when you have seen what brain metastases look like on a CT scan. The very training that equips clinicians to care for the sick may prime them to catastrophically interpret their own bodies.

The consequences of unaddressed health anxiety in this workforce are not trivial. Health anxiety in any population is associated with impaired mental and physical wellbeing, excessive healthcare utilisation, and diminished quality of life. In healthcare professionals, those costs compound: a clinician preoccupied with their own health may suffer reduced concentration, increased absenteeism, and higher risk of burnout and departure from the profession, pressures that ripple outward to patients and to health systems already strained by workforce shortages. The authors argue that health anxiety should be recognised as an occupational safety issue, placing it in the same category as needlestick injuries, infectious exposure, and workplace violence, hazards that health services are expected to anticipate, monitor, and mitigate rather than treat as private misfortunes.

One of the more encouraging threads in the review concerns treatment. Effective interventions for health anxiety already exist, most prominently cognitive behavioural therapy, which has a robust evidence base in general populations, with acceptance and commitment therapy emerging as another option supported by randomised controlled trials. The problem, the authors emphasise, is not a lack of therapeutic tools but a lack of understanding of how those tools translate to healthcare workers, whose illness beliefs are shaped by professional knowledge and occupational exposure in ways that standard treatment protocols were never designed to address. The aetiology of health anxiety in this group, its specific risk factors, and the optimal timing and format of intervention all remain open questions. A clinician may also face unique barriers to seeking help, including stigma, fear of professional consequences, and the pervasive culture of self-reliance that pervades medical training.

The methodological limitations of the underlying literature are themselves a finding of the review. The dominance of pandemic-era cross-sectional studies means the field lacks longitudinal data that could establish whether health anxiety in healthcare workers precedes occupational stress or follows from it, whether it fluctuates with disease outbreaks, and whether it resolves or consolidates over time. The extreme heterogeneity in measurement, with studies using different instruments and cutoffs, including the Short Health Anxiety Inventory, complicates comparison across settings. The authors’ decision to present their pooled estimate as exploratory rather than definitive is a model of responsible synthesis, resisting the temptation to headline a single prevalence figure that the data cannot support.

What the review ultimately delivers is an agenda. The authors call for further research to elucidate the mechanisms underlying health anxiety in healthcare professionals and to develop strategies for both prevention and treatment, work that would need to disentangle the contributions of vicarious trauma, professional knowledge, personality, and workplace conditions. If the cognitive model and the vicarious trauma hypothesis hold up under that scrutiny, the implications for health systems are concrete: screening programs for at-risk roles, psychologically informed occupational health services, and adapted psychological therapies that account for the clinician’s dual identity as healer and potential patient. The Covid-19 pandemic revealed how quickly the healthcare workforce can be pushed to its psychological limits. This study suggests that one of the injuries sustained in that pressure, the fear of illness itself, has been hiding in plain sight, and that recognising it as an occupational hazard is the first step toward treating it.

Subject of Research: Health anxiety among healthcare professionals as a potential occupational hazard

Article Title: Exploring health anxiety among healthcare professionals: a scoping review and exploratory quantitative summary of health anxiety findings

Article References: Schlub, G. M., Freeman, L., Barlow-Stewart, K., & McEwen, A. (2026). Exploring health anxiety among healthcare professionals: a scoping review and exploratory quantitative summary of health anxiety findings. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15573-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15573-0

Keywords: health anxiety, healthcare professionals, scoping review, vicarious trauma, Covid-19 pandemic, occupational health, cognitive behavioural therapy, mental health, illness anxiety disorder, burnout, Short Health Anxiety Inventory, BMC Health Services Research