Letters to the Editor

Physicians Should Be Aware of Colleagues' Impairments

Am Fam Physician. 2010 Jan 15;81(2):123.

Original Article: Dealing with the Impaired Physician [Curbside Consultation]

Issue Date: November 1, 2009

Available at: http://www.aafp.org/afp/2009/1101/p1007.html

to the editor: I noticed this title, “Dealing with the Impaired Physician,” on the November 1, 2009, cover of American Family Physician and went to it with interest, as I am an impaired physician. I was disappointed the authors of this Curbside Consultation included this definition of “impaired physician” by the American Medical Association: “unable to fulfill professional and personal responsibilities because of a psychiatric illness, alcoholism, or drug dependency.”1 I hope that this is not the current definition, as it is much too narrow. Physicians in a practice need to understand that there are many situations in which a fellow physician may become impaired, and they should be ready and able to offer help and appropriate referral for medical care or professional evaluation by state Physician Health Programs (PHPs) as needed. PHPs are present in most, if not all, states. The Colorado PHP is a nonprofit organization, independent of other medical organizations and the government that provides the peer assistance services for licensed physicians and physician assistants of Colorado. Confidential peer assistance services aid individuals who have any problems (emotional, psychological, or medical) that would affect ones' health.

In my situation, I slipped and fell on ice and “rang my bell.” Unfortunately, it was my sixth concussion and I had significant cognitive consequences. I continued to see patients and managed a primary care medical office for four days after this incident before consulting with a partner about my bothersome cognitive issues. I had commented to peers that I had fallen and hit my head, and that I had been experiencing subsequent double vision (a computed tomographic scan was normal) and was having difficulty with my memory and finding words. No one who heard this information seemed to consider that I might be impaired. In later discussions with patients I had seen during this time, I learned that they were aware that I was not functioning normally, but had not felt it was their place to say anything to me or anyone else.

All practicing physicians need to be aware that many situations may lead to physician impairment, including but not limited to substance abuse and psychiatric illness. Trauma (including mild traumatic brain injury), brain tumors, or progressive neurologic diseases could also lead to impairment. In these cases, the impaired person may not even realize they have a problem as the functions of self-perception and perception could be impaired. We all need to be aware of the potential for impairment with certain trauma and medical conditions and refer fellow physicians for appropriate evaluations.

Author disclosure: The author has received profits from TBI Journey, Inc. from the sale of her book, “Brain Injury Survival Kit,” and honorariums for educational programs at the University of Denver funded by grants from the Colorado Traumatic Brain Injury Trust Fund.

REFERENCES

1. The sick physician. Impairment by psychiatric disorders, including alcoholism and drug dependence. JAMA. 1973;223(6):684–687.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


Copyright © 2010 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article