Chemical Dependency and the Physician

Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clinic Proceedings (Impact Factor: 6.26). 08/2009; 84(7):625-31. DOI: 10.1016/S0025-6196(11)60751-9
Source: PubMed


Although the nature and scope of addictive disease are commonly reported in the lay press, the problem of physician addiction has largely escaped the public's attention. This is not due to physician immunity from the problem, because physicians have been shown to have addiction at a rate similar to or higher than that of the general population. Additionally, physicians' addictive disease (when compared with the general public) is typically advanced before identification and intervention. This delay in diagnosis relates to physicians' tendency to protect their workplace performance and image well beyond the time when their life outside of work has deteriorated and become chaotic. We provide an overview of the scope and risks of physician addiction, the challenges of recognition and intervention, the treatment of the addicted physician, the ethical and legal implications of an addicted physician returning to the workplace, and their monitored aftercare. It is critical that written policies for dealing with workplace addiction are in place at every employment venue and that they are followed to minimize risk of an adverse medical or legal outcome and to provide appropriate care to the addicted physician.

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    • "Referral options and an action plan should be in place so that the health care professional-patient will be enabled to follow the recommended assessment and/or treatment. Arguments have been made for a chain-of-custody transfer of the health care professional-patient to the area where the assessment will occur to decrease the risk of a tragic outcome (Berge et al., 2009). "
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    • "As a physician, he had confidence that he could treat his depression without any assistance. Approximately 10% to 12% of physicians will develop a substance use disorder during their careers, a rate similar to, or exceeding, that of the general population in America.15-17 "
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