Impairment among medical professionals continues to be an under-recognized, under-identified and under-treated problem with serious implication for public health. Substance use disorder, depression, anxiety, and stress disorders are associated with high rates of professional burnout and suicide. Yet the development and growth of state physician health programs have resulted in countless careers and lives saved. The five-year success rate is unparalleled in addiction treatment, in part because this model has embraced a chronic disease management model such as is available for persons with asthma, diabetes, coronary artery disease and hypertension. All of which provide continuous care, medical monitoring and social support.
Why Does This Matter?
The prevalence of substance use disorders among physicians is not unlike that observed in the general population, although burn out and self-medication during medical training is unique to the medical profession and is associated with increased suicide among medical students and residents.
As a result of the unique nature and risks associated with medical care, impaired medical professionals present a public health and safety problem. Accordingly, physician intervention and health programs provide an integrated system of identification, assessment, evidence-based, patient centered treatment, and long term care and monitoring. The results of this model are outstanding. The five-year abstinence and return-to-work rates are approximately 80%. In contrast, modalities available to the general population are commonly crisis driven, episodic, of sub-therapeutic duration and without continuous care or monitoring. Finding a way to duplicate this physician health model for all those seeking treatment has proven to be more challenging than expected. Education of policy makers is desperately needed if we are to impact the current epidemic of addiction and rising mortality.
Srivastava, A B. Impaired Physicians: Obliterating the Stigma. Residents Journal of the American Journal of Psychiatry 4-6 pp. March 2018.