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"impaired doctors"

Helen Kiel
This article reports and updates a study that analysed protective orders in medical disciplinary tribunals over a three-year period. It argues that the concept of the protection of the public has been undermined by protective orders that focus on the rehabilitation of problem and impaired doctors in the management of risk. The article posits a medical or psychiatric model of misconduct in which misconduct is seen in terms of illness, rather than attracting negative moral judgment and severe disciplinary sanctions...
November 2017: Journal of Law and Medicine
Joan K Morris, Ester Garne, Maria Loane, Marie-Claude Addor, Ingeborg Barisic, Fabrizio Bianchi, Miriam Gatt, Monica Lanzoni, Catherine Lynch, Olatz Mokoroa, Vera Nelen, Amanda Neville, Mary T O'Mahony, Hanitra Randrianaivo-Ranjatoelina, Anke Rissmann, David Tucker, H E K de Walle, Natalya Zymak-Zakutnia, Judith Rankin
Women with epilepsy need to continue to take anticonvulsants during their pregnancies to prevent seizures from occurring. Since the 1980's, it has been known that the use of valproate (an anticonvulsant) in the first trimester of pregnancy is associated with an increased risk of spina bifida. Recent studies have also demonstrated increased risks of other congenital anomalies as well as a risk of cognitive impairment. Doctors in the EU are now advised not to prescribe valproate in pregnant women, in women who can become pregnant or in girls unless other treatments are ineffective or not tolerated...
September 2018: European Journal of Medical Genetics
Caroline Christie, Simon Wynn-Thomas, Bianca McKinnon
INTRODUCTION In New Zealand, 41% of general practitioners (GPs) intend to retire by 2025. Increasing workforce shortages and other stressors are putting doctors at risk of burnout, which in turn can put patients at risk of harm. Offering a range of resources can signal an organisation's commitment to physician wellness while improving patient safety and organisational stability. AIM To replace the current reactive approach to impaired doctors with a proactive system of monitoring performance with the goal of identifying problems early...
September 2017: Journal of Primary Health Care
E Brooks, M H Gendel, A L Parry, S Humphreys, S R Early
BACKGROUND: Physicians are not immune to cognitive impairment. Because of the risks created by practising doctors with these issues, some have suggested developing objective, population-specific measures of evaluation and screening guidelines to assess dysfunction. However, there is very little published information from which to construct such resources. AIMS: To highlight the presentation characteristics and provide evaluation recommendations specific to the needs of physicians with actual or presumed cognitive impairment...
January 2017: Occupational Medicine
Mathilde Mastebroek, Jenneken Naaldenberg, Francine A van den Driessen Mareeuw, Antoine L M Lagro-Janssen, Henny M J van Schrojenstein Lantman-de Valk
BACKGROUND: Accurate health information exchange (HIE) is pivotal for good quality of care. However, patients with intellectual disabilities (ID) face challenges in processing and exchanging health information around GP consultations. Knowledge of HIE barriers and facilitators, including the roles of carers, may help to improve GP care for people with ID. OBJECTIVE: To gain more insight into HIE barriers and facilitators for ID patients in GP care. METHODS: A qualitative study exploring GP consultation experiences of people with ID (n = 35), professional carers (n = 20) and relatives (n = 15)...
October 2016: Family Practice
Kristina Klaus, Winfried Rief, Elmar Brähler, Alexandra Martin, Heide Glaesmer, Ricarda Mewes
When revising the former somatoform diagnoses to somatic symptom disorders, DSM-5 introduced psychological classification criteria in addition to somatic symptoms. The authors investigated the relevance of these and further cognitive, affective, and behavioral features as well as their predictive value concerning (a) somatic symptoms that are not better explained by a general medical condition (MUS) and somatoform disorders (SD), (b) impairment, and (c) health care utilization. A general population sample of 321 participants (M = 47...
November 2015: Journal of Abnormal Psychology
Jeff Y Zong, Jenny Leese, Alexandria Klemm, Eric C Sayre, Jasmina Memetovic, John M Esdaile, Linda C Li
OBJECTIVE: To explore rheumatologists' perceptions of patient decision aids (PtDAs) and identify barriers to using them in clinical practice. METHODS: A cross-sectional online survey of all members of the Canadian Rheumatology Association (CRA; n = 459) was conducted. We subsequently invited 10 respondents to participate in a 30-minute telephone interview to further explore their views on using PtDAs in clinical practice. Interview participants were purposefully sampled to achieve a balance in sex, years in clinical practice, and types of practice...
October 2015: Arthritis Care & Research
R G Beran
Mandatory reporting of impaired doctors is compulsory in Australasia. Australian Health Practitioner Regulation Agency guidelines for notification claim high benchmark though the Royal Australasian College of Surgeons and the Royal Australasian College of Physicians suggest they still obstruct doctors seeking help. Western Australia excludes mandatory reporting of practitioner-patients. This study examines reporting, consequences and international experiences with notification. Depressed doctors avoid diagnosis and treatment, fearing consequences, yet are more prone to marital problems, substance dependence and needing psychotherapy...
December 2014: Internal Medicine Journal
P Komesaroff
No abstract text is available yet for this article.
December 2014: Internal Medicine Journal
Helen Kiel
This article examines the regulation of impaired doctors in Australia and explores the inherent tensions in the new Health Practitioner Regulation National Law in attempting to both treat the doctor and protect the public. It discusses both informal and formal mechanisms of regulation with particular reference to therapeutic jurisprudence and mandatory notification. It focuses particularly on New South Wales and examines all the impairment cases which resulted in disciplinary proceedings in the Medical Tribunal of New South Wales in 2010...
December 2013: Journal of Law and Medicine
M O Vincent
This article deals with the question "What should you do when you suspect that a colleague's ability to practice medicine has become impaired?" The scope of the problem is now known, and the medical profession's response has been to organize provincial committees to help the impaired doctor. Several patterns suggesting impairment are summarized in this article. An affirmative response is needed; suggestions as to how one may respond are outlined.
June 1980: Canadian Family Physician Médecin de Famille Canadien
Wayne Cunningham, Tim Cookson
AIMS: In January 2006 the Medical Protection Society (MPS) and Medical Assurance Society (MAS) commenced a jointly funded counselling service for stressed doctors in New Zealand. Stressed and impaired doctors may impact negatively on patient care. This study aims to investigate the service's utilisation, acceptability, and utility, and to consider whether the service may improve the delivery of health services. METHOD: Psychologist or psychiatrist providers of the service between January 2006 and July 2008 were asked to anonymously complete a questionnaire about the service...
August 7, 2009: New Zealand Medical Journal
C Peisah, R G Adler, B W Williams
Our ageing medical workforce poses many challenges, not the least of which is acknowledging the contributions of ageing practitioners who continue to practise safely and competently while ensuring that those who are incompetent by virtue of impairment are identified, assessed and either rehabilitated or encouraged to retire. Hitherto, there has been little attempt to review approaches to impairment on a national basis in Australia, let alone with a focus on older doctors. Information regarding pathways for dealing with impairment was obtained from the websites and confirmed by representatives of regulatory bodies of every state or territory in Australia...
December 2007: Internal Medicine Journal
Christian Hirsch, Mike T John, Hans-Günter Schaller, Jens C Türp
OBJECTIVE: The purpose was to compare orofacial (temporomandibular) pain with other pain complaints regarding impairment and health care utilization in a sample of 1,011 children and adolescents from a metropolitan area in Germany. METHOD AND MATERIALS: Individuals aged 10 to 18 years were sampled in schools using a 2-stage cluster technique. Orofacial pain in the previous month was assessed according to the Research Diagnostic Criteria for Temporomandibular Disorders...
May 2006: Quintessence International
Gary Hulse, Moira G Sim, Eric Khong
BACKGROUND: The lifetime prevalence of substance abuse disorders among doctors in Australia has been estimated to be approximately 8%. These disorders can interfere with a doctor's ability to function and pose a risk to patient welfare and safety.' OBJECTIVE: This article identifies key indicators to the development of problem alcohol and drug use in a general practitioner, associated possible psychiatric morbidity, work deficits, and the need for colleagues to recognise and respond in a timely manner to resolve these events...
September 2004: Australian Family Physician
Kay A Wilhelm, Alison M Reid
The New South Wales Medical Board has developed the Impaired Registrants Program to deal with impaired registrants (doctors and medical students) in a constructive and non-disciplinary manner; the program is now well established. The Program enables the Board to protect the public, while maintaining doctors in practice whenever possible. Disorders that commonly lead to referral of impaired doctors include alcohol and drug misuse, major depression, bipolar disorder, cognitive impairment and, less commonly, psychotic and personality disorders and anorexia nervosa...
October 4, 2004: Medical Journal of Australia
Geoffrey J Riley
Stress in doctors is a product of the interaction between the demanding nature of their work and their often obsessive, conscientious and committed personalities. In the face of extremely demanding work, a subjective lack of control and insufficient rewards are powerful sources of stress in doctors. If demands continue to rise and adjustments are not made, then inevitably a "correction" will occur, which may take the form of "burnout" or physical and/or mental impairment. Doctors need to reclaim control of their work environment and employers need to recognise the need for doctors to participate in decisions affecting their working lives...
October 4, 2004: Medical Journal of Australia
Rita Gorawara-Bhat, Thomas H Gallagher, Wendy Levinson
BACKGROUND: Patients worry about financial conflicts of interest related to cost containment but may hesitate to share this concern with their physician. Little is known about how this issue affects encounters between doctors and patients, or about the communication strategies physicians endorse for responding to such concerns. OBJECTIVE: To understand physicians' perspectives on how managed care patients' concerns about conflicts of interest are impacting the physician-patient relationship in routine visits...
August 2003: American Journal of Managed Care
G K Hulse, G O'Neil, M Hatton, M J Paech
Doctors are at an increased risk for prescription drug use, particularly opioids and benzodiazpines. This use can interfere with work function and has major potential negative implications for patient safety. Oral naltrexone, an opioid antagonist, has been used as part of a management strategy for opioid dependent physicians. While some patients stabilize on oral naltrexone, others relapse to opioid use. An alternative method of naltrexone maintenance involves the injection or surgical insertion of a sustained release preparation of naltrexone...
April 2003: Anaesthesia and Intensive Care
Eric Khong, Moira G Sim, Gary Hulse
BACKGROUND: Problem drug use occurs within the medical fraternity as it does in other parts of the population. However, doctors have traditionally been discouraged from admitting vulnerability and frequently fail to recognise or respond to early signs of problem alcohol and drug use. OBJECTIVE: This article aims to identify sequential strategies to assist the doctor to detect and intervene early when problem drug use arises in themselves or a colleague. DISCUSSION: Where treatment and monitoring is instituted early in problem drug use, outcomes are typically positive while late acknowledgment commonly results in sanctions for the impaired practitioner and greater risk to patients...
December 2002: Australian Family Physician
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