"impaired doctors"

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...

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...

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...

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...

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...

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...

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...

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...

In the US, state medical licensing boards have the power to prevent sick doctors from practising if they do not undergo treatment. Every state has a programme for impaired doctors, most including a two-week hospital stay involving intensive psychotherapy. Research on recovery is limited, but some studies have found recovery rates of 75 per cent.

BACKGROUND: Australian medical boards now emphasize treatment and rehabilitation, where possible, for doctors who are ill or drug dependent and hence impaired. OBJECTIVE: This article describes the processes and experience of the Medical Practitioners Board of Victoria following the introduction of the Medical Practice Act 1994. DISCUSSION: Impaired practitioner programs usually encompass: assessment by an independent relevant specialist negotiation of appropriate conditions on practice to ensure both community protection and support for the doctor during treatment and rehabilitation medical supervision, regular urine testing and appropriate conditions on practice for drug dependent doctors...

The Physicians' Health Programs (PHP) of the Society's Educational and Scientific Trust boasts a better-than-average, 85 percent recovery rate for impaired physicians. PHP's efforts are not punitive, but instead are positive: PHP treats impaired doctors and gets them back into the community to practice medicine. The program's new medical director. Thomas Hobbs, MD, PhD, talks about the future of the program.

A national survey was conducted to assess the judgments of two sets of respondents (administrators of state physician health programs and highly experienced clinicians) about the effectiveness of treatment programs for chemically dependent physicians. Administrators consistently estimated higher rates of patient success (and less relapse) than their practitioner counterparts. Clinicians also identified factors (patient, therapist, group composition, context) they believed to be the most robust predictors of outcome with chemically impaired doctors...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

"Borderline" is a term used with increasing frequency to describe certain difficult patients. It refers to a heterogeneous population of patients who tend to get involved in impaired doctor-patient relationships. Different areas of psychiatry have their own, often conflicting definitions of these disorders. Early trauma, neglect and genetic diatheses to axis I disorders commonly occur in the backgrounds of these patients. Most have a combination of factors. With the multiple different definitions and the potential for misuse of the term, it should be used with caution and with an understanding of what definition is being used...

Sixty five patients were interviewed on an average of 42 months after a myocardial infarction. Using a semi structured interview, they were systematically questioned on their usual sexual activity just before their infarction and at the time of follow up. All were married men with a mean age of 54.4 years and had resumed a normal active life. Forty six (70%) reported a decrease in frequency of sexual intercourse (mean 6.9 times/month before infarction and 0.8 times/month at time of interview, p less than 0...

No abstract text is available yet for this article.