The Impaired Physician

Abstract

Identifying and managing the impaired physician is a difficult ethical dilemma. The physician may be impaired by alcohol and drugs, or by several more recently recognized types of impairment, including behavioral, psychiatric, and aging or cognitive decline issues. Identification may be facilitated through the use of observations by patients, peers, and other medical personnel, and structured assessment programs. Management may require the use of preestablished hospital protocols, physician health programs, and, at times, revocation of clinical privileges or licensure. This chapter reviews the evolution of the definition of physician impairment and types of physician impairment, and presents strategies to manage and assist the impaired physician while dealing with some of the ethical and legal concerns associated with the process. © 2012 John Wiley & Sons, Ltd.