Causes and treatment of impairment and burnout in physicians: The epidemic within

Abstract

No one knows the exact numbers or percent of physicians who are impaired in academic medicine. There is no reason to believe that it is significantly different from the national figures-15% throughout a professional career. Although the scope of impairment is growing wider, this chapter will focus on the traditional categories of drug and alcohol abuse, mental illness, particularly depression and suicide, and the newer category of the disruptive physician. This chapter will also link predisposing issues such as stress and burnout to the development of impairment and identify issues unique to the academic world that might foster the development of these impairments. These might include a very powerful drive for achievement, exceptional conscientiousness, an ability to deny personal problems, and an inability to achieve a balance between the professional and personal life. Identifying and even treating these problems before they evolve into true impairment is a continual challenge. Society and the professions are raising the standards of what they expect from their professionals, including physicians, and these include accountability, transparency, and expectations of high levels of function without impairment that could affect patient care. There is also an obligation to help our fellow professionals, particularly in academic settings, to be able to fulfill their lives with both professional and personal satisfaction. © 2009 Humana Press.