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The term impaired physician historically referred not only to physicians with substance use disorders but also to those with medical, psychiatric, or behavior disorders that impede the ability to practice medicine safely and effectively. This term is now considered archaic and should be replaced by more accurate, less pejorative language.

Physicians are vulnerable to substance abuse and dependence at rates comparable to those of nonphysicians.

Signs and symptoms of a substance use disorder often present first at home and other nonprofessional settings. When problems manifest themselves in the medical workplace, the substance use usually has been occurring for years.

The effect of a physician's substance misuse can extend far beyond the personal toll on the physician and may extend to professional colleagues, patients, and family members.

Early intervention for or prevention of physician substance misuse is vitally important.

Dealing with a colleague who has a substance use disorder often requires consideration of both legal and ethical issues.

Every state in the United States has a physician health program. State physician health programs provide or facilitate independent assessments for physicians with substance use disorders, provide guidance to hospital administrators and physician health committees, and contract with physicians who agree to treatment and complete abstinence from alcohol and drug use to provide monitoring and advocacy.

Physicians in monitoring programs should not be deprived of appropriate treatment for other psychiatric disorders or pain. Stimulant medications, tranquilizers, and narcotic analgesics can be safely prescribed with appropriate safeguards and open communication among all treating physicians.

The success rates for physicians who undergo substance abuse treatment are quite high, with most programs reporting positive outcomes in the 75%–85% range.

Recovering physicians should consult with an attorney before making a self-report to the state licensing board and when answering confidential health-related questions on license renewal, job application, and hospital or insurance credentialing forms.


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