RECOGNIZING IMPAIRMENT

The key to recognizing impairment is knowing the behaviors that commonly emerge in the impaired physician.

Because physicians usually do not diagnose their own impairment, colleagues, staff and family members need to heighten their awareness of the signs of impairment and be willing to take the steps necessary to assist the physician in getting help.

Early detection, treatment and rehabilitation are essential to getting the physician on the road to recovery and to reducing the risk to patients.

Most physicians do not drink or use drugs on the job, so a problem is not always easily recognized. Due to stress in the medical profession, practitioners are often granted more leverage in their behavior and appearance.

It is important to look for trends in attitude, actions and appearance. Signs of impairment typically emerge in six areas of a physician's life: physical appearance, family and home, community, office, hospital, and employment history.

The appearance of one of these signs does not necessarily indicate impairment, but a combination of signs may signify a problem:

Physical Appearance

Personality or behavior changes
Wearing long sleeves in warm weather
Deterioration of hygiene or appearance
Frequent or unusual accidents
Multiple prescriptions
Family or Home

Marital or sexual problems
Medicinal use of alcohol or drugs
Unexplained absences from home
Financial problems
Withdrawal from family activities
Community

Unreliability or neglecting commitments
Isolation or withdrawal
Unpredictable behavior
Embarrassing behavior at social functions
Arrest for DUI or other legal problems
Office

Frequent or unexplained absences
Excessive working
Inaccessible ("locked door syndrome")
Excessive ordering of drugs or excessive drug use
Complaints by patients or staff Hospital

Frequent trips to the rest room
Frequently late, absent, or ill
Desire to work alone or refusing work relief
Lack of or inappropriate responses to pages or calls
Decreasing quality of performance or patient care
Employment History Frequent job changes or relocations

Reluctance to undergo physical exams or lab tests
Complicated or unusual medical history
Limitations (current or previous) on licensure
Unexplained intervals between jobs on curriculum vitae

Gratitude is extended to the Foundation of the Pennysylvania Medical Society for allowing us to use the above information, is available on their site.