We often look at physicians and healthcare professionals as being invincible. They are a God-send for their ability, wisdom and training to make us feel better, even save our lives. But like all of us, they are only human and can succumb to mistakes and disease. In our society today, there are a number of threats that physicians face that can affect their well-being and resilience in the workplace. Namely, substance use disorders, mood disorders, anxiety disorders, sexual boundary violations, personality disorders, cognitive impairment and judgment impairment, as is the case when misprescribing drugs.
Dr. Dan Angres, Medical Director of Positive Sobriety Institute, has spent the majority of his career focused on the rehabilitation of professionals who become addicted to substance use and suffer from mental health disorders. What he has found is the need to strike a “tough love” balance with this physician population in order to maintain a culture of safety for their patients and ultimately help physicians overcome their addiction.
According to Dr. Angres, there is a critical need to both protect a patient from a physician who is impaired and care for the physician themselves, so he or she can resume safe practice. Treating a physician who is struggling with an addiction requires a delicate balance. They are typically concerned about their licensure, their practice, the stigma associated with the disease, or the lack of support they might receive from their peers or employer.
“Because physicians tend to become focused, they generally respond well to structured programs. Still, some challenges exist. Physicians may have a limited capacity for introspection that leads them to dismiss their problem usage. Pressured to see more patients in less time with fewer resources, they often rely on “curbside consults” or misdiagnose themselves. They can be defensive about any intervention that may threaten their licenses, making it important to support reentry to practice when possible” says Dr. Angres.
Physicians face many factors that increase their risk for addiction. They generally have easier access to controlled substances; they can write prescriptions for themselves and can access drugs online or on the street. Young physicians, residents and medical students in particular are affected by the heroin epidemic sweeping the country. Like their peers, many start using opioid painkillers, then they discover a cheaper and more accessible drug—heroin.
Physicians also face mounting pressure to succeed, beginning with medical school and throughout their careers. They work long hours with little sleep, often face very difficult life and death situations with their patients, and develop mental health disorders such as stress and anxiety due to the pressure.
Physicians are often afraid to admit they have a problem, the need for help, or talk to anyone about their issue. This leaves self-medication in the form of substance abuse as the only option for many.
Fortunately, there has been a light shined on the issue of addicted physicians as a result of the current opioid epidemic in the U.S. Many states implement Physician Health Programs to guide physicians and other healthcare professionals who are addicted to drugs or alcohol. Physicians who willingly participate in a physician health program tend to avoid formal complaints to the medical board along with punitive measures and are able to seek treatment confidentially from qualified treatment centers.
According to Dr. Angres, an efficient and successful treatment program should be multidisciplinary and offer neuropsychological screening, comprehensive toxicology, a detailed history and coherent report. In addition, the treatment program should include:
The vast majority of physicians who complete addiction treatment return to work right away, though some will change jobs to achieve a better balance between their work, recovery program and family or to reduce stress.
Read more about Positive Sobriety Institute’s addicted physician program. >>
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