Clinical management of physicians with addictive and mental disorders

Abstract

Introduction

Physicians presenting with addictive behaviours and mental illness can be a considerable challenge for psychiatrists. Impaired physicians usually tend to act as doctors while eschewing the role of a patient, which can result in poor compliance, self-diagnosis and self-medication. The psychiatrist confronted with such a patient may react defensively and not take into consideration the needs of the patient. On the other hand, when appropriately handled, impaired physicians can be an enormous source of help for themselves. An appropriate setting and the therapeutic relationship are key for reaching this goal.

Educational objectives:

• To identify the basic clinical problems posed by impaired physicians.

• To provide trainees with basic skills to effectively treat impaired colleagues.

• To demonstrate how to take advantage of the patients' professional status.

• To outline the basic characteristics and functioning of a specialized program for impaired physicians.

Course description:

The contents of the course will include:

• Basic concepts: the impaired physician.

• Risk factors in the medical professions.

• Some epidemiological data: Addictive and mental disorders in physicians.

• The doctor as patient: What makes him/her different?

• Attitudes and behaviours of impaired physicians.

• The most common mistakes made by psychiatrists

• Setting problems: avoiding corridor consultations.

• How to establish a fruitful collaboration: Essential elements of the therapeutic relationship.

• Taking advantage of the patients' condition: How to use her or his expertise in a constructively and collaboratively.

• Ethical considerations: confidentiality, licensure, etc.

• Basic characteristics of a specialized service for impaired physicians.