Healing the Healer: Understanding physician impairment
“Cancer is a piece of cake compared to addiction.”
That’s what “John Doe, MD” a physician and survivor of both drug abuse and cancer, believes. He told an audience at a GHP-sponsored forum that the stigma surrounding substance abuse blots out any empathy another disease, like cancer, might elicit. The stigma against physicians suffering from addiction is even greater—physicians are supposed to be perfect.
Physicians, of course, are not perfect. We suffer from depression, substance abuse, and impairment at a greater rate than the average population. The “Healing the Healer” forum in September spotlighted physician impairment and highlighted the resources available to help.
How many of you have had a colleague affected by substance abuse or depression?
"My own awareness of the topic goes back to my training, where a fellow resident, Dr. B. in anesthesia, stole narcotics and overdosed," said Michael Soman, MD, GHP's Chief Medical Executive. "His death was the first of many reminders I have had that we physicians are human, susceptible to the full range of dysfunctional behaviors—and deserve support and help."
“Physician impairment is the inability to practice with reasonable skill and safety,” forum speaker Mike Oreskovich, MD, said. Oreskovich is CEO of the Washington Physicians Health Program and a national expert on physician health, addiction and substance abuse. “Impairment can manifest as angry outbursts, poor self-care, depression, suicide, substance abuse and addiction, marital problems and social isolation.”
The very personality traits that lead to a successful career in medicine may also set us up for pain—perfectionism, exaggerated sense of responsibility, and reluctance to delegate control can predispose us to dysfunctional patters of coping.
A survey by the American College of Surgeons found that 39% percent of respondents experienced “burnout”, an emotional state that is highly correlated with medical errors. Six percent were actively suicidal, and 16% had experienced a depressive episode. “Suicide is the leading cause of death among young physicians,” Dr. Oreskovich told the audience.
“We don’t do enough to promote awareness of physician health,” said Jeffrey Grice, MD, Associate Medical Director of GHP Human Resources. Grice and Laurie Kutschia, GHP Human Resources Manager organized the forum, the third in a series of GHP-sponsored forums tackling a range of issues affecting patient safety and delivery of care. “As an organization, we need to do more to promote health and good habits among our physicians.”
Luckily, GHP’s Well Being Program offers early identification and intervention for problems that may interfere with professional functioning. “The great thing about the Well Being Program is that it’s a self-referral service.” said Dr. Grice. “But we know that a lot more people could benefit by using it.” Annually, only about 1-2% of staff contact the program with concerns associated with impairment due to substance use or mental health.
Dr. John Doe masked his addiction as best he could for years. But ultimately he lost control and was referred to The Washington Physicians Health Program. A confidential resource that helps health care practitioners recover from impairment and return to work, WPHP has treated over 800 practitioners in the last 22 years. Dr. Doe’s colleagues contacted WPHP to report his impairment. He was sent to Virginia for addiction treatment and monitored by WPHP following his return to work. Despite this painful process, Dr. Doe now is thankful for the treatment he received. “We’re lucky in this state to have the WPHP,” he said.
We value the health and well being of our physicians. The “Healing the Healer” forum was a great way for GHP to connect with the larger health care community—65 participants representing 25 organizations in the Northwest attended. This issue touches all of us, and we all need to be part of the solution.
Take care of yourselves, and each other.