Problematic Physicians: A Comparison of Personality Profiles by Offence Type

Abstract

Objective: This exploratory study compares objective personality test findings among physicians exhibiting different forms of misconduct. The importance of delineating distinctive personality characteristics by type of offence is that such characterizations can direct therapy and prognosis for remediation. Method: Eighty-eight physicians referred to the Vanderbilt Comprehensive Assessment Program for Professionals (V-CAP) completed the Minnesota Multiphasic Personality Inventory-2, the Personality Assessment Inventory, or both, as part of their evaluation. On the basis of referral information, physicians were partitioned into 3 groups of offenders: "sexual boundary violators," "behaviourally disruptive," and "other misconduct." Results: On both personality measures, the sexual boundary violators generated the greatest percentage of profiles indicative of character pathology. Conclusions: Although all 3 groups exhibited unacceptable behaviours, the pervasive personality features of the sexual boundary violators are associated with greater therapeutic challenge, and these individuals likely pose the greater risk of reoffending.

The Role of Family of Origin in Physicians Referred to a CME Course

“…They found that as a group, boundary violating physicians tend to experience greater problems with impulse regulation, are more self-centered, less empathetic, less likely to take responsibility for their offences (more likely to blame others or circumstances), and less likely to be influenced by societal norms in comparison to the two other groups of physicians referred for other types of problematic behavior. The physicians with boundary issues also produced the most MMPI-2 protocols suggesting exaggerated attempts to present themselves in an unrealistically positive light (Roback et al 2007). Neither of these studies presented a normal comparison group nor did they formally assess family dynamics.…”

Dealing with Difficult Medical Colleagues

“…The term “problem doctor” [33,34] and related terms [35,36,37] are used in two ways. Some articles restrictively define “problem doctors” as those with poor clinical skills [33], but in other papers definitions are broader, including physicians who commit sexual offenses, are impaired, are disruptive, or are less than competent.…”

Substance Abuse Patterns and Psychiatric Symptomology Among Health Care Professionals and Non–Health Care Professionals Evaluated in an Outpatient Program for Impaired Professionals

“…In addition, subscales (eg, cognitive aspects, affective aspects) within the parent scales of the PAI allow for greater diagnostic accuracy. 18 Variables Two groups were identified by occupation grouping as described above. Demographic variables used in analysis were sex, age, racial background, marital status, number of marriages, number of children, and years of experience.…”

“…We address 2 major limitations in the impaired professional literature by including objective psychological test results from the Personality Assessment Inventory (PAI) 17 to determine rates of psychiatric symptomology. Roback et al, 18 noted the importance of using objective personality testing in the evaluation of impaired professionals, but the use of objective psychological testing in studies on impaired professionals is still lacking with only rare exceptions. 18,19 We address the other limitation in the literature by empirically examining whether the HCPs and N-HCPs who were all evaluated within an outpatient program for impaired professionals 20 differed in any clinically significant way.…”