Treating the Chemically Dependent Health Professional

Skipper, Gregory E.

doi:10.1300/j069v16n03_07

Cited by 32 publications

(10 citation statements)

References 21 publications

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“…Estimates of alcohol dependence vary from 8% to 15% (12)(13)(14)(15)(16), the latter being similar to the 13.5% rate for the adult population (16 -18). The American Medical Association's estimate for drug dependence is 1% to 2% (18).…”

Section: Extent Of the Problemmentioning

confidence: 69%

Problem Doctors: Is There a System-Level Solution?

2006

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Physician performance failures are not rare and pose substantial threats to patient welfare and safety. Few hospitals respond to such failures promptly or effectively. Failure to ensure the quality and safety of the performance of colleagues is a breach of medicine's fiduciary responsibility to the public. A major reason for this deficiency is the hospitals' lack of formal systems to monitor physician performance and to identify and correct shortcomings. To develop and implement these systems, hospitals need better performance measures and substantial expansion of external programs for assessment and remediation. This is a task well beyond the capacities of individual hospitals; a national effort is required. The authors call on the Federation of State Medical Boards, the American Board of Medical Specialties, and the Joint Commission on Accreditation of Healthcare Organizations (organizations that already bear a fiduciary responsibility for ensuring safe, competent care) to collaborate on developing better methods for measuring performance and to expand programs for helping practitioners who are deficient.

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Section: Extent Of the Problemmentioning

confidence: 69%

Problem Doctors: Is There a System-Level Solution?

2006

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“…However, it appears that the care and management of addicted physicians, as coordinated through these PHPs, may be qualitatively and quantitatively different from the care available to the lay public (see Domino et al, 2005;Gold, Pomm, Kennedy, Jacobs, & Frost-Pineda, 2002;Skipper, 1997). Moreover, the available outcome studies of PHP-managed addicted physicians have reported remarkable results-much superior to those found in other populations of addicted patients or from other forms of addiction treatment.…”

mentioning

confidence: 99%

How are addicted physicians treated? A national survey of physician health programs

DuPont

McLellan

Carr³

et al. 2009

Journal of Substance Abuse Treatment

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197

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“…There is a high prevalence of alcohol dependence in the general adult population estimated at 8% to 15% [42][43][44][45] . This prevalence is similar in the physician population at a rate of 14% [46][47][48] .…”

Section: Substance Abusementioning

confidence: 99%

“…Furthermore, physician health programs may provide valuable resources, including grant money to help fund treatment, to the impaired physician undergoing intervention 18 . Physician-only inpatient treatment programs are available; however, general treatment programs may be just as effective 45,61 . All fifty states have programs in place aimed at helping the impaired physician 48 .…”

Section: Treatment Algorithmmentioning

confidence: 99%

Managing Stress in the Orthopaedic Family

Sargent

Sotile²,

Sotile³

et al. 2011

The Journal of Bone & Joint Surgery

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Stress is a double-edged sword. When managed appropriately, it can lead to peak performance in high-pressure professions, while the potential negative effects of stress are well documented, being directly related to seven of the ten leading causes of death in industrialized nations 1,2 .A major psychological manifestation of stress is burnout. Validated assessment tools, such as the Maslach Burnout Inventory, can be utilized to quantify the three components of burnout: emotional exhaustion, depersonalization, and a decreased sense of personal accomplishment 3,4 . Early signs of burnout, described by Quick et al., include declining professional performance and morale, physical and somatic symptoms, and behavioral changes. More advanced signs include self-medication and serious self-doubt 1 .In 2006, the results of a national survey of orthopaedic leaders (past, current, and acting chairs of orthopaedic departments, in addition to program directors) were presented to the American Orthopaedic Association (AOA) by Saleh et al. 5 . Numerous job stressors were identified, and the impact of these stressors was rated as moderate to severe in 70% of the leaders responding. High levels of emotional exhaustion and depersonalization were noted. A number of disturbing trends were identified. Only 15% were satisfied with their personal-professional life balance, and the percent dissatisfied with their job was increasing with time. Thirty-seven percent stated that they were moderately, very, or extremely likely to step down from their chair position within two years 5 .Stress and burnout have a substantial impact on patient care, especially an increase in medical errors. Fifty percent of physicians and 70% of the public believe that overwork, stress, and fatigue contribute to medical errors 6 . A recent survey of members of the American College of Surgeons assessed burnout among 7905 responding surgeons, 700 (8.9%) of whom reported committing a recent major medical error 7 . The commission of a major error correlated statistically with all three major burnout domains. Each 1-point increase in the depersonalization score raised the risk of error by 11%, and each 1-point increase in emotional exhaustion raised the risk of error by 5%. In addition, surgeons committing errors were twice as likely to have findings indicating depression. Factors frequently thought to be major drivers of medical errors, such as number of hours worked, frequency of night call, practice setting, and compensation, showed no statistical correlation with the likelihood of committing a major medical error 7 .In the years since the topic of stress had been discussed by the AOA, the relevance of the topic has only increased in importance. From 2007 to 2009, the Department of Justice investigation of orthopaedic device manufacturers resulted in a negative public image of the orthopaedic specialty and was the source of immense scrutiny and stress among many orthopaedic

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Treating the Chemically Dependent Health Professional

Cited by 32 publications

References 21 publications

Problem Doctors: Is There a System-Level Solution?

Problem Doctors: Is There a System-Level Solution?

How are addicted physicians treated? A national survey of physician health programs

Managing Stress in the Orthopaedic Family

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