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Roles
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Responsibilities
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9.3.2 Physician Responsibilities to Impaired Colleagues
Physical or mental health conditions that interfere with a physician’s ability to engage safely in professional activities can put patients at risk, compromise professional relationships, and undermine trust in medicine.
individually physicians have an ethical obligation to:
(c) Assist recovered colleagues when they resume patient care
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9.3.2 Physician Responsibilities to Impaired Colleagues
Physical or mental health conditions that interfere with a physician’s ability to engage safely in professional activities can put patients at risk, compromise professional relationships, and undermine trust in medicine.
…individually physicians have an ethical obligation to:
(c) Assist recovered colleagues when they resume patient care
(AMA, 2016)
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professional obligation to act
• This duty is subordinate to the duty to maintain patient confidences. when the colleague is a patient
(NCMB, 2010)
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skills
• Ensure
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Potential Outcomes of NCPHP Screening Appointment
1. For an error in judgment only, usually no recommendation• We screen, often recommend helpful book, attending workshop, or
professional help & advocate
2. For some we suggest short period of monitoring• Reassures NCMB, hospital, and individual of ability to self-regulate use
of alcohol or other drugs
3. On occasion we suggest outpatient assessment• Recommendations • Diagnosis
4. For small percentage we suggest immediate treatment • Followed by monitoring
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Category Number Percentage
Screened by NCPHP 98
Referred for outside assessment 8 8% (8/98)
Referred to treatment after outside assessment
1 12.5% (1/8)
Referred directly to treatment by NCPHP
3 3% (3/98)
No recommendation for outside assessment
87 89% (87/98)
NCMB referals 1/1/2017 – 6/30/2017
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Status
Pending 9
Signed to Monitoring 42
No Monitoring Recommended 32
Refused Monitoring 4
N=87 1/1/2017 – 6/30/2017
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Year Number Comment
2017 2 1 person impaired after treatment1 person relapsed while being monitored
2016 0
2015 3
2014 4
2013 1
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Johnson DH. JAMA 2017. doi:10.1001/jama.2017.10127
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The term impaired has been defined by the American Medical Association as any physical, mental or behavioral [state] that interferes with the ability to engage safely in professional activities.
Leape & Fromson. 2006 doi:10.7326/0003-4819-144-2-200601170-00008.
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"You can't have leaders compromised by drug use setting a horrible example for students and other faculty, jeopardizing donor relationships and alumni relationships, so I think they were
slow to move.“👎
However, they weren't necessarily slow to decide to fire him, Dr. Caplan added, given Dr.
Puliafito's right to due process. 👍
"But I certainly think the weight of the evidence as it began to accumulate required a
suspension while they took a look," he said. "He was in a pivotal, pivotal role.“👎
Dr Caplan says the likely next step for Dr. Puliafito will be rehabilitation. "Medicine tends to be
kinder to doctors with addiction problems than other professions might be," he said. 👍
He said suspension while Dr. Puliafito undergoes treatment will likely be followed by loss of his
medical license. 👎
Questions Surround USC and Its Disgraced Ex-Med School DeanMescape Marcia Frellick July 24, 2017
Asked about the university's responsibility over the past year, Art Caplan, PhD [said]
Dr. Puliafito
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The IV PoleCartoon by Aaron BacallFrom cartoonstock.com"I wasn't responding well to the pills but my doctor finally got my mood stabilized"
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Krakowski, A. J. Psychotherapy and Psychosomatics 1982
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Gabbard, G. O. “The Role of Compulsiveness in the Normal Physician.” JAMA 1985
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Gabbard, G. O. “The Role of Compulsiveness in the Normal Physician.” JAMA 1985
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to ease
• Let us know if you are interested in helping NCPHP in our mission of assisting medical professionals.
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Thank you & Questions
www.ncphp.org
Cartoon by Ron TherienFrom cartoonstock.com“Would it kill you to ask me how I’m doing?"