11 - Personal health of the doctor: illness and impairment

Summary

Doctors are ethically responsible for ensuring that their own health problems do not interfere with the welfare of their patients. Although doctors generally enjoy good physical health as measured by standardised mortality rates, studies concerning the ‘impaired practitioner’ indicate that up to 10 per cent may become impaired during their professional lives [1–3]. Such impairment may lead to harm to patients. While doctors may appear well placed to attend to their own health, in practice the reverse often applies as doctors tend to deny the presence of psychological or physical health problems, putting off getting help until too late. Professional colleagues often contribute to this denial [4–5]. This chapter explores some reasons for this, examines the extent of the problems, describes the most frequently recognised health problems and outlines ways of identifying and assisting colleagues with them. Advice that may help prevent such personal health problems for doctors is also provided.

ETHICAL AND LEGAL RESPONSIBILITIES

The ethical principle of ‘non-maleficence’ underpins the professional codes, which state that doctors must not permit their own ill health to put their patients at risk. In this regard the AMA Code of Ethics states: ‘Accept responsibility for your psychological and physical well-being as it may affect your professional ability’. This ethical duty extends also to medical colleagues and treating doctors who have a responsibility to ensure that an impaired colleague or doctor–patient, who may be putting patients at risk by continuing to practise, is guided towards treatment and, if necessary, notified to the medical board.