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Physician Wellness and Burnout

Federation of State Medical Boards Report and Recommendations of the Workgroup on Physician Wellness and Burnout View Article  

The Prevalence of Substance Use Disorders in American Physicians.

“There have been few studies on the prevalence of substance use disorders (SUDS) in the physician population at large nor have any studies compared the prevalence of SUDS in American physicians by specialty.”

Burnout and Alcohol Abuse/Dependence Among U.S. Medical Students.

“To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students.”

Risk Factors Measured During Medical School for Later Hazardous Drinking: A 10-year, Longitudinal, Nationwide Study

“To investigate the prevalence and temporal patterns of hazardous drinking and risk factors during medical school for future hazardous drinking among doctors.”

Prevalence of Alcohol Use Disorders Among American Surgeons

“To determine the point prevalence of alcohol abuse and dependence among practicing surgeons.”

Risk Factors for Relapse in Health Care Professionals with Substance Use Disorders

“Substance use disorders among physicians are important and persistent problems. Considerable debate exists over whether use of major opioids, especially among anesthesiologists, is associated with a higher relapse rate compared with alcohol and nonopioids. Moreover, the risk factors for relapse with current treatment and monitoring strategies are unknown.”

Anesthesiologists Recovering From Chemical Dependency: Can They Safely Return to the Operating Room?

Neurobiologic Advances from the Brain Disease Model of Addiction

This article reviews scientific advances in the prevention and treatment of substance-use disorder and related developments in public policy. In the past two decades, research has increasingly supported the view that addiction is a disease of the brain. Although the brain disease model of addiction has yielded effective preventive measures, treatment interventions, and public health policies to address substance-use disorders, the underlying concept of substance abuse as a brain disease continues to be questioned, perhaps because the aberrant, impulsive, and compulsive behaviors that are characteristic of addiction have not been clearly tied to neurobiology. Here we review recent advances in the neurobiology of addiction to clarify the link between addiction and brain function and to broaden the understanding of addiction as a brain disease. We review findings on the desensitization of reward circuits, which dampens the ability to feel pleasure and the motivation to pursue everyday activities; the increasing strength of conditioned responses and stress reactivity, which results in increased cravings for alcohol and other drugs and negative emotions when these cravings are not sated; and the weakening of the brain regions involved in executive functions such as decision making, inhibitory control, and self-regulation that leads to repeated relapse. We also review the ways in which social environments, developmental stages, and genetics are intimately linked to and influence vulnerability and recovery. We conclude that neuroscience continues to support the brain disease model of addiction. Neuroscience research in this area not only offers new opportunities for the prevention and treatment of substance addictions and related behavioral addictions (e.g., to food, sex, and gambling) but may also improve our understanding of the fundamental biologic processes involved in voluntary behavioral control.

Five Year outcomes in a Cohort Study of Physicians Treated for Substance Use Disorders in the United States

“To evaluate the effectiveness of US state physician health programmes in treating physicians with substance use disorders.”

How are Addicted Physicians treated? A National Survey of Physician Health Programs

“Physicians with substance use disorders receive care that is qualitatively different from and reputedly more effective than that offered to the general population, yet there has been no national study of this distinctive approach. To learn more about the national system of Physician Health Programs (PHPs) that manage the care of addicted physicians, we surveyed all 49 state PHP medical directors (86% responded) to characterize their treatment, support, and monitoring regimens.”

Beyond “Heal Thyself”: Physicians as Patients – An Uneasy Role

“In its position paper addressing physician impairment and rehabilitation (1), the American College of Physicians (ACP) Ethics, Professionalism and Human Rights Committee thoughtfully considers the imperfectly marked path that physicians are asked to tread: identify impairment, provide access to care, ensure patient safety, and
rehabilitate. These are the responsibilities of physicians as professionals (monitoring oneself and one’s peers) and as leaders (supervising highly trained persons).”

I Was One Of The Top Doctors In My Field. I Was Also An Opioid Addict.

Opioids have become a full-blown national crisis of epidemic proportions, killing 130 people each day. Drug overdose is now the number-one cause of death for Americans under 50. One doctor at the top of her game—who knew the risks better than anyone—almost became another statistic.

Physician Health Programmes and Malpractice Claims: Reducing Risk through Monitoring

“Physician health programmes (PHPs) are peer-assistance organizations that provide support to physicians struggling with addiction or with physical or mental health challenges. While the services they offer are setting new standards for recovery and care, they are not immune to public debate and criticism since some have concerns about those who are enrolled in, or have completed, such programmes and their subsequent ability to practice medicine safely.”

Physician Impairment and Rehabilitation: Reintegration Into Medical Practice While Ensuring Patient Safety: A Position Paper From the American College of Physicians

“Physicians share a commitment to care for ill persons, including each other. When physicians become impaired and are unable to practice competently, they should seek medical help and assistance in caring for their patients. When they cannot or do not do so, the profession and individual physicians have a responsibility to safeguard the welfare of patients and assist colleagues in obtaining help.”

Physician Health Program Act

“The Legislature hereby finds and declares that the purpose of this Act is to enhance the protection of the public by providing for a successful means of confidential and professional support of physicians and other licensed health care professionals who have a potentially impairing substance use disorder, mental health condition, or other medical disease that may adversely affect the physician’s or other health care professional’s ability to safely and effectively treat patients.”

The Sick Physician Impairment by Psychiatric Disorders, Including Alcoholism and Drug Dependence

Accountability to the public, through assurance of competent care to patients by physicians and other health professionals, is a paramount responsibility of organized medicine.
Occasionally such accountability is jeopardized by physicians whose functioning has been impaired by psychiatric disorders, including alcoholism and drug dependence. An equally important issue is the effective treatment and rehabilitation of the physician-patient so that he can be restored to a useful life.

Outcomes of a Monitoring Program for Physicians with Mental and Behavioral Health Problems

“Most states have programs that provide structured monitoring for physicians with substance use disorders (Substance Use Disorders (SUD)s). In recent years, the Massachusetts Medical Society’s Physician Health Services (PHS) program has used a similarly structured approach to monitor physicians with other mental and behavioral health (MBehavioral Health) problems. The objective of this study was to determine the outcomes of the PHS monitoring programs for Substance Use Disorders (SUD)s and MBehavioral Health problems, compare their overall success rates, and identify correlates of success.”

Details on Suicide Among US Physicians: Data from the National Violent Death Reporting System

“Physician suicide is an important public health problem as the rate of suicide is higher among physicians than the general population. Unfortunately, few studies have evaluated information about mental health comorbidities and psychosocial stressors which may contribute to physician suicide. We sought to evaluate these factors among physicians versus non-physician suicide victims.”

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