When a colleague is impaired, how should physicians respond?

Sara Berg, MS , Senior News Writer

Is it acceptable for physicians suffering from a cold to provide medical care if they take appropriate precautions? Does high blood-alcohol content incapacitate physicians in terms of  performing their duties? As a physician, do you have a responsibility to intervene when the health or wellness of a colleague appears to have become compromised?

These and other important questions are covered in an education module from the AMA. Produced by the AMA’s Ethics Group, the module, “Understanding the Code of Medical Ethics: Physician Wellness and Professional Conduct,” offers information to help physicians identify and understand their ethical obligations to maintain their own wellness, help fellow colleagues in need who may be impaired, and promote a profession that places patient well-being and safety first.

With a focus on impairment and incompetent behaviors, and a physician’s responsibility to help colleagues and report unprofessional or disruptive behavior, the module analyzes relevant ethics guidance, presents ethical dilemmas and quizzes users on how best to respond. After each scenario, follow-up answers are provided, along with in-depth explanations as to whether a situation is inappropriate.

About 15 percent of physicians will be impaired by psychiatric illness, alcoholism or drug dependency at some point in their careers, according to a study in the American Journal of the Medical Sciences. And one-third of physicians with direct personal knowledge of an impaired or incompetent colleague chose not to report it, a JAMA study discovered.  

There is a growing consensus that the most effective way to address physician burnout is to change the underlying systems, administrative burdens and workloads that contribute to the phenomenon.

As health care leaders and policymakers work to make that consensus a reality, physicians will sometimes find themselves in challenging situations where a colleague’s impairment, perhaps related to burnout, poses an ethical conundrum.

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Ethics training module helps clarify professional boundaries

The AMA education module explains how impairment differs from incompetence and how physicians can address impairment in themselves and others.

The  module is free to any AMA member and is worth one AMA PRA Category 1 Credit™. The Code of Medical Ethics is a living document, updated periodically to address the changing conditions of medicine. The new edition, adopted in June 2016, is the culmination of an eight-year project to comprehensively review, update and reorganize guidance to ensure that the Code remains timely and easy to use for physicians in teaching and in practice.

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