title: Physician impairment: is recovery feasible?
abstract: BACKGROUND
  Physician impairment is a serious public health issue affecting not only physicians, but also their families, colleagues, and patients. Physician impairment is used most often to refer to substance use disorders, which involve both substance abuse and substance dependence and/or addiction.
  
  
  OBJECTIVE
  This article aims to describe the problem of physician impairment within the context of substance use disorders. The concept of recovery and several strategies for effective recovery are explored.
  
  
  CONCLUSIONS
  Experts now define impairment as an enduring condition that if left untreated is not amenable to remission and cure. In terms of functional capacity, impairment renders the physician unable to provide competent medical services, with serious flaws in professional judgment. Herein, we define the scope of the problem, consider several theories to explain the reason physicians may be prone to develop substance use disorders, discuss diagnosis and reporting, as well as treatment and prognosis, and identify several relapse prevention strategies.
  
  
  CONCLUSIONS
  Physician impairment is a real and significant public health concern; however, recovery is feasible and the data support favorable odds of recovery and a return to clinical practice among those seeking appropriate treatment, counseling, and relapse prevention strategies.
authors.affiliation: Johns Hopkins University School of Medicine, Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Baltimore, MD 21205, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Carinci
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Christo
mesh_terms: D000223:Adaptation, Psychological / Q000187:drug effects / Q000941:ethics; D000700:Analgesics / Q000009:adverse effects; D006801:Humans; D010815:Physician Impairment / Q000523:psychology* / Q000706:statistics & numerical data*; D012307:Risk Factors; D055502:Secondary Prevention; D012651:Self Medication / Q000009:adverse effects / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data / Q000639:trends; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D035642:Whistleblowing / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology
chemical_list: D000700:Analgesics