title: Service provision to physicians with mental health and addiction problems.
abstract: OBJECTIVE
  Physicians are reluctant to ask for help when they suffer from substance use disorders and/or other mental illnesses (i.e. when they become 'sick doctors'). This can result in greater morbidity/mortality and may lead to significant problems in medical practice. This review aims to describe the nature and development of programs that specifically treat sick doctors [Physician Health Programs (PHPs)].
  
  
  RESULTS
  PHPs were first developed in the United States in the late 1970s. The purpose was to identify and treat physicians with problems resulting from mental health issues, mainly substance use disorders. Since then, other PHPs have been developed in Canada, Australia, and the United Kingdom, trying to reach sick doctors, offering counseling or other preventive interventions when needed. New models to help sick doctors, such as the Spanish PHP, were also developed. Counseling and support services for sick doctors have been implemented elsewhere in Europe (e.g. Norway and Switzerland).
  
  
  CONCLUSIONS
  PHPs provide interventions specifically designed for physicians and other medical professionals with substance use and other mental health problems. The balance between guaranteeing safe practice and yet encouraging all physicians to ask for help when in trouble raises questions regarding how these programs should be designed.
authors.affiliation: aIntegral Care Program for Sick Doctors, Galatea Clinic, Galatea Foundation, Col·legi de Metges de Barcelona bDepartment of Psychiatry and Legal Medicine, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain cGP Patient Safety Lead, NHS Somerset CCG (Clinical Commissioning Group), Somerset, UK dInstitute for Behavior and Health, Inc., Rockville, Maryland, USA.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Braquehais
authors.forename: Andrew
authors.initials: A
authors.lastname: Tresidder
authors.forename: Robert L
authors.initials: RL
authors.lastname: DuPont
mesh_terms: D001315:Australia; D002170:Canada; D037001:Directive Counseling; D005060:Europe; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D010815:Physician Impairment / Q000523:psychology*; D016730:Program Development; D019966:Substance-Related Disorders / Q000628:therapy*; D006113:United Kingdom; D014481:United States