Philip J. Candilis, MD; Daniel T. Kim, MA, MPH; Lois Snyder Sulmasy, JD; for the ACP Ethics, Professionalism and Human Rights Committee *
Acknowledgment: Philip J. Candilis, MD, received compensation from ACP for consulting on and coauthoring the manuscript. The authors and the ACP Ethics, Professionalism and Human Rights Committee thank peer reviewers Chris Bundy, MD; Humayun J. Chaudhry, DO; Paul H. Earley, MD; John A. Fromson, MD; and P. Bradley Hall, MD, and the many ACP leadership and journal reviewers of the paper for helpful comments on drafts, as well as Kathy Wynkoop of the ACP Center for Ethics and Professionalism.
Financial Support: Financial support for the development of this paper comes exclusively from the ACP operating budget.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3605.
Corresponding Author: Lois Snyder Sulmasy, JD, Director, ACP Center for Ethics and Professionalism, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, email@example.com.
Current Author Addresses: Dr. Candilis: Interim Director of Medical Affairs, Saint Elizabeths Hospital, 1100 Alabama Avenue SE, Washington, DC 20032.
Mr. Kim: Senior Associate, ACP Center for Ethics and Professionalism, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Ms. Snyder Sulmasy: Director, ACP Center for Ethics and Professionalism, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Author Contributions: Conception and design: D.T. Kim, L. Snyder Sulmasy.
Analysis and interpretation of the data: P.J. Candilis, D.T. Kim, L. Snyder Sulmasy.
Drafting of the article: P.J. Candilis, D.T. Kim, L. Snyder Sulmasy.
Critical revision of the article for important intellectual content: P.J. Candilis, D.T. Kim, L. Snyder Sulmasy.
Final approval of the article: P.J. Candilis, D.T. Kim, L. Snyder Sulmasy.
Provision of study materials or patients: P.J. Candilis.
Administrative, technical, or logistic support: D.T. Kim, L. Snyder Sulmasy.
Collection and assembly of data: P.J. Candilis, D.T. Kim.
Physician impairment, the inability to carry out patient care responsibilities safely and effectively, is a problem of functioning. However, the presence or treatment of a potentially impairing illness or other condition does not necessarily imply impairment. This American College of Physicians position paper examines the professional duties and principles that should guide the response of colleagues and the profession to physician impairment. The physician should be rehabilitated and reintegrated into medical practice whenever possible without compromising patient safety. At the same time, physicians have a duty to seek help when they are unable to provide safe care. When identifying and assisting colleagues who might be impaired, physicians should act on collegial concern as well as ethical and legal guidelines that require reporting of behavior that puts patients at risk. Health care institutions and the profession should support practice environments in which patient safety is prioritized and physician wellness and well-being are addressed. Physician health programs should be committed to best practices that safeguard patient safety and the rights of physician-patients.
Candilis PJ, Kim DT, Sulmasy LS, for the ACP Ethics, Professionalism and Human Rights Committee. Physician Impairment and Rehabilitation: Reintegration Into Medical Practice While Ensuring Patient Safety: A Position Paper From the American College of Physicians. Ann Intern Med. [Epub ahead of print 4 June 2019]170:871–879. doi: 10.7326/M18-3605
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Published: Ann Intern Med. 2019;170(12):871-879.
Published at www.annals.org on 4 June 2019
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