Carinci Adam J, Christo Paul J
Johns Hopkins University School of Medicine, Department of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Baltimore, MD 21205, USA.
Pain Physician. 2009 May-Jun;12(3):487-91.
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.
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.
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.
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.
医生的职业损伤是一个严重的公共卫生问题,不仅影响医生自身,还会波及他们的家人、同事和患者。医生的职业损伤最常被用来指代物质使用障碍,其中包括物质滥用以及物质依赖和/或成瘾。
本文旨在阐述物质使用障碍背景下医生职业损伤的问题。探讨康复的概念以及几种有效的康复策略。
专家们现在将职业损伤定义为一种持久的状况,如果不加以治疗,就无法缓解和治愈。就功能能力而言,职业损伤会使医生无法提供称职的医疗服务,在专业判断上存在严重缺陷。在此,我们界定问题的范围,考虑几种理论来解释医生可能容易患上物质使用障碍的原因,讨论诊断与报告、治疗与预后,并确定几种预防复发的策略。
医生的职业损伤是一个切实且重大的公共卫生问题;然而,康复是可行的,数据表明,在寻求适当治疗、咨询和预防复发策略的人群中,康复并重返临床实践的几率很高。