Lohr K M, Engbring N H
University of Tennessee, Memphis, College of Medicine.
J Med Educ. 1988 Mar;63(3):182-8. doi: 10.1097/00001888-198803000-00005.
An institution-wide program for residents impaired by alcohol, other drugs, or emotional problems was established in 1983 at the Medical College of Wisconsin Affiliated Hospitals. The goal of the program was to help impaired house staff members to continue their training in a nonpunitive environment. An approach to reviewing allegations of impairment and a legal agreement between the hospital and the recovering resident were implemented. Because no residents were reported for impairment during its first two years, the program's emphasis was shifted from an investigative to an educational, assistive role. Major problems in carrying out the program have been the program's lack of authority to ensure cooperation by program directors and by impaired residents; a widespread unfamiliarity with intervention procedures despite efforts to inform residents, their spouses, faculty members, and administrators about the program; and misconceptions that the program is punitive. Further impediments are lack of a budget to provide educational activities, inadequate socializing between the faculty and the house staff that would enable faculty members to recognize early signs of impairment; and inadequate health insurance coverage for long-term treatment.
1983年，威斯康星医学院附属医院设立了一项面向因酒精、其他药物或情感问题而受损的住院医师的全院性项目。该项目的目标是帮助受损的住院医务人员在一个非惩罚性的环境中继续他们的培训。实施了一种审查受损指控的方法以及医院与正在康复的住院医师之间的法律协议。由于在该项目的头两年没有住院医师因受损而被举报，所以项目的重点从调查转向了教育和辅助角色。实施该项目的主要问题包括：该项目缺乏确保项目主任和受损住院医师合作的权力；尽管努力向住院医师、他们的配偶、教员和管理人员宣传该项目，但对干预程序普遍不熟悉；以及认为该项目具有惩罚性的误解。进一步的障碍包括缺乏开展教育活动的预算、教员与住院医务人员之间的社交不足，这使得教员无法识别受损的早期迹象；以及长期治疗的医疗保险覆盖不足。
