Physician attitudes toward distressed colleagues.

Attitudes and behaviors of physicians toward their impaired colleagues often affect whether the latter seek treatment. Negative responses include (1) silence, usually based on anxiety, ignorance and pessimism; (2) tentative responses based on stereotyped assumptions or distraction by organic problems; (3) judgmental responses that may result in mutual avoidance, and (4) permissive responses that encourage continued use of alcohol or other drugs. Positive responses include (1) confrontation in a concerned, constructive manner as early as possible; (2) assistance to the impaired colleague in obtaining treatment, and (3) education and information sharing to increase awareness of potential and real problems. Educational programs can help physicians develop more positive attitudes toward both impaired colleagues and impaired patients. The emphasis is on active participation. The goals of these programs should include optimism about therapy, using structured treatment approaches that include paraprofessionals and formerly impaired physicians on the treatment team, and the development of confrontational skills on the part of each physician.