Fam Med.  2002 Mar;34(3):190-6.  
Working with impaired residents: trials, tribulations, and successes.
Winter RO, Birnberg B.

JFK Family Practice Residency, UMDNJ-Robert Wood Johnson Medical School, NJ,
USA. RWinter@SolarisHS.org

Impairment of physicians' ability to practice medicine safely and
effectively is relatively common. Chemical dependency, the leading cause of
physician impairment, has a lifetime prevalence of approximately 10%-15%
among physicians. Statistics from physician health programs indicate that
family physicians are overrepresented among impaired physicians. It is
therefore important for family practice residencies to monitor for and deal
with physician impairment. Over the past 11 years, we have worked with
eight impaired residents: five with chemical dependency, two with cognitive
impairment, and one with an affective disorder Seven of the eight residents
are currently practicing medicine, six in family practice. Based on our
experience and the literature, we have developed an algorithm that includes
the recognition, intervention, and aftercare of impaired residents. The
long-term success of the majority of impaired residents with whom we have
worked suggests that the trials and tribulations of working with this
potentially difficult group of residents are well worth the effort.