Forensic Addiction Psychiatry As It Pertains To The Impaired Physician/medical Healthcare Professional, A Brief Synopsis - Including A Review Of The Literature | 94151
Journal of Addiction Research & Therapy
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Impaired physicians and associated healthcare professionals,
i.e. HCPs, constitute a major problem and potential danger
for US and international healthcare delivery systems. Patients,
hospitals, and health networks are placed at an increased risk of
incompetent medical provider care as well as an increased risk
of medical malpractice and/or negligence by HCPs addiction.
Estimates of HCP impairment for physicians range from 12-
15%, nurses 15-20%, pharmacists 18-21%, and dentists 12 to
19%. Physicians experience the highest rate of suicide in any
profession. The most common cause of physician impairment
is substance abuse. Substance abuse risk stratification will be
reviewed according to the medical specialty, with anesthesiology,
emergency medicine, and psychiatry, constituting the highest
risk. The predisposing personality characteristics of HCPs
to addiction, including burnout syndrome, as additional risk
factors will be reviewed. Examples and prevalence rates of
specific substances of abuse for HCPs and comorbid psychiatry
disorders predisposing to addiction as well as the most common
reasons for addiction by HCPs at time of initiation of addiction
treatment will be discussed. Reasons for the reluctance of
physicians/HCPs to seek substance abuse treatment, including
fear of stigma in seeking treatment are reviewed. Goals of the
evaluation for HCPs will be reviewed by including the following
components of a prototypical addiction psychiatry evaluation:
obtaining an accurate diagnostic assessment of the underlying
substance abuse disorder, and related comorbid medical and
psychiatric disorders; provide an assessment of the individualized
treatment needs of the affected HCP. Potential medical/legal
consequences of HCP addiction will be reviewed including
malpractice liability, loss of licensure, ethical considerations, as
well as legal implications relating to return to practice. Finally,
a case example of an addiction psychiatry evaluation of an
impaired physician (independent medical evaluation) performed
by the presenter will be discussed.
David G. Petkash is a Physician as well as a Pharmacist. Upon graduating from St. John’s University College of Pharmacy he excelled in Pharmacology in medical school. During his Psychiatry Residency at Eastern Virginia School of Medicine he took interest in neuropsychiatry, chemical dependency and forensic psychiatry. Completing a fellowship in geriatric psychiatry/ neuropsychiatry at University of Pittsburgh Medical Center, he obtained clinical/academic positions as an Assistant Clinical Professor at University of Maryland Medical Center as well as Penn State University College of Medicine. His private practice forensic medical-legal evaluations have included psychopharmacological analysis, substance abuse and addiction psychiatry examinations concerning physicians and nurses. He is a Member of the Pharmacy and Therapeutics committee for not-for-profit HMO pharmacy benefit management organizations. His American Board of Psychiatry and Neurology certifications include: Addiction Psychiatry, Forensic Psychiatry, General Psychiatry, and Geriatric Psychiatry. His membership includes American Academy of Psychiatry and Law, American Psychiatry Association, and American Academy of Addiction Psychiatry.