Physician Impairment and Safety to Practice Medicine

  • Tracy D. GunterEmail author
Part of the Integrating Psychiatry and Primary Care book series (IPPC)


Physicians have a responsibility to treat their patients in a safe manner. When unable to do so based on a health condition, physicians may become “impaired.” As a fluid concept, the term impairment warrants better guidelines that support the medical community in identifying who is impaired and what steps should be taken to identify, report, and address impairment. Uniform regulations should be put in place in the United States to protect and support physicians. In addition, a regulated reporting system has the potential to safeguard both physicians and their patients. An evaluation system independent from—yet recognized by—medical boards, physician health organizations, credentialing agencies, and insurance companies could offer guidance in the process of identifying, evaluating, and treating impaired physicians.


Impaired physician Sick doctor Malfunctioning doctor Disruptive physician Fitness for duty 




A physical or mental disorder that limits one or more major life activities. The Americans with Disabilities Act (ADA) makes it unlawful to discriminate against a person who meets job requirements and can perform the essential functions of a job with or without reasonable accommodation.

Disruptive physician behavior 

A practice pattern—frequently resulting from maladaptive coping skills or personality traits—that interferes with a physician’s effective clinical performance, namely hostility, temper outbursts, demeaning comments, abusive behavior, and intimidating behavior. Such behaviors may also result from a mental health or substance use disorder (see also Chap.  3).

Fitness for duty 

Ability to do essential job functions.

Impaired Physician (also Impaired Provider or Malfunctioning Doctor) 

A physician who is unable to perform patient care tasks in a safe manner due to a physical or mental disorder, including substance use disorders.

Peer review 

Process by which physicians review the work of physician peers who have been identified as having a practice problem or about whom a complaint has been filed.

Physician burnout 

Emotional exhaustion, depersonalization, and diminished sense of personal accomplishments resulting from chronic exposure to workplace stressors, which may affect physicians at any point during their careers (see also Chap.  1).

Physician Health Programs (PHPs) 

Programs that, operating independently in each state, may offer monitoring services and/or treatment referrals to physicians. The scope of practice, role, and regulations of PHPs differ from state to state (see also Chap.  12).


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PsychiatryIndiana University School of MedicineIndianapolisUSA

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