Dilemma: Vulnerability to impairment
The cornerstone for well-being is a balanced life. No matter how much one loves his or her work, there must be balance between work, relationships, and hobbies. Without that equilibrium, everyone is put at risk.2
Just as our patients, we are not immune to mental illness, cognitive decline, or substance abuse.3 We might even be more susceptible. For many physicians, their identity is intimately tied to their work.4 Dr. Robin Weiss captured that intimate relationship5:
“… [A] therapist may spend hundreds of hours, perhaps more than a thousand, hearing about a patient’s most exalted aspirations and most murderous, hateful fantasies. During this time, the patient may endure excruciating losses, unbearable shame, bitter sadness and great triumphs. You may accompany patients through torturous adolescence into adulthood. Or you may meet them in middle age and be with them as they age and eventually die. You collaborate in a deep process of discovery. Few encounters are this deeply honest, and therefore intimate.”
Given the stories we hear and the resulting intimacy and countertransference that inevitably arise, psychiatrists are even more prone to burnout than other physicians.6 Physician impairment is a public health issue that affects not just physicians but also their families, colleagues, and patients.
“Impairment” for the purpose of this article means a physical, mental, or substance-related disorder that interferes with a physician’s ability to undertake professional activities competently and safely.7 Predisposing factors for physician impairment include an obsessive-compulsive personality type, a family history of mental illness, sensation-seeking behavior, denial of personal problems, perfectionism, and idealism.8,9 Also, work stress becomes a significant factor in already vulnerable physicians, leading to a greater risk for mental illness.10
Continue to: Some warning signs of impairment include...