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The conspiracy of silence.
Canadian Family Physician Medecin De Famille Canadien
|February 5, 2011
Summary
Physician impairment due to substance abuse is often ignored due to a "conspiracy of silence." Efforts to identify and rehabilitate impaired physicians have been challenging, perceived as punitive rather than therapeutic.
Area of Science:
- Medical Ethics
- Physician Health
- Substance Abuse
Background:
- The problem of physician impairment due to substance abuse is exacerbated by widespread denial and a "conspiracy of silence."
- Families, colleagues, and institutions often struggle to address deteriorating performance, fearing stigma and lacking knowledge on handling substance abuse issues.
Purpose of the Study:
- To examine the challenges in identifying and rehabilitating impaired physicians.
- To analyze the impact of a "conspiracy of silence" on addressing physician substance abuse.
Main Methods:
- Review of experiences from a Saskatchewan Medical Association committee formed in 1976.
- Analysis of the committee's efforts to penetrate the silence surrounding impaired physicians.
Main Results:
- The committee's efforts have been largely frustrating.
- The committee's function has been perceived as more punitive than therapeutic, hindering rehabilitation.
Conclusions:
- Overcoming the "conspiracy of silence" is critical for addressing physician impairment.
- A therapeutic, rather than punitive, approach is needed for successful physician rehabilitation.
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