Impairment in the medical and legal professions

Male doctors and lawyers are among the job groups with high mortality from alcohol-related diseases, although the prevalence of substance misuse among these groups is not known. Both professions have occupational risk factors. This article describes aspects of the work environment which have facilitated substance misuse by doctors and lawyers, and describes the professional consequences of addiction. Data will be presented from two studies: a retrospective casenote survey of doctors treated for substance misuse; and a questionnaire survey of lawyers in recovery from alcohol problems. Mechanisms for assisting impaired professionals into treatment have been developed in the UK and the USA. The most successful models separate health procedures from disciplinary procedures as much as possible, and offer a confidential evaluation and treatment program. Self-help groups play a crucial role in these therapeutic processes.