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Reason for Concerns

By Jock Hoffman, CRICO

Related to: Ambulatory, Clinical Guidelines, Communication, Emergency Medicine, Primary Care, Surgery


Depression impacts a significant portion of the general population including, of course, practicing clinicians. While much of the research, and subsequent press, have focused on depression and burnout among residents, more seasoned physicians (and nurses) are by no means immune. When professional burnout is factored in, the medical community’s mental health problems may be even more profound than for the general public.

Even mild depression or burnout can impact an individual’s empathy, energy, reaction time, and ability to concentrate. Patients who are counting on their doctor to conduct a thorough assessment, order appropriate tests, and correctly prescribe medications have reason for concern. Hospitals and physician groups who fail to recognize a provider’s impairment may well be considered complicit in the event of an error attributed to that provider’s mental disability. At the same time, when any clinician commits an error, he or she is likely to suffer less mental distress if professional support is available—and availed.

Our Recommendation

As with the general public, the stigma associated with depression has lessened in recent years, but it remains a mostly private affliction. Given the potential liability, hospitals and practice groups cannot afford to wait until a physician or nurse’s mental health problems become apparent, which is only after something has gone wrong. Patients should be encouraged to report impaired clinicians. Providers need to educate themselves about the potential for cognitive errors associated with any mental health problems they may incur. Leaders, mentors, and policy makers have an obligation to provide and promote resources for mentally impaired clinicians, and for those who have recently made a significant error or been named as a defendant in a malpractice case.

In addition to parochial support programs offered by hospitals and some larger practice groups, every state has a physician health program aimed at helping doctors remain in or return to the safe practice of medicine. In Massachusetts, Physician Health Services (operated by the Massachusetts Medical Society) includes programs for physicians with mental health issues.

Additional Materials

April 1, 2008
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