Physician Impairment
Revised and approved by the ACEP Board of Directors October 2006
Reaffirmed by the ACEP Board of Directors September 1999
Revised and approved by the ACEP Board of Directors April 1994
Originally approved by the ACEP Board of Directors September 1990
The American College of Emergency Physicians recognizes the need for mental and physical well-being among emergency physicians. Personal and professional stressors can impair the ability of emergency physicians to function successfully. Society at large has become increasingly aware of impairment issues since the impact of impairment extends well beyond the individual physician.
Physician impairment exists when a physician's professional performance is adversely affected by mental or physical illness, aging, alcoholism, chemical dependence or any other circumstance that interferes with his or her ability to engage safely in patient care. Impairment can be a self-limited state that is amenable to intervention and resolution.
In recognition of the problem of emergency physician impairment, ACEP endorses the following principles:
- The well-being of the emergency physician is essential to the practice of emergency medicine.
- The impaired emergency physician may be unable to practice emergency medicine with the skill necessary for the safety of patients. In any approach to managing problems related to physician impairment, consideration of patient safety must be of primary importance.
- Emergency physician groups, employers, and emergency medicine residency programs should have written policies that assure a fair and reasonable process of investigation of any physician suspected of being impaired.
- In general, with the exception of an imminent danger to patient safety or physician well-being, a thorough evaluation should precede any termination or suspension of the physician's usual rights and responsibilities. Such evaluation should consider the quality of care rendered and, if at issue, the physician's health.
- ACEP is committed to assist the impaired emergency physician through education, information, and collaborative processes.
- ACEP encourages the development and use of physician health and assistance programs sponsored by state medical societies, boards of medicine, professional societies and other organizations attuned to the range of impairment problems that affect physicians.
- It is the position of ACEP that utilizing the disease model of chemical dependence is the best method for successfully treating and rehabilitating the emergency physician who suffers from alcoholism or chemical dependence. The impaired emergency physician should be treated with the respect and dignity due any patient with an illness.
- Emergency physician groups, employers, and emergency medicine residency programs should have written policies regarding the return to practice of recovering physicians who successfully complete treatment and are receiving adequate follow-up. In addition, licensing and credentialing agencies are encouraged to allow recovering physicians who have completed treatment and are compliant with their recovery programs, and whose licenses are not otherwise encumbered, to maintain certification or participate in certification processes.
- Emergency physician groups, employers, and emergency medicine residency programs should have written policies that foster the well-being of emergency physicians by facilitating early recognition and non-punitive mechanisms of reporting impairment, and by promoting early intervention and treatment when appropriate.
- Education focusing on the prevention and management of physician impairment, including those factors that promote well-being or alternatively that lead to impairment, should be provided to medical students, residents, and included in continuing medical education curricula.
- ACEP encourages research directed at the detection, treatment, and prevention of emergency physician impairment.