August 26, 2009

What happens when a physician is addicted?

today we talked all about physicians who are addicted to different substances. We're learning about ethics, study design, public health and genetics - so we first read a few papers about an outbreak of a hospital infection in a surgical ICU that was most likely caused by one of the employees tampering with the fentanyl (a type of synthetic opiod) of patients who were acutely ill post-surgery in order to take some and use it. So we got to learn about how you study outbreaks (infection all over the surgical ICU), talk about how you deal with infection (public health), about whether we hold physicians to a different standard when it comes to drug abuse - and if so, why? (ethics), and then about addiction as an illness (genetics).

So suffice it to say, my mind is spinning. I also have my first exam on Friday (eek) so I'm trying to transform myself into a studying machine. I still feel pretty human so far, but here's hoping.

So what we should do for physicians who are addicts? Do we treat them differently than anyone else? In class, we read an excerpt from Abraham Verghese (a physician/writer)'s book, The Tennis Partner, which talks about him playing tennis with a fellow physician and the relationship that forms between them. Dr. Verghese ends up confiding in his tennis partner about his failing marriage, and his tennis partner confides in him all about his addiction to cocaine. Ultimately, the tennis partner gets addicted to perscription drugs and Dr. Verghese has to decide wha the best form of intervention is.

He thinks along the lines of: a physician is worth so much to society that we shouldn't put him in jail; plus rates of recovery from addiction are much higher in physicians than in other professions - potentially because they have more to lose by not recovering. He also thinks: this guy can't be treating patients when he needs to be a patient himself.

Thoughts? Here's a link to an interview with a doctor who treats addicted physicians for more background:

"just because you got the monkey off your back doesn't mean the circus has left town"
-George Carlin (about addiction)

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