The Physician as Patient

This practical handbook combines the perspectives of two seasoned psychiatrists who have been assessing and treating physicians for more than 30 years and who here discuss not only common illnesses and problems seen in doctors but also the many biopsychosocial treatments that are indicated.

Because physicians are shaped by the expectations and responsibilities of their profession and are especially susceptible to stress and illness, professionals treating them need to be attuned to a host of demands and considerations not applicable to other patients. The Physician as Patient meets that need by combining the perspectives of two seasoned psychiatrists who have been assessing and treating physicians for more than 30 years. Drs. Myers and Gabbard pool their career-long dedication to physician health, counseling, and risk management to demonstrate that, through accurate diagnosis and state-of-the-art treatment, most impaired physicians can recover and return to practice.

As the most current sourcebook available on this subject, The Physician as Patient not only discusses common illnesses and problems seen in doctors but also outlines the many biopsychosocial treatments that are indicated -- always with an emphasis on integrated care. It considers such issues as the reluctance of physicians to assume the role of patient and the uniqueness of the physician's psychological makeup that facilitates or impedes diagnosis and treatment. It describes the most common medical and psychiatric illnesses in physicians -- including addictions -- and addresses personality disorders and the increasingly important subject of boundary violations. And it helps readers determine what can be done about doctors behaving badly or out-of-character, or what strategies are useful in treating physicians to assure accuracy while also diminishing morbidity and relieving suffering. Among other key issues raised are: • The importance of considering sociocultural customs and values when treating the increasing number of minority and International Medical Graduate physicians • Addressing the many clinical, humanistic, ethical, and legal dimensions of the psychiatric evaluation of physicians• Distinguishing between long-standing patterns of personality disorders that manifest as disruptive behaviors and those patterns that lead to burnout and depression• Assessing amenability to rehabilitation in cases of sexual boundary violation, including an awareness of alcohol or drug abuse as contributing factors• Utilizing a physician's predisposition as a learner and pragmatist to enter into cognitive behavior therapy• The success of early diagnosis and treatment in lowering the occurrence of suicide, for which physicians are notoriously at risk Brimming with case examples, The Physician as Patient adopts a reader-friendly style that facilitates quick grasp of concepts, while an extensive list of references and websites provides an entrée for additional support. This book is an indispensable resource for all mental health professionals who take caregivers into their care.

IntroductionPart I: Physician Characteristics and VulnerabilitiesChapter 1. The Psychology of Physicians and the Culture of MedicineChapter 2. Minority Physicians (Racial, Ethnic, Sexual Orientation) and International Medical GraduatesChapter 3. Psychiatric Evaluation of PhysiciansPart II: Diagnostic and Treatment Issues in the Distressed and Distressing PhysicianChapter 4. Psychiatric and Medical Illness in PhysiciansChapter 5. Addictions: Chemical and NonchemicalChapter 6. Personality Disorders, Personality Traits, and Disruptive PhysiciansChapter 7. Professional Boundary ViolationsPart III: Prevention, General Treatment Principles, and RehabilitationChapter 8. Psychodynamic Psychotherapy Chapter 9. Individual Cognitive Therapy and Relapse Prevention TreatmentChapter 10. Couples in Conflict and Their TreatmentChapter 11. The Suicidal Physician and the Aftermath of Physician SuicideChapter 12. PreventionAppendix: Resources and Web SitesReferencesIndex