13% of doctors will experience some kind of substance abuse problem during their career. This is compared to 10% in the general population. Stress, fatigue, insomnia, and pain combine with ease of access to make it likely that physicians may resort to chemical dependence to get through the day. There is probably nothing wrong with a surgeon downing a martini after a long day’s work, but a disheartening number of physicians allow drugs and alcohol to impact our patient-care.
When I told my partner this, she said it’s amazing that even with physicians’ high IQs we can still succumb to abusing drugs. Honestly, though, our high intelligence probably contributes to our resistance to admitting we need help. Isolation is both a warning sign and a cause of abuse. Casual use often spirals to abuse as we continue to deny our condition. We deny the problem because we have a strong agenda of career ambition. In fact, the workplace is usually the last place that health professionals allow their symptoms to manifest. By the time colleagues notice, the user’s life is already in shambles.
When we notice a colleague acting strange or missing duties, we’re reluctant to address it for fear of being perceived as a tattler. That said, we have an ethical duty to our patients to ensure that no physicians are impaired. Also, if you truly care about a person, you intervene if you see them headed down a dark path. Let’s make this kind of intervention the norm in med school as well. There is a an emphasis on catching impairment early in medicine, but we as students are in a position to prevent it years in advance. Drug and alcohol abuse isn’t the only form that physician impairment can take. Disruptive behavior from anger and dissatisfaction is now just as common. We can head this off in med school by supporting each other, promoting self-care, and staying humble enough to ask for help when we need it.