Mental Health Conditions
Complex Psychiatric Health Situations
Approved: February 5, 2009
Revised: June, 2014
Complex health situations arise when assessment, treatment or monitoring of a physician’s health condition is not straightforward. This is often the case when substance use or other psychiatric illness is present.
The psychiatrically-ill physician may come to the attention of the College in the following ways:
- Self report
- Concerns expressed by colleagues, nurses, or other health professionals.
- Concerns expressed by family and friends.
- Complaints or concerns expressed by the physician’s patients.
- Police or other authorities.
Physicians are often late in seeking help for psychiatric illness and may present late in the course of their illness. In rare circumstances, they may require urgent medical attention and may need to remove themselves temporarily from practice. As with any medical condition, early assessment and treatment benefits all involved and is encouraged. Physicians with psychiatric illness are generally able to return successfully to practice with appropriate support and monitoring.
Affective disorder, psychotic illness, metabolic or traumatic (organic) psychoses, and cognitive impairment can all cause significant disability if not actively diagnosed and treated.
Physicians treating other physicians have two at times competing responsibilities:
- for the care of their physician-patients and
- to ensure that their physician-patients are able to provide care safely to their patients.
The safety of the public takes precedence; thus, when a treating physician has concerns about the ability of the physician-patient to care safely for patients, it is recommended that the physician-patient be encouraged to self-report to the College so a risk assessment can be done and patient care is not compromised because of an ill physician. In the event that the physician patient refuses to do this, the treating physician is obligated to contact the College to have the situation with the physician assessed.
Physicians, like other members of a community, can suffer from multiple medical conditions, including psychiatric. It is common for people to suffer from both a substance use disorder and other psychiatric and medical conditions; this is referred to as dual diagnosis. Physicians with multiple medical conditions will often require assessment and follow up over time to determine the complex interplay of each condition with their overall functioning and with their practice of medicine.
If the physician has been away from practice, the College may require an independent assessment prior to returning to work and will require reports from any treating physicians or therapists. The physician’s formal written consent to obtain personal health information will be requested.
The College may also impose practice restrictions based on the recommendation of assessors, treating professionals, or to ensure safety of the public.