Assessment Tools for Sexual Boundaries

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Assessment Tools for Sexual Boundaries
The Federation of State Medical Boards regards physician sexual misconduct very strictly, saying that “...misconduct exploits the physician-patient relationship, is a violation of the public trust, and is often known to cause harm, both mentally and physically, to the patient....
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Is it Risky to Disclose Depression  on a Licensure Application? by Robert Bondurant, RN, LCSW
Executive Director, MPHP There appears to be uncertainty among some physicians as to whether or not to disclose a history of depression when applying for licensure. It is an important concern as it may also affect one’s decision aboutExecutive Director, MPHP There appears to be uncertainty among some physicians as to whether or not to disclose a history of depression when applying for licensure. It is an important concern as it may also affect one’s decision about...
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Identifying Suicide Risk by Nancy Morton, B.S.

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Identifying Suicide Risk by Nancy Morton, B.S.
Due to the recent suicides that have occurred in Missouri’s medical community in the last year, I have been eager to learn more about what can be done to prevent such tragic losses. During a recent AMA webinar on Suicide in Medical Education: The Stresses of Medical School and Residency Training, I was pleased to learn that...
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Disruptive Behaviors Among Physicians

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Concerns regarding the “disruptive physician” have been reported in the medical literature for at least the past 30 years. Recently, there has been the perception that the problem is increasing, although it is unclear if this is because of increased awareness or greater surveillance or because more physicians are acting unprofessionally. A report from 2006estimated that 3% to 5% of physicians had demonstrated behavior that interferes with patient care or could be expected to interfere with the...
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BALTIMORE, MAY 7 --Johns Hopkins Medicine issued the following news release: To improve patient safety, hospitals should randomly test physicians for drug and alcohol use in much the same way other major industries in the United States do to protect their customers. The recommendation comes from two Johns Hopkins physicians and patient safety experts in a commentary published online April 29 in The Journal of the American.....
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Disease of Loneliness by an Anonymous Physician

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Disease of Loneliness by an Anonymous Physician
I had a patient experience that was profound for me. I was asked by the ICU to meet the parents of a 39 year old man who dying of liver and kidney failure from alcoholism. The ICU doctors ...
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The Aftermath of Trauma – Post-Traumatic  Stress Disorder
Most of us build our lives around the belief that we will be relatively safe. Granted, normal daily life involves many stressors, especially in these hectic times...
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The Physician Lifeline - November 2014

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The Physician Lifeline - November 2014
IN THIS ISSUE: Too Much Information —The Ethics of Self-Disclosure & A Response Tips from Dr. Bill W. Spotlight on Tracy Ellman Risk for Physician Suicide Decision Fatigue and Prescribing Practices Malpractice Claims Decrease in PHP Enrollees Recommended Reading
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Count the Full Cost of Retiring Your Medical License Before You Do It!
n 2008, after a long and successful career of some 28 years, I decided to branch out and start a new business. It happened to be the delivery of telemedicine to non-urban communities, and after some two years, the company had gained substantial traction and I was making a respectable income. All the while, I had not had occasion to practice clinically, so I began considering the idea of simply retiring my license and leaving clinical medicine for good. After all...
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Too Much Information -- The Ethics of Self-Disclosure by Kelly A. Curran, M.D.
“New admit,” the page reads. “14 y/o F r/o IBD, needs c-scope.” In person, the patient is spunky, sassy, filling the team’s day with joy. She dreams of professional dance, being en pointe under the bright lights. She is a fair sprite, ghostly pale after months of bloody diarrhea. After answering our questions, she declares that the hospital isn’t such a bad place and hunkers down with a Cake Boss marathon on television and several liters of prep...
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Rockwell Doctor Overcomes Stroke, Alcoholism to Return to Practice by Susan Shinn Each morning, he wakes up and asks God for another day of sobriety. Then he gets up and goes to work. He walks with a slight hitch in his gait. His speech and manner are deliberate, thoughtful. His brown eyes are clear. His smile is gentle. And his bedside manner is kind...
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Alternative Remedies to Reduce Physician Stress

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Alternative Remedies to Reduce Physician Stress
Elizabeth B. 'Libby" Stuyt, MD, Colorado Physician Health Program (CPHP) Associate Medical Director discusses Alternative Remedies to reduce physician stress. Most physicians experience a great deal of stress on a daily basis. This comes in many forms – pagers, phone calls, bad outcomes, administrative hassles, dealing with insurance companies, malpractice threats, family problems, health problems... the list goes on and on. No one is immune and no one escapes from these hardships...
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The Physician Lifeline - September 2013

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The Physician Lifeline - September 2013
Deal with Physician Impairment Before It’s a Safety Risk by Karen Caffarini Attorneys and experts recommend that practices have policies that address how to define and handle a colleague who might represent a safety threat to patients. An impaired or incompetent physician can be a liability to a medical practice and pose a safety threat to patients. Still, some practices have found it difficult to discipline or report such a physician, especially if he or she is a partner in the practi...
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The Physician Lifeline - September 2014

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The Physician Lifeline - September 2014
Thoughts on Legalization! by Jon Shapiro, MD! Medical Director, Physicians’ Health Programs of the Medical Society of Pennsylvania! ! Our recent trip to the PHP [Federation of State Physician Health Programs] conference in Denver highlighted some of the controversy surrounding the recent legalization of marijuana. It has raised several complex issues.!
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The Physician Lifeline - July 2014

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The Physician Lifeline - July 2014
IN THIS ISSUE: Physician Suicide - A Problem for our Time Spotlight on Martin Dressman, MSW Good news from the President of FSPHP
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The Physician Lifeline - May 2014

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The Physician Lifeline - May 2014
IN THIS ISSUE: When Bad Behavior Can’t Just Be Dismissed Spotlight on Jayne Niskey, PhD Meeting Announcements Recommended Reading A New Day is Dawning Emotional Sobriety: The Next Frontier
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The Physician Lifeline - March 2014

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The Physician Lifeline - March 2014
The name of Donald McIntosh, MD, may not be familiar to you, but among Dr. McIntosh’s many accomplishments as a physician was his crusading efforts that eventually resulted in the formation of the MPHP.
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The Physician Lifeline - January 2014

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The Physician Lifeline - January 2014
A major deficiency still plagues the MPHP! As we begin 2014, I would like to revisit what this is and ask for your help. During 2013 as I would interact with a variety of administrators and physicians, I again found that the range of services that we offer is not well known or remembered. What really caused me to pause and reflect on this was the termination of a highly qualified physician who could have benefited from some legitimate help. The group he was associated with responded to his ...
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The Physician Lifeline - November 2013

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The Physician Lifeline - November 2013
Creative street chemists never run out of ideas about how to come up with designer drugs that can be abused. These drugs are usually marketed to young people as a safe, fast way of getting high. Numerous cases of date rapes, bad trips and deaths have been linked to their use.
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The Physician Lifeline - July 2013

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The Physician Lifeline - July 2013
The Aftermath of Trauma – Post-Traumatic Stress Disorder Most of us build our lives around the belief that we will be relatively safe. Granted, normal daily life involves many stressors, especially in these hectic times, but we expect these pressures to happen and we become accustomed to handling them. The more flexible we are and the more we know ourselves and are in touch with our abilities, the easier it is to deal with normal everyday stress.
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The Physician Lifeline - May 2013

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The Physician Lifeline - May 2013
When Is It Okay to Date a Patient? Medscape Ethics Report 2012 by Shelly Reese Introduction To the besotted poet, love is intoxicating, exasperating, invigorating. To the doctor - if the would-be paramour is a patient - it’s also unethical. But physician responses to Medscape’s 2012 ethics survey clearly indicate that many physicians aren’t willing to condemn every romance. When asked, “Is it ever acceptable to become involved [in] a romantic or sexual relationship with a patient?”...
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The Physician Lifeline - March 2013

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The Physician Lifeline - March 2013
Malpractice Rates Lower Among PHP Participants Findings from a study recently presented at the AMA/CMA/BMA International Conference on Physician Health showed that although starting from a higher risk category, PHP participants decreased their risk to 20% below that of a non-PHP group after monitoring. Michael Gendel, MD, a Denver psychiatrist and medical director emeritus of the Colorado PHP suggested that “one advantage of PHP participation is increased safety and not just better hea...
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The Physician Lifeline - January 2013

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The Physician Lifeline - January 2013
Dear Friends and Supporters of MPHP, We know that there is a serious physician shortage, and replacing a physician may cost as much as $200,000. A critical part of our function is to salvage physicians so they can return to the safe practice of medicine. Each physician that we can return represents a significant savings. If we were to save only 5 physicians in a year, that would amount to a savings of over 1 million dollars and that is a very conservative number. Thus, our program is a very...
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The Physician Lifeline - November 2012

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The Physician Lifeline - November 2012
Because of stigma (feared or real), overwork and denial of vulnerability, many physicians do not take good care of themselves. Yet we are not immune to those conditions or illnesses we encounter in our medical practices on a routine basis, independent of specialty. Anxiety disorders are remarkably common in the general population and despite our wish for immunity, among physicians.
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The Physician Lifeline - September 2012

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The Physician Lifeline - September 2012
Tips for a Healthy Marriage/Relationship It is a fact that married physicians have a 10-20% higher divorce rate than that of the general population. Of those who stay married, almost half of physicians and more than half of their spouses report that they are unhappy; figures that are approximately 15 percent higher than those for the nonphysician population. “ ...The rate of suicide is greater for doctors’ wives than for wives of any other professional group.”
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The Physician Lifeline - July 2012

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The Physician Lifeline - July 2012
Tips for a Healthy Marriage/Relationship It is a fact that married physicians have a 10-20% higher divorce rate than that of the general population. Of those who stay married, almost half of physicians and more than half of their spouses report that they are unhappy; figures that are approximately 15 percent higher than those for the nonphysician population. “ ...The rate of suicide is greater for doctors’ wives than for wives of any other professional group.”
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The Physician Lifeline - May 2012

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The Physician Lifeline - May 2012
Opioid Prescribing Requires Close Patient Monitoring A
study
finds
that
primary
care
doctors
avoid
urine
screening
and
 other
methods
to
prevent
abuse
of
the
pain
medications
even
with
 highest-risk
patients. by Kevin B. O’Reilly Opioid analgesics help alleviate the symptoms of patients with chronic pain, but they are also vulnerable to abuse. About 14,000 people die annually from opioid overdoses, and the medicines are implicated in more than 300,000 emergency ...
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The Physician Lifeline - March 2012

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The Physician Lifeline - March 2012
Identifying Suicide Risk by Nancy Morton, B.S. Due to the recent suicides that have occurred in Missouri’s medical community in the last year, I have been eager to learn more about what can be done to prevent such tragic losses. During a recent AMA webinar on Suicide in Medical Education: The Stresses of Medical School and Residency Training, I was pleased to learn that the UC San Diego Health System has an innovative program called Healer Education Assessment and Referral or HEA...
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The Physician Lifeline - January 2012

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The Physician Lifeline - January 2012
I am pleased to announce the appointment of Charles Sincox, MD as Medical Director, by the Missouri State Medical Association. Dr. Sincox, a Family Practice Physician, has chaired the Physicians’ Health Committee for three years and has served on the committee since 1993. During his tenure with the committee, he has demonstrated his commitment and passion to physicians in recovery.
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The Physician Lifeline - November 2011

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The Physician Lifeline - November 2011
An overworked married pediatrician was attracted to a single mom in his practice... ...When his wife discovered the affair, he broke it off. The mother became angry, felt exploited and retained an attorney. Comment: It’s important to realize that family of patients can be considered patients too, especially in pediatrics, where the parents are considered patients along with their children.
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The Physician Lifeline - September 2011

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The Physician Lifeline - September 2011
“The most troubling finding is 94% of primary care physicians failed to include substance abuse among the five diagnoses they offered when presented with early symptoms of alcohol abuse in an adult patient.” This quote is taken from the CASA National Survey of Primary Care Physicians and Patients on Substance Abuse.
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The Physician Lifeline - July 2011

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The Physician Lifeline - July 2011
Hospital administrators, physician colleagues, and allied staff often grapple with the best approach to disruptive behavior. Some have advocated an approach which is limited to CME coursework. Krupa, writing in an AMA post, suggests that disruptive behaviors “signal poor judgment and a lack of understanding about rules governing medical practice.” 1 MPHP believes that this limited approach is misguided, as CME courses may be part of the solution in a few select cases, but are not a solut...
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The Physician Lifeline - May 2011

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The Physician Lifeline - May 2011
Those in the healing profession have prescribed cannabis, known in the vernacular as Marijuana (MJ), for at least five millennia. MJ was prescribed in China as early as 2737 B.C. for ailments ranging from “absentmindedness” to “female weakness.” In the United Sates, physicians routinely prescribed MJ until the late 1930’s when it seemed to fall out of favor. It was not until 1970 that the law would intervene and proscribe all use. In 1975 the Compassionate Use Program for MJ was estab...
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The Physician Lifeline - March 2011

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The Physician Lifeline - March 2011
In this issue, we present two articles on depression and suicide. Quite often in our work, we must confront this issue in a very personal way. Recently, one of our Regional Coordinators who works with our program participants became very concerned about one of the physicians in his monitoring group. The physician was depressed, and there was a history of suicide attempts within his family. Our Regional Coordinator (RC) met with the individual privately, but he was unwilling to ackn...
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The Physician Lifeline - January 2011

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The Physician Lifeline - January 2011
Our economy is a major concern. I referred to this last year in this column and it is as true today. Each year we rely on our contributors to continue or increase their level of financial support. The MPHP is not dependent on governmental support but it does need the ongoing support from our friends, the contributors, each and every year. They are our lifeline.
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The Physician Lifeline - November 2010

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The Physician Lifeline - November 2010
In this issue, we are pleased to present an excellent report authored by the task force on the Accommodation of the Pregnant Physician, published by the Physician Health Program of British Columbia called Medicine and Motherhood: Can We Talk? This study has many implications for the health care delivery system in this country, and includes specific recommendations on addressing the issues involved.
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The Physician Lifeline - September 2010

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The Physician Lifeline - September 2010
One of the blessings of the work that I do with the Missouri Physicians Health Program is the opportunity to work with remarkable individuals. It is an honor to work with our physicians. For me, the beauty of the program is the people, those that we support and those that provide the support. We have many providers throughout the state of Missouri that allow us to offer the quality of monitoring that we do.
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The Physician Lifeline - July 2010

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The Physician Lifeline - July 2010
This year we celebrate 25 years of service to Missouri physicians. 1985 was the year that the Missouri Physician Health Foundation became incorporated as a 501c3 not-for-profit corporation. Prior to 1985, the MSMA had a program to assist physicians under the leadership of Dr. Donald McIntosh. Dr. McIntosh volunteered his time and dedication to helping troubled colleagues. His dream eventually became the legal entity now known as the Missouri Physicians Health Program.
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The Physician Lifeline - May 2010

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The Physician Lifeline - May 2010
1 Program Notes by Bob Bondurant In this issue, we present part 2 of “Medical Malpractice: Anatomy of an Alabama Lawsuit and How to Cope When Your Physician Spouse is Sued”. We chose to present this extended article because the costs of a malpractice suit are considerable both financially and psychologically. One in three physicians will be sued for malpractice at least once during their career. For surgeons, the percentage climbs to between 50-60%.
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The Physician Lifeline - March 2010

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The Physician Lifeline - March 2010
In this issue, we continue to present vital information regarding malpractice. In our January issue, we presented information on avoiding malpractice. This issue presents a portion of an excellent article called Medical Malpractice: Anatomy of an Alabama Lawsuit and How to Cope When your Physician Spouse is Sued, by The Alliance of the Medical Association of the State of Alabama and The Alabama Physician Health Program, published in 2004.
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The Physician Lifeline - January 2010

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The Physician Lifeline - January 2010
I am very proud of the position MPHP finds itself in today. In spite of the economic challenges that we face, MPHP stands steadfast and is available to deliver a broad range of services to troubled physicians. The support of the Missouri State Medical Association has made the difference in the survival and development of the MPHP. It has assured our economic freedom and often stands with us in resolving difficult issues of physician advocacy.
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The Physician Lifeline - November 2009

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The Physician Lifeline - November 2009
In this issue, we are presenting Part II of Chemical Dependence in Anesthesiologists: What you need to know when you need to know it, written by the American Society of Anesthesiologists. There is one subject covered in the article which bears comment. In presenting the information on treatment, the authors mention that short term treatment programs are available. In my 16 years of experience as Program Coordinator, I have observed the results of short and long term treatment progr...
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The Physician Lifeline - July 2009

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The Physician Lifeline - July 2009
Program Notes by Bob Bondurant This issue’s lead article on Professional Sexual Misconduct is co-authored by Dr. Gregory Skipper, Medical Director for the Alabama Physicians Health Program. Dr. Skipper is one of the many talented and dedicated leaders in the constellation of physicians’ health programs. This article is an example of the sharing of information that exists among the members of the Federation of the State Physician Health Programs. The Missouri Physicians Health Pr...
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The Physician Lifeline - May 2009

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The Physician Lifeline - May 2009
Patient and Physician Safety I have often heard comments that the medical boards are concerned only about patient safety while the Physician Health Programs are concerned only about protecting physicians. Throughout the year, I have learned that these are not exclusive concerns but are
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The Physician Lifeline - November 2008

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The Physician Lifeline - November 2008
Hello, Friend: My name is [Fill in your name, here], and I am an addict. My name can definitely go in this blank. I became addicted to the prescription sleeping medication AmbienTM in the late 1990s. I had developed a peculiar obsession with getting “enough” sleep, and believed that the slogan “better living through chemistry” (the slogan of the DuPont Corporation in the late 1960s) applied especially well to me! I thought Ambien made me perform better, because after using it, I slept...
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The Physician Lifeline - September 2008

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The Physician Lifeline - September 2008
I have had many discussions with administrators and chiefs of staff since the last issue appeared on disruptive physician behavior. One concept that seems to be most troubling is the “lack of insight” the physician displays when confronted about their behavior. This is a type of denial that is often associated with chemical dependency. However, this is also one of the unique characteristics of personality disorders.
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