PROFESSIONAL ACTIVITIES BY PHYSICIANS WITH RESTRICTED MEDICAL LICENSES

Introduction

Physicians who suffer from illness often come to the attention of their Medical Boards. If they are deemed by their Medical Boards as able to practice medicine with reasonable skill and safety to patients, they often enter into binding agreements with their Medical Boards which allow them to practice under specific conditions. These agreements constitute license restrictions. This position statement addresses the professional restrictions frequently encountered by this group of physicians.

Statement

Decisions as to whether such physicians should be permitted to undertake certain professional activities should be made on a case by case basis in which all of the facts and circumstances are considered, rather than categorically on the basis of the license restriction alone.

When deciding individual cases, the decision maker(s) should consider the opinions of appropriate professionals, including treating professionals, Physician Health Programs and experts in the field of physician illness.

Background

The American Academy of Addiction Psychiatry (AAAP) and the American Psychiatric Association (APA) are concerned about inflexibly restrictive policies of entities as they apply to physicians who have been deemed safe and capable of practicing but have restrictions on their medical licenses. Such entities, including certifying, accrediting and credentialing agencies, may restrict physicians from activities that are essential to working successfully as a physician. These activities may include practicing at a hospital, participating in a provider panel, being accredited by an agency, or sitting for a certifying examination.

Restrictive policies, though intended to protect patients, institutions, or the integrity of the profession, may unnecessarily and inequitably exclude physicians who have suffered from medical illness but are not impaired in their ability to practice.

AAAP/APA is not only concerned about physicians with addictions and other psychiatric disorders but also about physicians who suffer from other medical conditions. AAAP/APA believes that competent physicians who are not impaired by illness and who do not practice in an unprofessional manner should not be excluded from a variety of important professional activities on the basis that they suffer from an illness and have also come to the attention of their Medical Board.

In many states, simply suffering from an addictive disorder constitutes professional misconduct and may result in exclusion from certain professional activities. In other cases, a physician may commit an act of professional misconduct solely caused by his/her illness, misconduct that is preventable by successful treatment.

This position statement does not apply to physicians whose professional misconduct is not attributable to illness.

Given the range of illnesses and circumstances, the decision as to whether a physician should be permitted to undertake professional activities needs to be made on a case by case basis in which all the circumstances are considered. It is also valuable to seek input from clinical professionals who know the most about the physician, his/her illness, and the field of physician health and impairment.

Approved by AAAP Board of Directors: December 1999