Practice management

ACP Releases New Position Paper on Physician Impairment

The American College of Physicians’ Ethics Professionalism and Human Rights Committee has released a new position paper on physician impairment and rehabilitation.

Physician impairment is defined as “the inability to carry out patient care responsibilities.” Causes of this impairment include substance use disorder, mental illness, profound fatigue, and decline in cognitive or motor skills, among many others.

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However, the Committee specifies that the presence or treatment of a disorder associated with impairment does not necessarily imply that the physician is impaired.

The 5 positions outlined in the paper include:

  • Professional duties require physicians to recognize and address physician illness and impairment.
  • Assistance should be guided by the distinction between functional impairment and potentially impairing illness.
  • Best practices for physician health programs should be developed systematically, informed by available evidence.
  • physician health programs should aim to rehabilitate and reintegrate the physician in the context of established standards of ethics and with safeguards for patient safety and physician rights.
  • Maintenance of physician wellness must be a professional priority of the health care community.

“Physicians share a commitment to care for ill persons, including each other. When physicians become impaired and are unable to practice competently, they should seek medical help and assistance in caring for their patients. When they cannot or do not do so, the profession and individual physicians have a responsibility to safeguard the welfare of patients and assist colleagues in obtaining help.”

—Michael Potts


Physician imCandilis PJ, Kim DT, Sulmasy LS. Impairment and rehabilitation: reintegration into medical practice while ensuring patient safety: a position paper from the american college of physicians [published online June 4, 2019]. Ann Intern Med. DOI: 10.7326/M18-3605.