• Alan Rosen, Andrew Wilson, Patte Randal, Andrew Pethebridge, David Codyre, David Barton, Peter Norrie, Peter McGeorge, and Lynette Rose.
• Department of Psychological Medicine, University of Sydney, and School of Public Health, University of Wollongong, Chatswood, NSW, Australia. arosen@nsccahs.health.nsw.gov.au
• Australas Psychiatry. 2009 Feb 1; 17 (1): 11-8.

ObjectiveThe aims are to briefly review treatment outcomes for impaired practitioners, and to explore how preventive and early intervention, and the accessing of and retention within treatment systems for impaired medical practitioners, and particularly psychiatrists, could be improved to maximize the doctors' chances of full recovery and to minimize danger to self and others.MethodsThe literature on the treatment and care of medical practitioner impairment due to mental illness, and substance use, with special reference to impaired psychiatrists is briefly reviewed. The implications of deficiencies of usual clinical management of doctors impaired by mental illness and opportunities for improvement in services for them are explored, including the impact of the experience of being an impaired medical practitioner under psychiatric treatment. The roles of medical boards and advisory services are examined.ResultsMedical practitioner impairment due to mental illness has a severe impact on doctors' lives and the lives of their families due to both the effects of the disorder and the experience of communal, professional and self stigma and discrimination. Deficiencies in usual practice in the treatment and rehabilitation of such individuals are identified, and alternatives explored.ConclusionsPrevention, early detection, intervention, and treatment programs that are more continuous more sensitive to the needs of impaired practitioners, that are more continuous, better structured, and rehabilitation and recovery focused, may be more likely to produce a positive outcome.

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