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Providing safe, high quality care is fundamental to physicians’ fiduciary obligation to promote patient welfare. Yet a variety of physical and mental health conditions—including physical disability, medical illness, and substance use—can undermine physicians’ ability to fulfill that obligation. These conditions in turn can put patients at risk, compromise physicians’ relationships with patients, as well as colleagues, and undermine public trust in the profession.

While some conditions may render it impossible for a physician to provide care safely, with appropriate accommodations or treatment many can responsibly continue to practice, or resume practice once those needs have been met. In carrying out their responsibilities to colleagues, patients, and the public, physicians should strive to employ a process that distinguishes conditions that are permanently incompatible with the safe practice of medicine from those that are not and respond accordingly. 

As individuals, physicians should: 

  1. Maintain their own physical and mental health, strive for self-awareness, and promote recognition of and resources to address conditions that may cause impairment.  
  2. Seek assistance as needed when continuing to practice is unsafe for patients, in keeping with ethics guidance on physician health and competence. 
  3. Intervene with respect and compassion when a colleague is not able to practice safely. Such intervention should strive to ensure that the colleague is no longer endangering patients and that the individual receive appropriate evaluation and care to treat any impairing conditions.  
  4. Protect the interests of patients by promoting appropriate interventions when a colleague continues to provide unsafe care despite efforts to dissuade them from practice.  
  5. Seek assistance when intervening, in keeping with institutional policies, regulatory requirements, or applicable law. 

    Collectively, physicians should nurture a respectful, supportive professional culture by: 

  6. Encouraging the development of practice environments that promote collegial mutual support in the interest of patient safety. 
  7. Encouraging development of inclusive training standards that enable individuals with disabilities to enter the profession and have safe, successful careers. 
  8. Eliminating stigma within the profession regarding illness and disability. 
  9. Advocating for supportive services, including physician health programs, and accommodations to enable physicians and physicians-in-training who require assistance to provide safe, effective care. 
  10. Advocating for respectful and supportive, evidence-based peer review policies and practices to ensure fair, objective, and independent assessment of potential impairment whenever and by whomever assessment is deemed appropriate to ensure patient safety and practice competency.
AMA Principles of Medical Ethics: II
Read the Principles