Need For Effective Impairment Interventions And Mandated Treatments Extends To Attorneys, Too

By Stefan P Kruszewski, MD
Letters to the Editor, American Medical News
March 21, 2011

AmedNews-DrKruszewski-Opinion-NeedForEffectiveImpairmentInterventionRegarding: "Corrective medical education" (Article, Jan. 24): After I finished reading this article, I was reminded that attorneys are involved in many of the situations when physicians are in trouble, either through lack of updated medical education or emotional, sexual boundary or drug impairments.

Like many psychiatrists/addictionologists, I have worked on both sides of the issue, confronting and comforting physicians as associate medical director for impaired health professionals in the Commonwealth of Pennsylvania through the Pennsylvania Medical Society (2002-05) or, separately, with multiple state boards.

That said, although I have worked with highly competent counsel whose professional practices are both fit and sober, the opposite, not surprisingly, also has been true. I've met many attorneys who are severely impaired by incompetence, drug and sexual addictions, emotional disturbances and highly questionable financial and/or ethical actions.

My question is this: Where can these attorneys receive help, including mandated monitoring and interventions, comparable to what is provided for health care professionals? Who can refer them, knowing that their impairments will be treated?

I am aware that state programs for attorneys exist. However, in my clinical experience, programs to assist members of the legal professions are lacking, in number, quality and effective mandate, in their ability to reach the majority of their constituents with serious impairments.

Since physicians do not operate in a vacuum and are constantly engaged with attorneys, we need to make sure our legal counterparts have the same expectations of assessment, treatment and monitoring available to us.

--Stefan P. Kruszewski, MD, Harrisburg, Pa.