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Recognizing Impairment

Home > Foundation > Physicians Health Program > Recognizing Impairment

Because physicians usually do not diagnose their own impairment, colleagues, staff, and family members should heighten their awareness of potential warning signs and be willing to assist that physician with getting help.

Early detection, treatment, and rehabilitation are essential to getting a physician on the road to recovery and to reducing the risk to patients.

It is important to look for trends in attitude, actions, and appearance. Signs of impairment typically emerge in six areas of a physician's life: physical appearance, family and home, community, office, hospital, and employment history.

The appearance of one of these signs does not necessarily indicate impairment, but a combination of signs may signify a problem:

​ ​Signs of Impairment

​Physical Appearance:

  • Wearing long sleeves in warm weather
  • Deterioration of hygience or appearance
  • Frequent or unusual accidents

​ ​Offie/Hospital:

  • Frequent or unexplained absenses
  • Excessive working
  • Inaccessible ("locked door syndrome")
  • Desire to work alone or refusing work relief
  • Frequent trips to the rest room
  • Excessive ordering of drugs, excessive drug use, multiple prescriptions
  • Complaints by patients or staff
  • Lack of or inappropriate responses to pages or calls
  • Decreasing quality of performance or patient care

​Family or Home:

  • Marital or sexual problems
  • Personality or behavior changes
  • Medicinal use of alcohol or drugs
  • Unexplained absences from home
  • Withdrawal from family activities
  • Financial problems


  • Unreliability or neglecting commitments
  • Isolation or withdrawal
  • Unpredictable behavior
  • Embarrassing behavior at social functions
  • Arrest for DUI or other legal problems

​Employment History:

  • Frequent job changes or relocations
  • Reluctance to undergo physicial exams or lab tests
  • Complicated or unusual medical history
  • Limitations (current or previous) on licensure
  • Unexplained intervals between jobs on curriculum vitae