The Physician as Patient

A Clinical Handbook for Mental Health Professionals

Michael F. Myers, M.D., and Glen O. Gabbard, M.D.

2008
252 Pages
Editorial Reviews

ISBN 978-1-58562-878-0
Item #62878

List Price: $54.00
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Description
Contents
Editorial Reviews
About the Authors

Because physicians are shaped by the expectations and responsibilities of their profession and are especially susceptible to stress and illness, professionals treating them need to be attuned to a host of demands and considerations not applicable to other patients. The Physician as Patient meets that need by combining the perspectives of two seasoned psychiatrists who have been assessing and treating physicians for more than 30 years. Drs. Myers and Gabbard pool their career-long dedication to physician health, counseling, and risk management to demonstrate that, through accurate diagnosis and state-of-the-art treatment, most impaired physicians can recover and return to practice.

As the most current sourcebook available on this subject, The Physician as Patient not only discusses common illnesses and problems seen in doctors but also outlines the many biopsychosocial treatments that are indicated—always with an emphasis on integrated care. It considers such issues as the reluctance of physicians to assume the role of patient and the uniqueness of the physician's psychological makeup that facilitates or impedes diagnosis and treatment. It describes the most common medical and psychiatric illnesses in physicians—including addictions—and addresses personality disorders and the increasingly important subject of boundary violations. And it helps readers determine what can be done about doctors behaving badly or out-of-character, or what strategies are useful in treating physicians to assure accuracy while also diminishing morbidity and relieving suffering. Among other key issues raised are:

The importance of considering sociocultural customs and values when treating the increasing number of minority and International Medical Graduate physicians
Addressing the many clinical, humanistic, ethical, and legal dimensions of the psychiatric evaluation of physicians
Distinguishing between long-standing patterns of personality disorders that manifest as disruptive behaviors and those patterns that lead to burnout and depression
Assessing amenability to rehabilitation in cases of sexual boundary violation, including an awareness of alcohol or drug abuse as contributing factors
Utilizing a physician's predisposition as a learner and pragmatist to enter into cognitive behavior therapy
The success of early diagnosis and treatment in lowering the occurrence of suicide, for which physicians are notoriously at risk

Brimming with case examples, The Physician as Patient adopts a reader-friendly style that facilitates quick grasp of concepts, while an extensive list of references and websites provides an entree for additional support. This book is an indispensable resource for all mental health professionals who take caregivers into their care.

Introduction
Part I: Physician Characteristics and Vulnerabilities
Chapter 1. The Psychology of Physicians and the Culture of Medicine
Chapter 2. Minority Physicians (Racial, Ethnic, Sexual Orientation) and International Medical Graduates
Chapter 3. Psychiatric Evaluation of Physicians
Part II: Diagnostic and Treatment Issues in the Distressed and Distressing Physician
Chapter 4. Psychiatric and Medical Illness in Physicians
Chapter 5. Addictions: Chemical and Nonchemical
Chapter 6. Personality Disorders, Personality Traits, and Disruptive Physicians
Chapter 7. Professional Boundary Violations
Part III: Prevention, General Treatment Principles, and Rehabilitation
Chapter 8. Psychodynamic Psychotherapy
Chapter 9. Individual Cognitive Therapy and Relapse Prevention Treatment
Chapter 10. Couples in Conflict and Their Treatment
Chapter 11. The Suicidal Physician and the Aftermath of Physician Suicide
Chapter 12. Prevention
Appendix: Resources and Web Sites
References
Index

Michael F. Myers, M.D., is Director of the Marital Therapy Clinic at St. Paul's Hospital and Clinical Professor in the Department of Psychiatry at the University of British Columbia in Vancouver, Canada.

Glen O. Gabbard, M.D., is Brown Foundation Chair of Psychoanalysis and Professor in the Department of Psychiatry and Behavioral Sciences and Director of the Baylor Psychiatry Clinic at Baylor College of Medicine in Houston, Texas. He is also Training and Supervising Analyst at the Houston–Galveston Psychoanalytic Institute in Houston, Texas.

This book by Michael Myers and Glen Gabbard is the most comprehensive well written summary that is available on the diagnosis and treatment of physicians with mental and behavioral disorders. Every medical school dean, resident program director, risk management coordinator, medical staff director and family of the physician should read this book. The book outlines in exquisite detail the various approaches psychiatrists, counselors and even family members can take in understanding and caring for the physician with these mental health disorders.—Anderson Spickard, Jr., M.D., Professor of Medicine, Chair, Faculty & Physician Wellness Committee, Medical Director, The Center for Professional Health, Vanderbuilt University Medical Center

Physicians are not immune from physical and mental illness, often resist getting help for their problems, and die by suicide more frequently than others. In this much-needed and readable book, Drs. Myers and Gabbard use poignant case examples to highlight practical and successful prevention, diagnostic, and treatment strategies for this special population that every mental health professional can use.—John A. Fromson, M.D., Harvard Medical School

How are physician-patients like other patients. . . and how are they different? In a comprehensive manner, well referenced and using plenty of case examples, Drs. Gabbard and Myers tackle this question head on. This text will become a valuable, if not essential, resource to every clinician who wishes to understand the needs of their physician-patient and the cultural context in which their problems arise.—Michael Kaufmann, M.D., Director, Physician Health Program, Ontario Medical Association

As a psychiatrist and physician who has been involved in physician licensure and discipline for most of my professional career, I would recommend this book to all state licensing board members and their staff. It should also be a resource for those involved in the education of medical students and residents and is particularly pertinent for any health professional who treats physicians and their families. Extremely comprehensive and well written.—Barbara S. Schneidman, M.D., M.P.H., Clinical Associate Professor, Northwestern University Medical School, Department of Psychiatry and Behavioral Sciences

The Physician as Patient in 12 chapters is superb, complete, concise, and easy to read and to apply. All health professionals should keep it handy for ongoing self and other referral, and insights into psychiatrically ill physicians. Detailed diverse patient examples include recognition of sex, gender, age, cultural, racial, ethnic, spiritual and relational factors important for accurate diagnosis and effective treatment.—Leah J. Dickstein, M.D.M.S., Professor Emerita, University of Louisville, Department of Psychiatry

This excellent and well written book tackles a very difficult subject with care and concern, but manages to remain pragmatic and objective. The sections on suicidality, the culture of medicine, and professional boundary violations are particularly good. The case examples are relevant and appropriate and the writing is clear and unambiguous. I would highly recommend this book to anyone — licensing board members, deans, clinicians — who is involved with treating ill physicians.—Doody Enterprises, 8/1/2008

Myers and Gabbard have made a significant contribution to physician mental health. While reading this book, I repeatedly muttered to myself, they really get it. On page after page, I consistently admired the authors' ability to reflect upon their experience with their corresponding impact on mental health. Their ability to integrate clinical assessment, diagnosis, and psychotherapy with medical culture and physician characteristic makes this book very useful to a wide audience.—PsycCRITIQUES, 8/1/2008

This is a valuable, and much needed, resource for any mental health professional who treats physicians and their families. It should also be read by administrators concerned with the future of impaired physicians.—The Journal of Nervous and Mental Disease, 8/1/2008

This book a gift of wisdom and generosity from authors who have been in the trenches for decades caring for physicians-and the medical profession as a whole. Their experiences are exposed thought case vignettes, and their breath and depth of knowledge are succinctly revealed. Dr. Michael F. Myers and Dr. Glen O. Gabbard ably entreat a paradigm shift in the culture of medicine and the care of physicians. This is a must-read text.—Journal of Clinical Psychiatry, 8/1/2008

This handbook, co-authored by two of the leading psychoanalytic educators in Northern America, covers an important topic rarely addressed in the training of mental health care providers: providing treatment to the physician-patient. The entire book is an easy read and very well written.—David Baron, M.S.,Ed., D.O., Psychiatric Services, 8/1/2008