My brother's keeper: assisting the impaired PA.

Impairment is defined as the inability to practice medicine with reasonable skill and safety to patients because of physical or mental illness, including deterioration through the aging process, loss of motor skills, or excessive use or abuse of drugs, including alcohol. A practitioner is also impaired when personal problems interfere with the administration of medical care. Acknowledging the issue of impairment can be unpleasant. By doing so, practitioners often realize that their perceptions of themselves and their colleagues as invulnerable guardians of public health and healers of disease, are delusions. This growing problem reflects not only on the individual practitioner suffering from impairment, but on the profession as a whole. Thus, the problems of the impaired PA must be addressed in a reasonable and compassionate manner. The authors discuss how to deal with affected colleagues, and outline an alternative, nonpunitive, and humanitarian model for assisting impaired PAs, established by the Michigan Academy of Physician Assistants.