We present to you the challenges of treating a fellow physician in dire straits. A resident who is mid- way through residency training is referred to us by the Committee of physician health for Addiction treatment , which the patient must complete to stay enrolled in the program. How do we deal with this situation when the physician minimizes symptoms, the circumstances of referral, the need for treatment despite having lost multiple support in life and is now about to lose a residency position, possibly the only remaining protective aspect of the patients life.

• How do we, as physicians, manage to eliminate our biases, engage the patient in treatment, set limits and boundaries while also establishing a therapeutic relationship?
• How do we maintain patient engagement when they feel coerced to attend treatment, they feel they don’t need/want treatment due to poor insight, stigma or both?
• What are the criteria for such a patient to be given “cleared to return to work” status?
• How do we support our fellow health care providers in their recovery journey while protecting the public interest and prevent harm to other patients under their care?
• Patient signed release to share PHI with employer which is consistent with CFR 42 part 2, does she really have a choice?

• Impaired Physician
• Residents and Medical Students
• Training