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Case Conference: Alcohol Use Disorder in One of Our Own- Challenges of Treatment Engagement in a Resident Physician

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.

Learning Objectives
  • 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?
Keywords / Topics
  • Impaired Physician
  • Residents and Medical Students
  • Training
Arun Prasad, MD


Dr. Prasad is a current PGY-5 Addiction Psychiatry Fellow, at Mount Sinai West/Morningside, New York. He completed his general psychiatry training at Bronxcare health systems, New York. He is an awardee of the AAAP John Renner Travel Award for 2023 and looks forward to continuing to be an active member of the AAAP. 

Marc Galanter, MD, Discussant

Marc GALANTER | Professor (Full) | Professor | New York University, NY ... 

Marc Galanter, M.D. is a Professor of Psychiatry at NYU. He founded the Division of Alcoholism and Drug Abuse at NYU, and the journal “Substance Abuse.” He is co-editor of the APA’s “Textbook of Substance Abuse Treatment,” and has written four books, “Cults: Faith, Healing, and Coercion,” “Network Therapy for Alcohol and Drug Abuse,” “Spirituality and the Healthy Mind,” and “What is Alcoholics Anonymous? A Path from Addiction to Recovery,” and published over 200 peer-reviewed articles. His NIH and foundation-funded studies have addressed Network Therapy for substance abuse, pharmacologic treatment for addiction, the psychology of Twelve-Step recovery, and spirituality in healthcare. Dr. Galanter attended Albert Einstein College of Medicine where he did his residency in psychiatry. After that he was a Clinical Associate at the National Institute of Mental Health, then an NIH Career Teacher. He later served as President of the Association for Medical Education and Research in Substance Abuse (AMERSA), the American Academy of Addiction Psychiatry (AAAP), and the American Society of Addiction Medicine (ASAM). Among his awards are the Gold Achievement Award for innovation in clinical care, and the Seymour Vestermark Award for Psychiatric Education, both from the American Psychiatric Association; the McGovern Award for Medical Teaching from AMERSA; the Founder’s Award from AAAP; New York State’s Award for Psychiatric Research; and the Smithers Distinguished Scientist Award from ASAM. 

Karen Miotto, MD, Discussant

Karen A. Miotto, MD 

Dr. Karen Miotto is a Professor of Clinical Psychiatry in the Department of Psychiatry and Behavioral Sciences at UCLA and the immediate past president of the California Society of Addiction Medicine (CSAM). She is the chair of the UCLA Physician Health Committee and the Director of Physician and Faculty Wellness at UCLA. 
Availability: On-Demand
Cost: FREE
Credit Offered:
1.25 CME Credits
1.25 Other Professionals Credits
American Academy of Addiction Psychiatry
The content on this site is intended solely to inform and educate medical professionals. This site shall not be used for medical advice and is not a substitute for the advice or treatment of a qualified medical professional.

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