Doctors are ethically responsible for ensuring that their own health problems
do not interfere with the welfare of their patients. Although doctors generally
enjoy good physical health as measured by standardised mortality rates, studies
concerning the 'impaired practitioner' indicate that up to 10 per cent may
become impaired during their professional lives.¹,²,³ This impairment may
lead to harm to patients. While doctors may appear well placed to attend to
their own health, in practice the reverse often applies. This chapter explores
some reasons for this, describes the most frequently recognised health problems
and outlines ways of identifying and assisting colleagues with them. Advice
is also provided which may help prevent such personal health problems
occurring.

The ethical principle of 'non-maleficence' underpins the professional codes
which state that doctors must not permit their own ill-health to put their
patients at risk. In this regard the Australian Medical Association Code of
Ethics states: 'Accept responsibility for your personal health, both mental and
physical, because it affects your professional conduct and patient care.' This
ethical duty extends also to medical colleagues and treating doctors who have
a responsibility to ensure that an impaired colleague or doctor-patient, who
may be putting patients at risk by continuing to practise, is guided towards
treatment and, if necessary, notified to the medical board. In Victoria, this is
a statutory responsibility under the Medical Practice Act 1994. These respon-
sibilities and the manner in which medical boards handle these matters are
described in Chapter 7.

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