Narcissism Affects Many Impaired Physicians

Article excerpt

MENDOZA, ARGENTINA -- Physicians with addictions to alcohol, drugs, or gambling--or those charged with sexual misconduct--generally do well in overcoming their problems with good treatment, Dr. Gregory Collins reported at the Sixth World Congress on Depressive Disorders.

But treating colleagues is particularly challenging, partly because often they are initially defensive and hostile.

"The doctor typically blames someone else," said Dr. Collins, who is head of the Alcohol and Drug Recovery Center at The Cleveland Clinic Foundation.

"A big problem is the sense of entitlement or narcissism."

The success of treatment hinges on the impaired physician's serious self-examination and recognition of mistakes. It is imperative that the physician agree to accept help and comply with monitoring, Dr. Collins said.

"Eventually, when they figure out that they really are in trouble, they have a sense of overwhelming guilt and shame," Dr. Collins said.

Suicide can be a major risk under those circumstances.

Of course, an arrest or even an accusation of impairment can be as damaging to the doctor's career as a conviction, Dr. Collins said. In these cases, a report is filed with licensing boards, and the incident becomes part of the public record.

An arrest might be given prominent coverage, but exoneration might not be considered as newsworthy. The negative publicity alone in such cases can cause permanent damage to the doctor's career, even if the physician is later found innocent.

Impaired physicians often are extremely talented, creative, and intelligent individuals who are successful in their careers.

Narcissism can be a major factor underlying disruptive behavior, in which the doctor disregards all hospital rules.

"He is abusive, criticizes fellow employees, throws things in the operating room, curses people out, uses a lot of profanity, tells dirty jokes, makes racist remarks, parks in the handicapped space right next to the hospital, takes the president's parking space," Dr. …