"I suspect my colleague has a substance abuse problem..."
Dear Expert:
I suspect one of my colleagues has a substance abuse problem, but don’t have concrete evidence. He’s been coming in to work late pretty often and looks a wreck. That might not have made me suspicious, but recently I’ve had to point out what could have been major errors in dispensing medications (wrong medication, wrong size) and he seems to lose his train of thought when he’s talking to clients. For the record, he has made several mistakes that I have had to fix.
Should I confront him directly or tell the practice owner about my suspicions? Or should I mind my own business (like I said—no concrete evidence). It’s shaky ground as I don’t want to cause him irreparable career damage by falsely accusing him, nor do I want to see a patient accidentally injured by someone who is compromised.
-Concerned Colleague
Dear Colleague,
One of best clarification exercises to help you decide if you should "myob" or take steps to investigate further is to ask yourself; "Would I feel comfortable having this colleague care for my pet, given the behaviors that I've observed?" If the answer is "no", then you've got your answer.
Substance abuse and addiction problems are serious risks to both the person with the problem and the people and animals under his or her care. Veterinary medicine is a profession based on trust and clients assume that we "self police" ourselves and one another when it comes to professional impairment. Although it is a difficult call to make and a tough step to take, it is imperative that we put our patients’ safety first. In addition, the health of an impaired colleague almost never improves on its own, so ignoring the issue, or covering up the resulting signs and symptoms, is almost never helpful.
Unfortunately, veterinarians are human and human beings struggle with any number of maladies that can interfere with providing best care. Of course you don't want to falsely accuse a colleague, or do harm to the career of an innocent professional, but it sounds as though you already have seen ample evidence of impairment to make you concerned. It is imperative that you begin to document, objectively, what you are seeing in your colleague’s behavior that is making you suspicious. In addition to the symptoms and behaviors, document the date, time and situation in which you observed these aberrant actions or conduct.
Some of the most common symptoms you may see in job performance are increasing absenteeism, lessened performance, careless charting and excessive errors in judgment and patient care. Personal changes may include personality changes, excessive moodiness, increased isolation, unkempt appearance, and mental lapses.
Take this information and contact your state Physician Health Program (PHP), which currently exists in all 50 states. These programs are designed specifically for medical professionals with substance abuse problems and they are able to provide excellent resources and support to both impaired professionals and concerned colleagues. Your state licensing board can help you obtain the contact information if you have difficulty finding it.
Discuss your findings and concerns with your PHP representative. These types of consultations are confidential and will help you learn both more about the situation you are dealing with and available resources. The PHP will be able to tell you what intervention and treatment options exist in your area, and help guide you through getting your colleague the help needed. These services have been designed specifically to help physicians, nurses, veterinarians, dentists and other medical professionals who have access to protected substances, and they have a high success rate in helping the impaired recover and regain their ability to practice.
I urge you to follow through with these steps as quickly as possible. There is a great deal at stake and quick action is needed to ensure your colleague’s personal and professional safety, the safety of your clients and the professional reputation of your practice.
I wish you courage and strength as you take on this challenge.
Sincerely,
Dr. Ruby
Got a question or clinic conundrum for Dr. Ruby? Email her at editor@myevt.com
