What is Impairment?
Impairment is defined as the condition of being unable to perform one’s professional duties and responsibilities in a reasonable manner and consistent with professional standards. Cognitive function, judgment, reaction time, and ability to handle stress, may be affected, with the likelihood of such increasing over time. As impairment progresses the potential for compromised patient care increases.
Impairment may result from the use of mind or mood altering substances; distorted thought processes resulting from mental illness or physical condition; or the more extreme mood and anxiety states.
Coworkers and staff of impaired professionals often feel frustrated and helpless. Staff morale and performance tend to deteriorate while the impaired professional becomes more disabled. Associated problems usually stay unresolved without effective intervention and treatment of the impairing or potentially impairing condition. Reaching the individual prior to overt impairment at work is important.
What signs may indicate impairment?
Because professionals are human, compiling a complete and definitive list is impossible. Co-workers, friends, and family members generally notice when “something is up”. Warning signs may include:
Increased absenteeism which may be more pronounced following weekends, holidays, or scheduled days off.
Subtle changes in behavior or appearance that may increase in severity over time. Job performance and progress notes deteriorate.
Mood swings or personality changes. The socially outgoing individual may become withdrawn; a usually quiet individual may become talkative and gregarious; a calm and agreeable person may become argumentative and agitated.
The person may disproportionately overreact in response to situations that were handled appropriately in the past.
What should I do if I suspect a professional is impaired?
Any person suspecting impairment of a professional's ability to provide safe care may make a report to PRN and/or the DOH.
Referrals of individuals occur through various avenues, including: self, hospitals, group practices, individual partners and/or staff, patients, treatment providers, family, friends, pharmacies, other work settings, attorney, law enforcement, DEA, DBPR, DOH (Including those licensure applicants referred for evaluation due to history of illness that may affect the ability to practice) and the respective Boards.
How does the evaluation process work?
Upon referral of an individual with a suspected illness, and given sufficient evidence, the individual is required to undergo an independent evaluation with a PRN approved provider. Such providers have been approved, due to their credentials, expertise in treating healthcare practitioners, and the diverse services they offer. PRN will typically offer the referred individual three (3) options for evaluators based upon the suspected impairment, the intensity/severity of the situation and the geographical location when possible. Evaluations will vary from one hour in-office assessments to 3-5 day multidisciplinary evaluations. A second opinion evaluation by a PRN approved evaluator, is allowed if the practitioner disagrees with the original recommendations.
How is treatment provided?
In those cases where there is a recommendation for treatment following evaluation, PRN will again typically offer three options for an approved provider. This selection will be based on the illness identified, the type of treatment needed, the intensity of treatment required and the geographic location when possible. Treatment modalities will vary from office follow-up for medication management and/or therapy to extended residential treatment for several months.
What are the costs for PRN services?
PRN is a non-profit organization funded through a contract with DOH to implement the statutorily mandated Impaired Practitioners Program and through charitable contributions. Participants are not charged for PRN services. The Program has no financial relationship with any evaluator, treatment provider or facilitator. PRN does not provide medical services; therefore, participants pay directly to the providers.
Likewise, in the monitoring phase, the participant pays directly to the third party testing administrator for urine toxicology testing, psychotherapy, and the weekly group sessions.
Can a participant still practice?
Initially, the participant may be required to refrain from practice during evaluation and any resulting treatment. The approval for a return to practice is based upon recommendations from approved treatment providers in consultation with PRN. Practice limitations may be required during the early phase of return to practice.
Does PRN protect practitioner’s license?
The Professionals Resource Network routinely supports participants who are in compliance with the recommendations of the Program given in the evaluation, treatment and/ or monitoring phase. PRN will work with hospitals, practice partners, insurance carriers, HMO's, disability carriers, DEA, criminal courts, other state impairment programs and other state licensing agencies; and offer support for participants if they are deemed impaired.
As Consultant to the Department of Health, Department of Business and Professional Regulation and the Licensing Boards, PRN supports compliant participants who have disciplinary investigations, complaints, or action taken against their license. Participation in PRN is often used as mitigation in disciplinary cases charging impairment, and PRN will speak in support of those in compliance.