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Physician return-to-work policies

Deepak Gupta, MD
Physician
October 2, 2023
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Police officers are required to undergo second-victim counseling before returning to duty. Should physicians also undergo such counseling before resuming their work? This question arises, especially in light of the ongoing shortage of health care professionals. It prompts us to consider whether the prerequisites for returning to work are deemed more critical for police officers than for doctors. Perhaps physicians should establish specific scenarios where taking time off before returning to work becomes mandatory.

The most recent model policy established for law enforcement can serve as a model for national and international medical associations. They could create their own tailored policies, taking into account that guidelines for police officers have been in place since the 1980s and 1990s. In the face of critical incidents, we should ask: Should doctors also have well-defined policies and procedures in place? Should health care institutions involve qualified mental health professionals and peer support personnel for physicians immediately and mandatorily? Should institutions promptly initiate investigations following internal administrative protocols? Should doctors engage their personal attorneys if litigious investigations are a possibility? Should second-victim counseling extend to other health care staff who may not be directly involved but are part of the proceedings and their aftermath? Should doctors be placed on mandated administrative leave for defined periods before returning to work? Should some undergo psychological fitness-for-duty evaluations prior to returning? Will doctors recognize the varying boundaries of privacy, confidentiality, and privilege during post-event communications? Will they agree to psychological services, even if they believe they understand the pathophysiology involved? Will doctors consent to regular training on updated policies and procedures to prepare for such situations and their consequences? Should their families be involved in these procedures, recognizing potential early signs and managing accordingly? Should doctors consent to audio-video recordings of their formal statements? Instead of personal social media campaigns, should doctors support public awareness through mainstream media about transparent policies and procedures? Will the general public understand that non-judgmental policies and procedures are not necessarily disciplinary but rather address human performance factors that are often, if not always, at play? How can doctors prepare to handle any disciplinary actions or litigious investigations? How can they cope with resulting sleep problems, stress reactions, memory issues, and post-traumatic stress disorders?

In essence, while the Lethal Weapon movie franchise from the 1980s and 1990s may have raised awareness about the need for post-incident psychological services for police officers, physicians should not wait for Hollywood to romanticize or sensationalize professional issues in medicine. Instead, they should proactively develop customized model policies for their return to work after critical incidents.

Deepak Gupta is an anesthesiologist.

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