Guidelines to help evaluate anesthesiologists who desire to continue their careers in anesthesia

I. Return after appropriate treatment (for health care professionals)

  1. Accepts and understands disease of addiction
  2. Bonding with Alcoholics Anonymous/Narcotics Anonymous (AA/NA) with active sponsorship
  3. Good relapse prevention skills
  4. Other psychiatric disorders in remission
  5. Healthy family relationships
  6. Balanced lifestyle
  7. Anesthesia department supportive
  8. Committed to five-year monitoring program
  9. Confident to be in operating room, administer anesthetic drugs and not relapse
  10. All of the above required for immediate return to anesthesia

II. Possible return, with reassessment after one or two years

  1. Incomplete bonding to AA/NA but improving
  2. Some denial / minimizing
  3. Lacks complete confidence to be in operating room and not relapse to chemical use
  4. Recovery skills improving
  5. Brief relapse may have occurred
  6. Other psychiatric disorders improving
  7. Dysfunctional family members improving (may require therapy)
  8. Healthy attraction to anesthesia

III. Never return to clinical anesthesiology (any of these conditions)

  1. Prolonged addiction history
  2. Significant relapse despite adequate treatment
  3. Lacks confidence to return to operating room and not self-administer anesthetic drugs
  4. Significant Axis I or II psychopathology
  5. Inability to follow treatment and monitoring contract
  6. Poor bonding to AA/NA and recovery skills
  7. Significant family pathology

Source: Excerpted from article by Eric B. Hedberg, MD, Associate Medical Director, Talbott Recovery Campus, Atlanta, in American Society of Anesthesiologists Newsletter/ copyright 2001 of the American Society of Anesthesiologists. A copy of the full text can be obtained from ASA, 520 N. Northwest Highway, Park Ridge, IL 60068-2573. Based on guidelines in Angres DH, Talbott GD, Bettinardi-Angres K. Healing the Healer: The Addicted Physician. Madison, CT: Psychosocial Press; 1998.