Doctors' health and fitness to practise: the need for a bespoke model of assessment

Doctors' performance and fitness to practise are attracting increased attention. High profile cases have brought into question the assessment of fitness to practise and the monitoring of professional performance. In the UK, the chief medical adviser for England has proposed strengthening systems to improve the performance of doctors which include addressing problems of ill-health. The behaviour of the impaired physician, or the doctor-patient, presents unique challenges and a review of the various issues highlights the need to address how the medical profession and society deal with the occurrence of illness in doctors. Conditions such as mental ill-health and substance abuse may affect doctors' fitness to practise, but other conditions may also be relevant. This paper will discuss the occurrence of ill-health and the need for a bespoke model of assessment.