Review of a tutorial approach with disruptive physicians

September 24, 2013

My friend and colleague, Mike Plaut, has another paper out (actually it’s still in press) in the Journal of Health Care Law and Policy.  Mike’s writing is great – almost conversational – so I always enjoy reading his stuff.  In this paper he describes the work he’s been doing for years at the University of Maryland’s Medical School with health care professionals who act out sexually with patients.  Similar to the work I do with disruptive professionals, Mike works individually with physicians and other providers rather than working with groups, and he tailors his interventions to the individual.  Now, in contrast to most of my work, Mike holds tighter to the role of the academic advisor than therapist or even coach, as he guides the professional through the relevant literature and has them write a paper about the reason for their referral to him.  I typically blur the boundary between coach and therapist as I believe there are more similarities between remedial coaching and psychotherapy than differences, and I have found this to be an invaluable approach to my work with physicians, psychologists, nurses, other healthcare providers and other professionals who have gotten themselves into hot water at work, usually because of interpersonal problems.

Physician Fitness for Duty Evaluations

September 19, 2013

I just found an interesting article that is still in-press about fitness for duty evaluations for physicians.  A significant part of my practice is devoted to assessing and addressing issues related to physician (and other professional) impairment and disruptive behavior.  Much of the consulting I do is with licensing boards, professional associations, hospitals and practices, so this article was of great relevance to my practice.  One of the findings that I was particularly pleased to read was that the authors noted that of the physicians they evaluated, most of the time those referred for “disruptive” behavior were assessed as being fit for duty.  This is consistent with the majority of my findings; however, this should not be misinterpreted as saying that there are not very significant potential risks and dangers of disruptive conduct within the workplace.  In fact, this is precisely what makes it so difficult to perform fitness for duty evaluations for disruptive professionals: though such healthcare providers may not be impaired personally, the effects of their behaviors may (and often do) negatively affect the safety and efficacy of their colleagues performance.  So while the disruptive physician may be assessed as being fit, her disruptive behavior may still pose significant problems to the overall functioning of the work environment including compromising patient safety.

Psychotherapy is as good as (or better than) medication

September 13, 2013

Yet another article was published recently that touted the positive effects of psychotherapy.  In this study the authors noted that psychotherapy was as effective as antidepressant medication at treating and preventing relapses of depressive episodes.  Of course the side effects from psychotherapy are much less than those from medication, which is nice.  But what made this article special was that it was published in JAMA Psychiatry.  Yup, one of the best professional publications for psychiatrists said that medications are not better that psychotherapy.  This is great for several reasons.  First and foremost, it’s a wonderful demonstration that the ever-increasingly medicalized field of psychiatry is willing to acknowledge the benefits of non-medical approaches.  Of course the content of the article is great too; there are many people who cannot tolerate psychiatric medications or simply do not want to use medicine to treat their psychological issues, and this (and many other) article(s) supports these individuals in not caving in to popping a pill to rid themselves of psychological pain.  Now, please don’t get me wrong… in no way am I opposed to appropriate use of psychiatric medication.  However, I am very frequently disappointed by medical professionals who prescribe antidepressants, sleep aids and antianxiety medications without considering empirically validated better options first or at least in conjunction with the medications.

Individual Therapy & Counseling

Through individual psychotherapy, I can help you improve your relationships with others in your life, stabilize your moods and cope with anxieties and worries.

Couples & Marital Therapy

If you and your partner are struggling to communicate with each other, having problems with romance and intimacy or even dealing with an affair, by engaging in couples therapy I can help the two of you refocus yourselves back onto improving your relationship.

Why Dr. Heitt?

I bring decades of experience working in a variety of settings and with a variety of people to my clinical practice. In addition to doing therapy with couples and individuals, I specialize in helping people like you deal with work-related problems.