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.