Northwest Center for Physician Well-Being.

Abstract

In October 1997, The Foundation for Medical Excellence, a medical education foundation based in Lake Oswego, Oregon, announced the creation of the Northwest Center for Physician Well-Being. This was the culmination of almost 50 years of work by many organizations and individuals throughout the Pacific Northwest, and particularly in Oregon, to help physicians. Physicians have been helping physicians most likely since the time of Hippocrates. Most of their efforts were probably personal and were not reported to those who carry the mantle of helping physicians in their professional and personal lives. The late 19th century writings of William Osler are replete with concern about his own burnout and that of his colleagues. In a talk to medical students in 1899, he said, Engrossed late and soon in professional cares—you may so lay waste that you may find, too late, with hearts given way, that there is no place in your habit-stricken souls for those gentler influences which make life worth living.1 At that time in the United States, there was no organized response by the medical community to this potential burnout. That came later in Osler's time (late 19th and early 20th centuries) with the creation of medical boards, which are among this country's oldest state agencies. Many of them have existed for more than 100 years. Much of their early focus was on issues surrounding licensure, with particular emphasis on licensing physicans from accredited medical schools. Since World War II, the Oregon Board of Medical Examiners has been involved in protecting the public and enhancing the profession of medicine through the licensing, monitoring, and disciplining of physicians. Major efforts toward the rehabilitation of physicians impaired by mental illness and substance abuse date to the early 1970s and include those of the American Medical Association (AMA), which focused the attention of the medical community on the problems of impaired physicians.2 Oregon has a noteworthy tradition of active involvement in issues concerning impaired physicians. In 1968, Blachly and associates called attention to the pattern of suicide among physicians.3 In 1980, Crawshaw and associates reported an epidemic of suicide among Oregon physicians on probation.4 Smith and Steindler participated in the pioneering effort of the AMA to develop the National Impaired Physician program and emphasized the importance of a comprehensive approach to assessing and treating impaired and addicted physicians.5 In 1982 and again in 1986, Shore reported on the Oregon experience with impaired physicians on probation.6,7 The Oregon Board of Medical Examiners and the Oregon Medical Association collaborated to develop a monitored treatment program for addicted physicians. This program existed from 1984 to 1987 and was funded primarily by the Oregon Medical Association.