Case and Commentary
Sep 1999

If a Colleague is Impaired

Audiey Kao, MD, PhD
Virtual Mentor. 1999;1(1):2. doi: 10.1001/virtualmentor.1999.1.1.hlaw1-9909.


Tom and Jack have been friends since the start of medical school, and are about to start their third-year rotations. Tom considers himself a social drinker, but he noticed that Jack has been drinking more and more over the last year. Tom was not concerned about this during the 2 years of basic science training, but now that Jack will start seeing patients on a more regular basis, he has become worried. He wants to get some help, but does not want to strain his friendship.

Question for Discussion

What should Tom do?

AMA Code of Medical Ethics Opinion E-8.15 on substance abuse, E-9.031 on reporting impaired, incompetent or unethical colleagues, and E-9.04 on discipline and medicine, as well as AMSA principles regarding physician impairment and substance use, all speak to the issues facing Tom. Are these opinions and principles helpful in your decision-making regarding this case? Why or why not?


Virtual Mentor. 1999;1(1):2.



The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.