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patient care‖. Behavior exhibited as a pattern of being unable, or unwilling, to function well with others to such an extent that his/her behavior, by words, attitude or action, has the potential to interfere with quality healthcare. The physician’s behavior (attitudes, words or actions) intimidate and demean others potentially resulting in a negative impact on patient care. Disruptive behavior is a descriptive label, not a diagnosis. Diagnostic evaluation should be performed by professionals with expertise in the differential diagnosis of illness that can manifest as disruptive behavior, e.g., personality disorders, substance-related disorders and psychiatric clinical illnesses. Disruptive Behavior is a serious problem and a full discussion is beyond the scope of this policy. Disruptive behavior impairs the ability of the healthcare team to function effectively thereby placing patients at risk. The majority of PHPs address disruptive behavior. The committee recommends PHPs and their boards work cooperatively to devise contractual language and agreed upon strategies, ensuring that this important issue affecting patient safety is carefully addressed in each state. 3. For the purpose of this document, ―physician‖ and ―licensee‖ are sometimes used interchangeably. Federation of State Medical Boards 8 3. Process addiction – A process addiction is compulsive activity or process of psychological dependence on a behavioral activity. The process consumes the attention of the individual to the exclusion of other aspects of the individual’s life and it thereby creates problems. The following are some examples of activities--if they are compulsive and excessive activities—that fall into the category of process addictions: Compulsive gambling, compulsive spending, compulsive video gaming, and workaholism. The presence of a process addiction can be problematic or even impairing in itself, and it can contribute to relapse of a physician in recovery. As such, process addictions should be identified and treated. 4. Substance – a. mind and mood altering substances defined in law as controlled substances; b. alcohol or other legal or illegal substances that are mood altering and can potentially impact the ability to practice 5. Substance-Use Disorder (According to DSM-IV) – Substance Abuse – ―The essential feature of Substance Abuse is a maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances…‖ Substance Dependence – ―The essential feature of Substance Dependence is a cluster of cognitive behaviors and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems…‖ According to ASAM, these disorders can be referred to as ―addictive illness‖. 6. Addictive Illness – According to ASAM, an addictive illness is ―a biochemical, psychosocial, genetically influenced primary illness hallmarked by loss of control or continued use of mind and/or mood altering substances regardless of negative consequences frequently accompanied by a powerful denial of the existence and effects of the illness.‖ 7. Physician Health Program (PHP) 4 – Historically, PHPs were referred to as ―Impaired Physician Programs.‖ A PHP is a program of prevention, detection, intervention, rehabilitation and monitoring of licensees with potentially impairing illnesses, approved and/or recognized by the state medical board. PHPs are charged with oversight of licensees who are in need of evaluation and/or treatment. In addition, the PHP monitors licensees with illnesses that have the potential to interfere with the safe practice of medicine. Through a formalized contract, each state medical board should have available to it a PHP that meets the standards set by this document and the FSPHP Guidelines. 4. Physician Health Programs are often referred to as Professionals Health Programs. They often have responsibility for different types of healthcare professionals in addition to or other than physicians. 9 Policy on Physician Impairment 8. Recovering Physician – A recovering physician who has been impaired or who has been diagnosed with a potentially impairing illness, such as addictive or mental illness, is one who is receiving