OBJECTIVE: The purposes of this article are 1) to review federal and
state laws relevant to confidentiality in group therapy with impaired
physicians and 2) to provide empirical data concerning the actual
confidentiality practices and experiences of group therapists treating
chemically impaired physicians. METHOD: In the clinical research phase, 25
state medical societies identified 45 rehabilitation centers as those to
which the societies preferentially referred chemically impaired physicians.
Fifty-one group leaders from 33 of these rehabilitation centers completed
the survey questionnaire employed in this project. RESULTS: Because of the
risk of potentially irreversible social and professional injury, physician
patients were exceedingly concerned about breaches of confidentiality.
Co-members' infractions most often involved the violator sharing with close
friends and family members the name and abuse history of a fellow
physician. In contrast, transgressors rarely leaked information about a
co-member's drug- related illegal behaviour. CONCLUSIONS: Chemically
impaired physicians would feel safer in sharing secrets in group therapy if
more jurisdictions adopted legislation making co-members liable for
violating confidentiality. Currently the pertinent body of law is confusing
and inconsistent and provides little protection to impaired physicians who
enter group therapy. The authors propose ideas for model legislation.