RESUMO
Physician impairment due to substance abuse or dependence is at least as prevalent as amongst non-physicians and is a real challenge. Not only for the impaired physicians themselves, but also for their colleagues, family members and patients. A 68-year-old physician describes her experiences of being an alcoholic as well as a patient with concomitant psychiatric disorders, including the hurdles she had to get over to deal with her disease and remain abstinent. Although colleagues knew what was going on, some of them took no action. The initial treatment by her general practitioner proved compromised. Addressing addiction amongst fellow physicians can be challenging and for this reason the Royal Dutch Medical Association (KNMG) has started the ABS Programme. On prompt and adequate intervention, treatment in specialised facilities has proved to be highly and durably effective. Addicted physicians who have been successfully treated should be monitored and supported, thus enabling their safe return to practice.
Assuntos
Relações Interprofissionais , Transtornos Mentais/diagnóstico , Inabilitação do Médico/estatística & dados numéricos , Médicos/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Idoso , Comportamento Aditivo , Feminino , Humanos , Transtornos Mentais/terapia , Países Baixos , Inabilitação do Médico/psicologia , Prevalência , Transtornos Relacionados ao Uso de Substâncias/terapiaRESUMO
The recent technical development of multidetector CT (MDCT) has contributed to a substantial increase in its diagnostic applications and accuracy in children. A major drawback of MDCT is the use of ionising radiation with the risk of inducing secondary cancer. Therefore, justification and optimisation of paediatric MDCT is of great importance in order to minimise these risks ("as low as reasonably achievable" principle). This review will focus on all technical and non-technical aspects relevant for paediatric MDCT optimisation and includes guidelines for radiation dose level-based CT protocols.