The very fact that this problem exists means your colleague has not been able to get control of it. Nor are you, no matter how well-meaning and concerned, able to offer all the assistance needed. Sometimes, a friend's well-intended attempts to help may actually have the effect of enabling the colleague to persist with the very behaviors that are causing the problem. Fortunately, impairment can be helped if approached properly. Whether the problem stems from substance abuse or from emotional or physical factors, there has been a great deal of experience in working with impaired physicians, and experts are readily available to help.
Early intervention is critical.
Severely impaired physicians may be endangering the safety of patients and colleagues, as well as themselves, on a daily basis. On the other hand, the earlier an impaired individual gets help, the greater the likelihood that help can be obtained confidentially, voluntarily and without jeopardy to the physician's family, career or permanent health. In fact, like other impaired persons, they usually deny that there is a problem. Because denial is so common in situations of impairment, it is even more critical that you, the concerned colleague, take some action to see that help is made available to the physician who may need it. Remember that a failure to act on your part may have the effect of enabling the problem to continue.