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Table 1 Wording used to survey respondents for endorsement of 25 state physician health program descriptions of impairment

From: How broad are state physician health program descriptions of physician impairment?

   Specifies if  
Description Currently? At work? Narrow Broad
1 Intimidation No Yes Have you intimidated someone at work? Have you ever intimidated someone at work?
2 A deterioration in personal hygiene No No Has there been deterioration in your personal hygiene? Has there ever been deterioration in your personal hygiene?
3 Constant sadness or tearfulness No No Have you been constantly sad or tearful? • Have you ever been constantly sad?
• Have you ever been constantly tearful?
4 Occurrence of spouse, child abuse No No Has your spouse or have your children been abused? • Has your spouse or ex-spouse ever been abused?
• Has your child or have your children ever been abused?
5 Easily agitated, irritable No No Have you been easily agitated or irritable? • Have you ever been easily agitated?
• Have you ever been irritable?
6 Increased patient complaints No Yes Have there been increased complaints about your work from clients, customers, or other consumers? Have there ever been increased complaints from client, customer, or other consumer complaints about your work?
7 Personality and behavioral changes No No Have you had personality and behavioral changes? Have you ever had personality and behavioral changes?
8 Neglected social commitments No No Have you neglected social commitments? Have you ever neglected social commitments?
9 DWI arrest or DUI violations No No Have you had a DWI arrest or DUI violation? • Have you ever been arrested for DWI?
• Have you ever had a DUI violation?
10 Other mental health concerns that directly impact work performance No Yes Have you had mental health concerns that directly impact work performance? Have you ever had mental health concerns that directly impacted your performance at work?
11 Direct statements indicating distress No No Have you made direct statements indicating distress? Have you ever made direct statements indicating distress?
12 If the resident is experiencing problems coping with patients or with the typical stress of a busy residency Yes No Are you experiencing problems coping with clients, customers, or other consumers at work, or with the typical stress of a busy job? • Have you ever had problems coping with clients, customers, or other consumers?
• Have you ever had problems coping with the typical stress of a busy job?
13 Sweating when otherwise comfortable No No Have you been sweating when otherwise comfortable? Have you ever been sweating while otherwise comfortable?
14 Tremors, hands shake No No Have you had tremors or hands shake? Have you ever had tremors or hands shake?
15 Rapid or pressured speech No No Have you had rapid speech? Has your speech ever been rapid?
16 Hospital personnel question competence and/or behavior Yes Yes Do personnel at work question your competence and/or behavior? • Have work personnel ever questioned your competence?
• Have work personnel ever questioned your behavior?
17 Makes degrading or demeaning comments regarding patients, families, nurses, physicians, hospital personnel, or the hospital. The physician’s non-constructive criticism often works to intimidate, undermine confidence, belittle, or imply stupidity or incompetence in his or her victims. Yes No Do you make demeaning or degrading statements regarding clients, customers, or consumers, work colleagues, or other personnel? • Have you ever made demeaning or degrading statements regarding clients, customers, or consumers?
• Have you ever made demeaning or degrading statements about work colleagues?
• Have you ever made demeaning or degrading statements about other work personnel?
• Have you ever criticized someone from your work?
18 Deterioration in clothing and dressing habits No No Has there been deterioration in your clothing and dressing habits? Has there ever been deterioration in your clothing and dressing habits?
19 Disorganized schedule No Yes Have you had a disorganized schedule at work? Has your work schedule ever been disorganized?
20 Intoxicated at social events or odor of alcohol on breath while on duty No No Have you been intoxicated at social events or had odor of alcohol on breath while on duty for work? • Have you ever been intoxicated at social events?
• Have you ever had alcohol on your breath while on work duty?
21 Avoidant, unreliable No Yes Have you been avoidant or unreliable at work? • Have you ever been avoidant at work?
• Have you ever been unreliable at work?
22 Public intoxication or impairment No No Have you been intoxicated or impaired at work? • Have you ever been intoxicated in public?
• Have you ever been impaired in public?
23 Impaired or decreased work performance No Yes Have you had impaired or decreased work performance? • Has your work performance ever been impaired?
• Have you ever had decreased work performance?
24 Smell of alcohol on breath or in perspiration No No Have you had the smell of alcohol on your breath or in perspiration? • Have you ever had the smell of alcohol on your breath?
• Has your perspiration ever smelled of alcohol?
25 Low or elevated self-esteem No No Have you had low or elevated self-esteem? • Have you ever had low self-esteem?
• Have you ever had elevated self-esteem?
  1. DWI driving while intoxicated, DUI driving under the influence