When Patient is Provider: How a Deeper Understanding of Patienthood and Disability Can Improve Medical Regulation

While medical regulation supports the medical profession to fulfill its social contract with society, regulation for providers with serious mental illnesses is a particularly complex topic. Conventional framing describes medical regulation as protecting the public from incompetent and unfit providers. This framing of the public versus providers implies that providers do not belong to the public and therefore, do not need protection. Recognizing that physicians are humans with their own patienthood and illnesses, this article attempts to take a nuanced exploration into how disability may allow us to identify and address barriers for providers at risk of workplace impairment, such as those with serious mental illness. To date, physician impairment within medical regulation is largely understood through the medical model of disability which views disability as a problem inherent to an individual. This model neglects the ways in which unaccommodating or harmful work environments contribute to impairment. The author, a bipolar physician, provides personal narratives to unpack the duality of experience as a vulnerable member of the public and a provider deemed at risk for impairment. He proposes local and structural solutions to address some of the issues in medical regulation regarding providers with serious mental illness.