Illness in doctors and dentists and their fitness for work—are the cobbler's children getting their shoes at last?

Doctors and dentists with health problems face unique problems in obtaining help [1]. It has been reported widely that mental ill-health and substance abuse problems are particular issues for a large percentage of doctors and dentists who become ill and the stigma associated with such problems might explain, in part, their difficulty in obtaining assistance. However, the explanation is likely to be much more complex. A number of confidential support services have been made available to doctors for several years. Oxley [2] has reviewed the services available for sick doctors in the United Kingdom and has highlighted the provision of both local and national services. Local services include National Health Service (NHS) occupational health services and counselling services, but often exclude dedicated specialist treatment services for addiction [1]. National services include the National Counselling Service for Sick Doctors, a counselling and a ‘doctors for doctors’ service provided by the British Medical Association, the British Doctors and Dentists Group and the Sick Doctors' Trust, which provide assistance for addicted doctors and the Doctors' Support Network for doctors with mental health problems. There is also the Doctors' SupportLine, which is a first step telephone help line for personal or work-related problems. Some medical royal colleges have established support for their members in the form of confidential advice or mentors. Yet despite these and other support services, doctors and dentists continue to run into difficulties that may culminate in a referral to either the General Medical Council (GMC) or the National Clinical Assessment Service (NCAS).