Physician Re-Entry After a Short Term Leave of Absence - American Society of Anesthesiologists (ASA)

Physician Re-Entry After a Short Term Leave of Absence

Physician Re-Entry After a Short Term Leave of Absence

The Department of Anesthesia has the responsibility and authority, through its Director, for developing policies and procedures governing the provision of anesthesia services, including specifying the minimum qualifications for practitioners. These responsibilities and authority include developing criteria for determining the anesthesia service privileges to be granted to an individual practitioner and a procedure for applying the criteria to individuals requesting privileges, The MADOM and the QMDA Toolkit provide guidance, considerations and methods for the Director of Anesthesia Services to review when developing local policies that are most appropriate for the local environment of care and the patient populations served.  

The ASA frequently receives questions seeking guidance for maintenance and re-approval of privileges for practitioners following an absence from practice that may be of variable duration. The following is a preliminary collection of issues and sources to consider when developing a local policy that addresses these unique circumstances.

A local practice should consider that a clinician may require a short term leave of absence for a variety of reasons. The practice might seek to develop a policy that meets the needs of its professional staff in a way that appropriately manages and addresses local responsibilities. One initial source to consider is the American Medical Association (AMA) website on Resources for Physicians Returning to Clinical Practice.

What are some reasons that a clinician may require a medical or short term leave of absence?

A clinician may require a leave of absence from practice for a variety of reasons, including, but not limited to, medical illness, surgical or other procedural care, accident or injury.

Are there official guidelines related to short term leaves of absence?

The Guidelines for the Ethical Practice of Anesthesiology includes the following statement:

“The practice of quality anesthesia care requires that anesthesiologists maintain their physical and mental health and special sensory capabilities. If in doubt about their health, then anesthesiologists should seek medical evaluation and care. During this period of evaluation or treatment, anesthesiologists should modify or cease their practice.”

Why is it important to take a leave of absence when necessary?

Anesthesiologists have the responsibility to maintain their health and vigilance in order to place their patient’s interests foremost and protect their patients from exposure to undue risk. Part of this is to ensure optimal team performance, which includes managing the overall fitness of the anesthesia care team, including but not limited to, addressing the effects of recovery from medical or surgical illness, accident or injury.

What issues must be addressed following the end of a leave of absence?

In instances of extended absence from practice unique Re-Entry concerns apply (see Questions to Ask Regarding Physician Re-Entry). The Federation of State Medical Boards (FSMB) has additional information on Physician Re-Entry. We also recommend checking whether your hospital or facility has an existing policy regarding return to practice after a medical leave of absence.

When can clinicians return to work following a short term leave of absence?

Fitness for return to work following shorter leaves may depend on the nature of the medical leave and attendant patient risk if the clinician has not realized sufficient recovery. Several competing interests may impact the ability for a clinician to delay return to patient care. Similarly, these interests make it challenging for an anesthesiologist to question another clinician’s ability to perform adequately.

What should policies regarding short term and medical leaves of absence include?

Anesthesia groups and departments should work within their organizational structures to develop and implement policies to address medical absences from work and return to work following medical leave. Policies may include defining essential job performance requirements for clinicians. Considerations may include technical areas of practice, e.g. intellectual, sensory, motor, behavioral and social aspects of clinician performance. Policies may also include processes for requesting leave and for objective assessment prior to return to delivery of clinical care.

It may be useful to review recommendations from relevant medical and nonmedical sources when creating policies. These sources may include accrediting bodies and governmental agencies concerned about occupational health.

 Quality and Regulatory Affairs may be contacted at (202) 289-2222 or by email at qra@asahq.org.

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