Impaired Healthcare Executives

February 1991
March 1995 (revised)
November 2000 (revised)
November 2005 (revised)
November 2006 (revised)
November 2012 (revised)

Statement of the Issue

The American College of Healthcare Executives recognizes that impairment is a significant problem that crosses both societal and professional boundaries. For healthcare executives, impairment can be defined as a condition that limits or diminishes a healthcare executive’s ability to perform his or her responsibilities and duties in accordance with the prevailing professional standards and expectations. Some examples of causes of impairment include alcoholism, substance abuse, chemical dependency, mental/emotional instability, cognitive impairment and illness.

Impaired healthcare executives affect not only themselves and their families, they have a significant impact on their profession, their professional society, their organizations (including colleagues, patients, clients and others served), their communities, and society as a whole. Impairment typically leads to misconduct in the form of incompetence and unsafe or unprofessional behavior, which can result in substantial costs associated with loss of productivity and errors in judgment.

The impaired healthcare executive can damage the public image of his or her organization of employment. Public confidence in the organization diminishes if it appears that the organization is not being managed with consistently high standards of professional and ethical practice. This lack of public confidence may cause the community to deem the organization unworthy of its support.

Society expects healthcare executives to practice the standards of good health that they advocate for the public. Impaired healthcare executives diminish the credibility of the profession and its ability to manage society’s healthcare when they are not appropriately managing their own personal health.

Policy Position

The preamble of the American College of Healthcare Executives Code of Ethics states, “Healthcare executives have an obligation to act in ways that will merit the trust, confidence, and respect of healthcare professionals and the general public. Therefore, healthcare executives should lead lives that embody an exemplary system of values and ethics.”

The American College of Healthcare Executives believes that healthcare executives who are impaired for any reason should refrain from assuming responsibilities that they may not be able to discharge effectively. Whenever there is doubt, they should seek appropriate assistance in performing their responsibilities.

Therefore, all healthcare executives have an ethical and a professional obligation to:

  • Maintain a personal health that is free from impairment.
  • Refrain from all professional activities if impaired.
  • Seek assistance, whenever there is uncertainty, in understanding whether impairment exists.
  • Expeditiously seek treatment if impairment occurs.
  • Urge impaired colleagues to expeditiously seek treatment and to refrain from all professional activities while impaired.
  • Support peers who identify healthcare executives in need of help.
  • Intervene and report the impairment to the appropriate person(s) should the colleague refuse to seek professional assistance and should the state of impairment persist.
  • Review applicable legal obligations to report the impairment to ensure compliance with federal and state requirements (such as those required by licensing boards).
  • Recommend or provide, within one’s employing organization, confidential avenues for reporting impairment, and either access or referral to treatment or assistance programs.
  • Consider establishing an organizationwide program or committee that coordinates a reporting process and also reviews, addresses and prevents impaired executives.
  • Recognize that individuals who have successfully received treatment for impairment and are no longer deemed impaired should be considered for employment opportunities for which they are qualified.
  • Assist recovering colleagues when they resume their professional activities.
  • Urge the community to provide information and resources for assistance and treatment of alcoholism, substance abuse, mental/emotional instability and cognitive impairment as needed and as appropriate.
  • Raise the awareness of key stakeholders (such as employees, governing board members, etc.) on impairment issues and the resources available for assistance.

Approved by the Board of Governors of the American College of Healthcare Executives on November 12, 2012.