All registered doctors who are in practice, i.e. who are not retired or infirm, have the right to receive assistance from the PAIMM, since the Program was created so that doctors with mental and/or addiction problems might once more renew their careers in optimum conditions for themselves and with the maximum guarantees for their patients.

I have a problem. Dialling this telephone number: 902 362 492 may be a good first step.

One of the team's specialised physicians will attend to us confidentially and inform us. If appropriate, a first appointment will be made for assessment purposes.

A fictitious name will be assigned to you, in order to preserve your identity and maintain discretion, thus avoiding the social stigma that this type of illness, even today, can still generate.

Before the first appointment, there takes place the signing of the entry acceptance document, by which you agree to follow, at all times, the indications of your therapist and by which the PAIMM is committed to giving you the care and the services necessary to bring about a good recovery.

It's a colleague who has the problem. - Our support for fellow-physicians cannot be based on a covering-up of situations of risk. Not to act, far from helping our colleague, is the worst possible option.

In fact, mutual trust and solidarity among peers, as well as professional duty, are the basis for advising a sick colleague about the existence of specialized, confidential services like those of the PAIMM.

It is important to get a colleague to find out about the PAIMM, its philosophy and characteristics, because this may well give him/her the security and confidence to take the first step. Going a little further, suggesting that he/she should access the Website of the program: paimm.fgalatea.org may prove effective, above all if it is followed up with a direct telephone call to 902 362 492.

When this colleague finally agrees to being treated in the Program, he/she will have to sign, before the first visit, the entry acceptance document, by means of which he/she agrees to follow the treatment program indicated to him/her by their psychiatrist, and by means of which the PAIMM is committed to giving him/her the most appropriate care and services until recovery has been achieved.

The sick physician does not want to receive the appropriate treatment.-Dialogue, from a position of mutual trust, is important in trying to convince the sick physician of the need to learn about the PAIMM and to dial 902 362 492 as soon possible.

However, a sick physician's refusal to receive specialized treatment may persist over time. One consequence of this is a greater risk of malpractice, but - obviously - there will also be an increase in the risks to the physician's own health, not to speak of the impact on his/her work and family environments. It may be useful, here, to remind ourselves of the deontological duty of the doctor who becomes aware of the plight of a sick physician to communicate it to the Secretary of the corresponding Medical Council.

Once a sick colleague has taken the first steps in seeking treatment under the aegis of the Program, there takes place the signing of a Therapeutic Contract, a document whose aim is to reinforce the therapeutic agreements adopted verbally concerning the adherence to the indications and prescriptions given to the patient by his/her psychiatrist (be he/she private or one of the PAIMM team's). The therapeutic contract does not have legal force but it is an ethically-binding commitment between the parties that sign it.

When one is the doctor of a sick physician.- One must start from the base that doctors, in general, are not very good patients, no matter what the health problem that they are suffering from may be.

In the PAIMM-type illnesses, however, it is even more difficult to find a doctor-patient relationship that is the appropriate one. Informal corridor contacts or occasional contacts by telephone, not showing up for a consultation, failing to implement prescriptions and therapeutic indications, and other vicissitudes, mean that any treatment, in most cases, is quite ineffective.

We therefore recommend that the treating physician lay down, from the beginning, with the sick physician, certain conditions, certain criteria - not forgetting a certain rigour - which make the doctor-patient relationship sustainable. If, in spite of this, the sick physician does not collaborate along these lines, and there begin to be serious doubts concerning risks in his/her praxis, the treating physician has the obligation to inform the Secretary of the corresponding Medical Council and to break off the therapeutic relationship with the sick physician, thus avoiding any responsibilities towards him/her.

It is important to know that the PAIMM makes available to physicians who are treating sick doctors the diverse specialized services that the program has at its disposal (the Residential Unit, day hospital, psychotherapies, ...) for them to use in the treatment of their doctor-patients, reinforcing and complementing, if it is necessary, their own therapeutic plan.