Abstract
Many sociological commentators have noted the reluctance of the professions to engage in active self-regulation. However, in the last ten years in the USA a new form of professional control has emerged that encourages active intervention. This focusses on the issue of the ‘impaired physician’ and is concerned with physician ill-health and its effects on medical practice, and is manifested in medical programmes for the identification, treatment and rehabilitation of impaired physicians. This interest in physician behaviour and its consequences for medical practice has developed and is contained mainly within the medical profession and tempers external surveillance and control. The success of the impaired physician movement rests on the ability to take certain areas of conduct such as alcoholism and drug abuse (which are formally disciplinary issues) and handle them as diseases.

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