The physician as sponsor | 3.5.2019

The physician as sponsor

 

These remarks bear solely upon 12-Step programs and the position of the participating physician – a significant portion of this readership.  An important topic raised among physicians on a private listserv was that of the boundaries needed in assuming sponsorship of a fellow recovering addict*.  The conclusions as of Monday favored a clear line between the 12-step fellowship role of a sponsor, and the caregiver role of a physician. One contributor summarized, “Once a patient never a sponsee, and vice versa.”  The discussion reflects directly back to the AMA’s Code of Ethics and the APA’s Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry.  These guidelines admittedly impose somewhat more stringent limits on psychiatrists than on physicians as a group, but both emphasize the need to keep the job of the physician apart from other roles.  The unintended ambiguity in the Principles, I believe, is that it focuses on romantic and financial relationships with patients, but does not explicitly recognize the unique relationship created by sponsorship.  That likely just wasn’t on the radar, although I can imagine other examples of dual roles that would also be concerning (e.g., the physician who is a religious minister or a missionary).

What was equally strongly emphasized, however, was the importance of sponsorship to recovery in 12-Step models, and that the role of sponsor is not precluded to physicians.  Nor is it necessary, of course, that physicians sponsor only other physicians.

* For brevity, those with the illness of addiction

- W. Haning, MD