1. Prepared by JoAnne M. Zboyan, Esq. Of Identifying and Assisting Clients and Colleagues with Major Medical Issues

2. High Risk Clients Physical Disability Substance Issues (Drug, Alcohol) Emotional/Mental Health Issues/Acute Psychological Issues Aging Loss of Independence/Inability to Care for Self Medical Board/Licensure/Privileging Issues Civil Litigation Practice Break Up/Exclusion

3. High Risk Clients (Continued) Criminal Issues (Alcohol, Theft, Fraud, Sex Assaults, Sexual Boundary Issues) Domestic/Divorce/Loss of Children Rehabilitation (Required) Financial Issues/Business Continuation Expenses Bankruptcy Loss of Status/Friendships/Focus/Purpose/Identity/Loss of Hope Anniversary of Significant Events Isolation Disability-Individual (STD/LTD); SSDI

4. Warning Signs Excuses for refusing treatment Avoiding CPHP/Attorney Regulation Missed Medical Appointments Missed Urine Drops Failure/Unwillingness to Proceed with Treatment/Proceedings Inability/Unwillingness to Assist Counsel “Bending the Facts,”/Evasive Behavior

5. Physician Suicides  As many as 400 MD’s each year (equivalent of 1 entire med school class) (Louise Andrew study updated 3/8/12) Physicians  mortality risk from cancer/heart disease (sufficient care and early diagnosis) Med school students (Accidents No. 1; Suicides No 2) General Population Depression estimated 12% males; 18% females Stigma of mental health issues ANDREW STUDY

6. Physician Suicides (Continued) Medical Students/Residents 15-30% screen positive for depression/mental health issues ANDREW STUDY Medical Personnel  Increased knowledge of suicide; increased knowledge of lethal means Failure to report/undereporting of suicides Highest suicide rates – affective disorders (depression, bipolar disease, alcoholism, substance abuse)  chance of death by suicide for physicians as much as 70% higher for male M.D.s than men in the general population ANDREW STUDY

7. Physician Suicides (Continued) As much as 250-400%  risk for female M.D.s than other women in the population ANDREW STUDY Physicians who attempt suicide have a much higher success rate

8. Barriers – Access to Psychiatric Care

9. Case Study B Long Time Client Anesthesiologist-Access to Drugs Extended Addiction Issues/Treatments (alcohol, drugs) Multiple Rehabilitation Attempts Resistance to Treatment Isolation/Loss of Friendships Financial Issues

10. Legal Issues PENDING/PROSPECTIVE LEGAL ACTIONS  Medical Board/Attorney Regulation  Civil Litigation  Practice/Firm Dissolution  Criminal Matters  Domestic Matters  Bankruptcy

11. Coordination of Counsel Criminal Domestic (Restraining Orders) Board Disability (Individual/SSDI) Civil Bankruptcy Partnership Hospital Personal Counsel Estate/Probate

12. Resources Hotline-Nat’l Suicide Prevention1-800 273-TALK CPHP/COLAP AA Caduceus Insurance COPIC/Liability coverage (Board/Attorney Reg/Claims) Disability Survivor Benefits Health –Mental Health coverage (therapy, psychiatrist) Internist