Caduceus Unwound

“Please call your MDO before you call APHRA.”

“The board can handle you telling them you have a health condition, what they will not tolerate is you lying about it.”

“We can mobilize a whole army in your corner and none of us are judgmental.”

In this episode, Gen interviews Caroline, a medical indemnity lawyer with more than 20 years experience including many years working for AHPRA, but now working for an MDO.

Caroline is passionate about helping clinicians with addiction navigate working safely while getting treatment. She describes the changes in AHPRA’s practice since 2022 and the difference in the experience of doctor’s with health impairments who receive a notification. We discuss the practical reality of notifications, the difference between a health issue and a conduct issue, and what happens when a practitioner is genuinely impaired versus simply unwell and seeking help.

Most importantly, she debunks a number of myths and misconceptions that continue to be problematic:

* A notification means you’ll probably lose your registration

* Good practitioners don’t receive notifications

* Notifications are shameful and should be kept secret

* You can’t keep working if you have a health-related notification

* Seeking professional help will automatically lead to mandatory reporting.

* Practitioners must report their own health condition to the board

The episode also covers:

* The perception of addiction as first and foremost a health condition, but that objective risk to patients is still the primary mandate for AHPRA

* Caroline outlines the role of MDOs, GP referral, addiction specialists, state based Doctors Health Programs, and other supports before any board notification happens. We talk through undertakings, conditions, hair and urine testing, breath testing, and when these are used as safeguards rather than punishment.

* Relapse is normalized as part of the illness, with emphasis on early disclosure, support, and recalibrating the plan rather than assuming failure.

Links

* Am I an Addict? & Support Services for doctors struggling with mental health and addiction, and relevant resources.

* Dr Anne Tonkin, former medical board chair, recipient of the order of Australia, plus many other accolades, talking about her experience of recieving a health notification in an AHPRA podcast.

* Keeping a Notifcation in Perspective

* Mandatory reporting details - FAQ & Guidelines, A Health Issue Rarely Needs Reporting, Myth Busting

* the AHPRA expert advisory group on Minimizing Practitioner Distress.

Credits

* Sound editing by Hugh M Hamilton (HughHamiltonPhotography)

* This podcast would not exist without the wonderful educational content provided by Hiwote Getaneh at Emerging Voices

Show Notes

In this episode, Gen and Tom explore a difficult but important question: are doctors really that different from other people with addiction?

We unpack the idea that doctors often have specific vulnerabilities — perfectionism, emotional compartmentalising, tendency to intellectualize — that can make substance abuse disorder harder to recognize, confront and then treat. The conversation also looks into why recovery can be especially challenging and the need for support, humility and self compassion, and emphasising the emotional transformation needed.

Links:

* The model of addiction mentioned in this episode was misidentified as Volkow and Koob, but actually refers to Berridge’s Incetive Salience Model.

* Am I an Addict?

* Support Services for doctors struggling with mental health and addiction, and relevant resources.

Credits

* Sound editing by Hugh M Hamilton

* This podcast would not exist without the wonderful educational content provided by Hiwote Getaneh at Emerging Voices

One of the fears that plagues clinicians with substance use disorder - what if AHPRA finds out?

In this episode, James discusses one of the most difficult experiences a healthcare professional can face: navigating the mental health crisis of addiction, while facing a notification to AHPRA and suspension of registration. James shares the destructive impact, but also his courage, growth, and perspective. Together Gen and James discuss the role of stigma, isolation and the need to find cognitive frameworks that are empowering.

Links:

* Relevant articles: The Devastation and Deliverance of AHPRA

* Support Services for doctors struggling with mental health and addiction.

Credits

* Sound editing by Hugh M Hamilton

* This podcast would not exist without the wonderful educational content provided by Hiwote Getaneh at Emerging Voices

Show Notes:

In this episode, Gen and Hamish have an honest, thoughtful conversation about what it looks like when substance dependency intersects with work. Gen shares her experience of approaching her employer about alcohol addiction, and Hamish reflects on what it was like to receive that disclosure as a manager. They discuss the emotional weight of disclosure, the fear and shame that often surround addiction, and why transparency can sometimes become a turning point. The conversation also explores how employers can respond with care while still protecting workplace safety, and how shared decision-making can create a more workable path forward.

Gen outlines a practical four-step framework that she would have liked to have available for approaching an employer when dealing with addiction or recovery.

Hamish adds the employer perspective, including the importance of open communication, external verification where appropriate, and maintaining clear boundaries that support both the employee and the workplace. Together, they discuss how recovery is rarely perfect, why relapse should be planned for rather than hidden, and how empathy can coexist with accountability. They also touch on APHRA, mandatory reporting, and the difficult balance between privacy, safety, and professional responsibility. Throughout the episode, both speakers emphasize that addiction is not a moral failing, and that support, structure, and compassion can make a meaningful difference.

Related articles:

* How do I approach my employer?

* Developing a Relapse Prevention Plan

Resources:

* Services for doctors struggling with mental health and addiction

Credits

* Sound Editing by Hugh M Hamilton

* I would not have been able to do the work behind getting this podcast up and running without the educational content from Hiwote Getneh at Emerging Voices

S1E2 ADHD & Addiction: A Conversation with Tom

In this episode, Tom shares his personal journey navigating ADHD, addiction, and the path toward self-acceptance and recovery. Join us as we discuss the interplay between neurodiversity and substance use, coping strategies, and lessons learned along the way.

Main Topics:

- Personal experiences with undiagnosed ADHD in childhood and adulthood

- The relationship between ADHD symptoms and substance addiction

- The oscillation between hyperfocus and inattention, especially during critical academic periods

- Coping mechanisms: spirituality, medication, and community support

- The role of self-compassion and creativity in managing neurodiversity

- Reflections on early diagnosis

- The importance of accepting limitations and seeking help without shame

Resources & Links:

The Power of Now - Eckhart Tolle

How to ADHD

Services for Doctors Struggling with Addiction

ADHD & Alcohol

Creative & Compassionate Discipline

Discover personal stories and frameworks from doctors who have faced addiction, exploring how they’ve navigated recovery while debunking myths and emphasizing connection. This episode offers practical advice, models of understanding addiction, and highlights the importance of vulnerability and support.

Main Topics:

* Personal journeys of addiction among medical professionals

* Role of compartmentalising, tolerating distress, workaholism, perfectionism and stigma and the impact on finding help

* Models of addiction: physical allergy, obsession, spiritual malady; biopsychosocial

* The role of connection in recovery

* Common misconceptions about addiction and hidden struggles

* Crisis and burnout as precipitants for recovery

* Practical steps for seeking help and building supportive networks

* Guest insights on self-awareness and ongoing recovery as a journey

Resources & Links:

* Services for Healthcare Workers with Addiction & Mental Health struggles

* Addicted Australia - SBS Documentary Series

* The Unbroken Brain by Maia Szalavitz

* In the Realm of Hungry Ghosts by Gabor Mate

Caduceus Unwound: Exploring Clinicians’ Lived Experience with Addiction and Recovery

Join Gen, a clinician and recovering addict, as she shares her personal journey and discusses the importance of community, shared experiences, and destigmatizing addiction within the healthcare profession. This episode offers insights into navigating dual identities and fostering compassionate recovery strategies.