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For years, physicians have shuddered at labels such as "impaired," "disruptive," or "burned out," terms typically used to describe doctors who are suffering from depression, substance addiction, or work stress acute enough for them to consider leaving medicine. As part of their professional tradition and culture, such doctors rarely seek help for their problems or confront a distressed colleague, says Larry Vickman, MD, MHA, FACEP, FACPE, president of physician wellness consultancy The Vickman Group in Tampa, FL. "There's an epidemic of denial," he says. "We continue to make excuses for ourselves and others, but in the end, that's not the way to go."