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Safety Sensitive Positions: Are You at Risk?

Feb 21, 2016 02:12PM ● By MED Magazine

By Amanda McKnelly and Maria Eining


There are occupations in our communities that are considered “safety sensitive” because they are responsible for the welfare and safety of others. Safety sensitive positions include pilots, police officers, firefighters, attorneys and healthcare professionals. Because these individuals have a responsibility to the public, these positions require personal accountability and public oversight and are often regulated by a licensing board or similar authority.


Like all professionals, workers in safety sensitive positions are susceptible from illnesses that can lead to impairment. Such illnesses are common in society; both depression and alcoholism each reportedly affect 1 in 10 Americans. If a safety sensitive work is impaired, errors may occur which could cause significant harm to themselves or others.


Fortunately, there is an organization in South Dakota that provides confidential assessments, resources and ongoing monitoring of individuals at-risk for impairment. Midwest Health Management Services is a confidential, clinical resource for people in safety sensitive positions, including healthcare professionals.  MWHMS was founded to assist professionals and organizations, to be a resource in addressing any of the following:


●      Education regarding health and wellbeing for professionals in safety sensitive positions

●      Education and assistance and evaluation if substance use or mental health concerns are identified

●      Referral to appropriate treatment services and ongoing monitoring of continued recovery status.


To date, MWHMS has provided assistance to more than 420 professionals and students across South Dakota. Monitored recovery services offered by MWHMS follow and replicate strategies used by State Physician Health Programs (PHP) and the Federal Aviation Medicine Advisory Service


Studies of PHP programs, including the Domino Study and the Dupont Study revealed that, nationally, PHP participants demonstrate a 78% success in recovery without relapse at an average of over 7 years of monitoring. Long-term success rates of pilot monitoring programs reported by the aviation industry note abstinence rates exceeding 85%.  These rates are in stark contrast to recovery rates for the general public, as generally, only about 40% remain in remission at 1-year follow-up. 


When an ill professional engages in appropriate treatment and monitored recovery services, a highly valuable resource is preserved and is a benefit to the public.  In addition, given the morbidity and mortality related to untreated and undertreated substance use and mental health disorders, professional monitoring programs offer great advantages in recovery outcomes.  


A vibrant monitored recovery program for professionals in safety sensitive positions can actually enhance public safety by encouraging early intervention, reducing risk associated with potentially impairing health conditions. Assisting professionals in safety sensitive positions to obtain the appropriate treatment and continued care is key.  Professional monitoring programs acknowledge a primary concern for public safety, while taking into account that appropriate intervention and monitoring can save a career, a reputation, or even a life.


MWHMS welcomes questions or referrals from any source including, peers, self, physicians, colleagues, attorneys, treatment centers, family or friends.


 Amanda McKnelly and Maria Eining are co-owners of Sioux Falls-based Midwest Health Management Services.



Domino, K.B., Hornbein, T.F., Pollissar, N.L., Renner, G., Johnson, J., Alberti, S & Hankes, L. (2005) Risk factors for relapse in healthcare professionals with substance use disorders. Journal of the American Medical Association, 293, 1453-1460.
DuPont, R., McLellan, A.T., Carr, G., Gendel, M., & Skipper, G.E.  (2009) How are addicted physicians treated?  A national survey of physician health programs.  Journal of Substance Abuse Treatment.  37(1), 1-7.
Aviation Medicine Advisory Service, FAA-Sanctioned pilot alcohol abuse programs in business aviation.  Accessed online on 7/4/