OCD Among Physicians: How an IOP in Texas Supports Doctors Facing OCD
OCD Treatment for Physicians
Medicine demands extraordinary dedication. Years of study, sleepless nights, long shifts, and the weight of life-and-death decisions are all part of the journey. Yet even for highly skilled physicians, the mind can become a source of added pressure. Intrusive thoughts, persistent doubts, or the compulsion to double-check every detail, hallmarks of Obsessive-Compulsive Disorder (OCD), can creep in and make even familiar tasks feel overwhelming.
For some, these behaviors are subtle: a mental check before prescribing medication, reviewing patient charts repeatedly, or replaying interactions to ensure nothing was missed. For others, the patterns are more intense, consuming hours of mental energy, interfering with sleep, and leaving a sense of exhaustion that no amount of skill or experience seems to alleviate.
Intensive Outpatient Programs (IOPs) designed specifically for OCD offer structured, evidence-based care that accommodates the unique demands of medical professionals. This article explores how OCD often manifests among physicians, common triggers, impacts on professional and personal life, and how an OCD IOP center in Austin, Texas can provide support while maintaining the rigorous demands of a medical career.
What is OCD?
Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by intrusive, persistent thoughts, images, or urges (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to reduce the anxiety these thoughts provoke. For physicians, obsessions often focus on patient safety, contamination, or the fear of making a critical mistake, while compulsions can appear as repeated checking, excessive note-taking, or mental rehearsal of tasks. These behaviors are not a reflection of professional diligence; rather, they are driven by anxiety and a sense of over-responsibility that can feel exhausting and difficult to control. OCD is treatable, and evidence-based therapy can help reduce the impact of these intrusive thoughts and compulsions on both professional and personal life.
Why Physicians May Be Especially Susceptible to OCD
Several aspects of medical training and practice can contribute to the development or intensification of OCD symptoms among physicians:
High-stakes responsibility
Every decision matters. Intrusive thoughts about potential mistakes, even unlikely ones, can feel all-consuming. The sense of responsibility is constant, and this pressure can amplify obsessive worry.Exposure to medical knowledge
Knowledge of rare complications, infections, or treatment errors can fuel obsessive thinking. Physicians are trained to anticipate problems, but excessive anticipation can evolve into intrusive thought patterns.Perfectionism and professional culture
Medicine rewards precision and thoroughness. While these traits are strengths, they can reinforce compulsive checking, reassurance-seeking, or mental rituals in the context of OCD.Long hours and sleep deprivation
Fatigue reduces cognitive flexibility, making intrusive thoughts harder to resist and compulsions more automatic. Night shifts, extended rotations, and irregular schedules can intensify symptoms.Co-occurring anxiety and stress
Physicians experience higher rates of anxiety, depression, and burnout, which can intersect with OCD symptoms and make them more persistent.
These elements create a perfect storm where even small obsessions can escalate, disrupting workflow, reducing energy, and contributing to emotional exhaustion.
What OCD Often Looks Like Among Physicians
OCD patterns often align with professional responsibilities and the medical environment. Common presentations include:
Common Obsessions Among Physicians with OCD
Obsessions in physicians with OCD often revolve around the high-stakes nature of medical practice. They are persistent, unwanted thoughts, images, or doubts that can be difficult to dismiss, even when logically you know your work is competent.
Common manifestations include:
Persistent doubts about decisions or treatment plans: A physician might constantly replay a patient interaction in their mind: “Did I prescribe the correct medication?” or “What if I missed a critical detail in the chart?” Even after reviewing the notes multiple times, the doubt lingers, prompting compulsive mental or behavioral checking.
Fear of harming patients through error or oversight: Thoughts like “What if I misread that lab result?” or “What if I forgot to ask a question that would have changed the diagnosis?” can intrude at any moment, during rounds, while driving home, or at night while trying to fall asleep, creating ongoing tension and mental exhaustion.
Intrusive harm-related thoughts (harm OCD): Some physicians experience distressing thoughts about intentionally harming patients, even though they would never act on them. For example, a surgeon might have the image: “What if I stab the scalpel in the wrong place on purpose?” or a resident might imagine administering the wrong medication deliberately. These thoughts are ego-dystonic, completely contrary to the physician’s values, but they can provoke extreme anxiety, guilt, and mental exhaustion. Such obsessions are distressing precisely because they conflict with the physician’s ethics and sense of responsibility, yet they are uncontrollable and involuntary, not reflective of intent.
Intrusive contamination fears, including concerns about family safety: Some physicians develop obsessions around germs or infections, not only in the hospital environment but also at home. Thoughts such as “What if I bring a dangerous infection home to my children or spouse?” can trigger compulsions such as repeated handwashing, changing clothes multiple times, or mental decontamination rituals far beyond standard precautions. These behaviors can be mentally exhausting and can intrude on family life, creating guilt or anxiety even during time off.
Recurrent “what if” scenarios: Many physicians experience mental loops that replay after shifts, on call, or during downtime: “What if I didn’t notice the subtle symptom that mattered?” or “What if a patient outcome could have been different if I had asked just one more question?” “What if my advice was misleading?” These scenarios are mentally vivid and distressing, and they often trigger compensatory behaviors, such as reviewing charts or calling colleagues for reassurance, even when unnecessary.
These obsessions are not a reflection of lack of skill or diligence. In fact, they often arise in individuals who are highly conscientious, perfectionistic, and particularly committed to patient safety. Yet the intensity and persistence of these thoughts can be exhausting, making even routine clinical decisions feel mentally heavy and stressful. Over time, the constant mental rehearsal, second-guessing, and anticipatory worry can contribute to burnout, emotional fatigue, and difficulty disengaging from work, blurring the line between professional responsibility and intrusive anxiety.
Common Compulsions Among Physicians
Compulsions are repetitive behaviors or mental rituals performed in response to obsessions. In physicians, these actions are driven by anxiety rather than logic, medical standards, or evidence-based guidelines, and are intended to prevent imagined harm, reduce doubt, or temporarily “neutralize” intrusive thoughts. While these behaviors may feel relieving in the moment, they reinforce obsessive thinking and make anxiety stronger over time. Each repetition sends the subconscious message that the thought is dangerous or that the behavior is necessary to prevent catastrophe, creating a cycle in which anxiety grows and obsessions become more frequent and intense.
Even routine tasks such as rechecking a chart, sanitizing hands repeatedly, or mentally rehearsing patient interactions can evolve into time-consuming rituals that disrupt workflow, consume personal energy, and interfere with rest and recovery. Over time, compulsions not only fail to reduce worry but also increase vigilance, perfectionism, and emotional fatigue, making it harder for physicians to disengage from work and recover from stress.
Common compulsions among physicians include:
Excessive chart reviewing or note-checking: After seeing a patient, a physician may feel compelled to reread charts or re-check orders multiple times: “I need to make sure I didn’t miss anything important.” Even after confirming the information, mental loops may continue, replaying the encounter in their mind for hours.
Repeated handwashing or sanitizing beyond protocol: Contamination fears, especially around patient care or home exposure, can lead to rituals like washing hands multiple times, changing scrubs repeatedly, or meticulously sanitizing equipment. At home, this may extend to behaviors like undressing in the garage or showering immediately upon returning, even when risk is minimal, in an attempt to protect children or family from germs.
Mental rehearsal of patient interactions: Physicians often silently replay conversations or procedures to prevent imagined errors: “Did I explain the risks clearly?” or “Did I ask all the right questions?” This internal rehearsal can continue during commutes, evenings, or while trying to sleep, making it difficult to relax or disengage from work.
Over-cautious recommendations or over-referral: Some physicians feel compelled to take extra precautions in patient care, such as referring patients to specialists, ordering additional imaging, or recommending tests that may not be aligned with clinical protocols or best practice. These behaviors are often driven by anxiety rather than medical necessity, reflecting a fear of missing something, rather than informed by established guidelines or best practice. While these actions can temporarily relieve worry, they can also increase patient burden, healthcare costs, and personal stress.
Reassurance-seeking from colleagues or supervisors: Some physicians repeatedly consult peers not for guidance, but to temporarily reduce anxiety: “Did I prescribe the correct medication?” or “Are my instructions clear enough?” “Would you have done anything differently?” Even after reassurance, intrusive thoughts often return, prompting further checking or questioning.
Harm-specific compulsions: Physicians with harm OCD may develop behaviors aimed at “neutralizing” unwanted violent thoughts. For example, a surgeon may repeatedly check instruments, confirm patient identity, or rehearse safety protocols excessively, attempting to reassure themselves that they will never act on the intrusive thought of intentionally harming a patient. These rituals are mentally exhausting and often intensify the anxiety rather than diminish it.
Ritualistic scheduling or task sequencing: Physicians may create strict sequences for routine tasks, continually reorganize checklists, or repeat minor tasks to ensure “nothing is left to chance.” These rituals provide temporary relief but can reduce efficiency, increase stress, and make transitions between work and personal life feel impossible.
Compulsive documentation: Some physicians feel driven to repeatedly review, revise, or expand patient charts and progress notes, even when the information is already complete and accurate. Thoughts like “Did I document everything perfectly?” or “What if I missed an important detail?” can lead to excessive time spent on charting. While this may temporarily reduce anxiety, it reinforces obsessive thinking, increases mental fatigue, and makes it harder to disengage from work.
Even small compulsions can accumulate into hours of mental and behavioral activity, leaving physicians drained and emotionally exhausted. The demands of medical practice already require extraordinary dedication, focus, and long hours, and OCD can hijack that commitment, turning conscientiousness into persistent anxiety. Compulsive behaviors go beyond what policies, procedures, and standard medical practice call for. While careful checking and vigilance are essential in high-stakes situations, OCD-driven compulsions are excessive, time-consuming, and motivated by anxiety rather than clinical necessity, often interfering with workflow, personal time, and well-being, and ultimately reinforcing the obsessive cycle and magnifying stress.
Evidence-Based Treatment for Physicians Living with OCD
OCD is treatable, and we are forntuate to have decades of research to inform evidence based treatment protocols. Effective treatment requires interventions that directly target intrusive thoughts and compulsive behaviors rather than relying on reassurance or avoidance. Several evidence-based approaches have strong research support:
Cognitive Behavioral Therapy (CBT): CBT is the foundation of OCD treatment. It helps individuals identify and challenge distorted thought patterns, recognize how obsessions drive compulsions, and develop healthier ways to respond to intrusive thoughts. For physicians, CBT can help distinguish between realistic clinical concerns and anxiety-driven obsessions, reducing mental rehearsal and doubt.
Exposure and Response Prevention (ERP): ERP is the most well-supported behavioral treatment for OCD. It involves gradual, controlled exposure to feared thoughts, situations, or triggers while refraining from compulsive behaviors. For example, a physician with contamination fears might intentionally follow routine hand hygiene without performing extra cleaning rituals, or a physician with harm obsessions might confront intrusive “what if” thoughts without engaging in reassurance-seeking. Over time, ERP reduces anxiety and weakens the compulsive cycle.
Acceptance and Commitment Therapy (ACT): ACT focuses on accepting intrusive thoughts without judgment and committing to values driven behavior. Physicians can learn to acknowledge obsessions, such as doubts about patient care or fear of harming others, without letting these thoughts dictate behavior. ACT helps reinforce professional values, improving the ability to work effectively despite anxiety.
These treatments are most effective when tailored to the unique demands of a physician’s schedule and responsibilities, and when therapists understand the high-stakes, high-pressure environment of medical practice. While outpatient therapy can be effective, more intensive treatment formats, such as an IOP for OCD, can accelerate progress by providing structured, focused, and supervised practice of these evidence-based strategies in a supportive environment.
Why Working With an OCD Specialist Matters
OCD responds best to treatment that is highly specific and evidence-based. While many licensed therapists are trained to treat anxiety, depression, and stress-related concerns, OCD requires a distinct approach. Interventions that may be effective for other clinical presentations - reassurance, extensive cognitive restructuring, or avoidance-based coping - can unintentionally strengthen OCD symptoms over time.
For physicians, this distinction is familiar. In medicine, care is often matched to complexity and diagnosis. A patient with a cardiac condition is appropriately referred to a cardiologist not because a primary care physician lacks skill, but because specialized training leads to better diagnostic precision and outcomes. OCD treatment follows the same principle.
Many physicians with OCD have already engaged in therapy or attempted to manage symptoms through insight, stress reduction, or self-monitoring, only to find that intrusive thoughts and compulsive behaviors persist. In these cases, the challenge is rarely motivation or effort. More often, it reflects the need for OCD-specific treatment, particularly Exposure and Response Prevention (ERP).
An OCD specialist understands:
How OCD can disguise itself as responsibility, ethical concern, or clinical vigilance
How reassurance-seeking, checking, and over-documentation can maintain the disorder
How to design ERP exercises that respects professional standards while still targeting compulsive behavior
How to distinguish appropriate medical caution from anxiety-driven compulsion
For physicians, working with a specialist can also reduce the burden of having to justify or explain the medical context of their obsessions. Treatment can focus on interrupting the obsessive–compulsive cycle, rather than debating whether a feared outcome is realistic or preventable.
How Austin Anxiety and OCD Specialists’ IOP Supports Physicians
At Austin Anxiety and OCD Specialists, our Intensive Outpatient Program (IOP) offers structured, flexible treatment designed for high-functioning physicians who are motivated to reclaim their lives and professional identity. Our treatment program is built to address the unique pressures of medical practice while providing the intensity of care often required to effectively treat OCD.
Our IOP integrates evidence-based therapy with optional peer support through group sessions, alongside individualized clinical guidance, all within a format that accommodates demanding schedules. While group therapy can be helpful for some, our program is distinct in its strong emphasis on individual therapy, recognizing that physicians often benefit from greater discretion, confidentiality, and highly personalized treatment planning.
FAQs for Physicians Considering IOP OCD Treatment
This program is designed for physicians, residents, fellows, and other high-responsibility medical healthcare professionals who find that standard outpatient therapy are insufficient for symptom severity or occupational impact.
How is IOP different than weekly individual therapy for OCD?
An Intensive Outpatient Program (IOP) provides more frequent, focused, and structured therapy than standard weekly therapy sessions. Weekly therapy is beneficial for mild to moderate OCD, but may not provide enough regular practice of skills like ERP to produce rapid, measurable change in symptoms, especially when OCD is severe. IOP gives therapists and clients time to apply evidence-based treatments (CBT, ERP, ACT) repeatedly and in context, helping accelerate progress and break rigid patterns more efficiently than once-a-week therapy alone.
How many hours per week does IOP for OCD involve?
Our IOP at Austin Anxiety & OCD Specialists typically runs over a period of about two weeks, with clients receiving multiple hours of therapy each week (typically 2 hours of therapy per day, five days per week). The total treatment time is designed to offer intensive, concentrated care while allowing clients to continue daily responsibilities.
How much does IOP cost?
Costs vary depending on the length of the program and individualized treatment planning. Austin Anxiety & OCD Specialists provides a treatment rate and collects a deposit to reserve the program dates. Our administrative team discusses cost, scheduling, and options (including superbill for potential insurance reimbursement) during your initial contact or consultation. Many clients do seek out-of-network reimbursement through their insurance provider using a superbill.
Our Intensive Outpatient Program (IOP) is billed weekly and rates are typically as follows:
Daytime (before 4:45 PM): $2,500 per week
Weekday Evenings: $3,000 per week
Weekends: $3,250 per week
A one-time intake fee of $400 applies for all new clients.
Can OCD begin or worsen during residency, fellowship, or early practice?
Yes. High-pressure training environments, prolonged stress, sleep disruption, and increased responsibility can precipitate or intensify OCD symptoms in individuals who are predisposed. Onset during training or early career is common and does not reflect weakness or lack of resilience.
Can OCD affect my clinical work or patient care?
OCD can impact efficiency, confidence, presence, and cognitive load. Intrusive doubts, mental replay, or compulsive checking can slow decision-making, increase fatigue, or contribute to avoidance of certain tasks. With appropriate treatment, these patterns are treatable, and early intervention helps prevent escalation or burnout.
Will ERP require me to lower my professional standards?
No. Evidence-based OCD treatment does not ask physicians to abandon clinical judgment, ethical standards, or patient safety. ERP focuses on reducing OCD-driven behaviors that go beyond accepted medical standards, such as excessive checking, reassurance-seeking, or over-documentation, while preserving appropriate vigilance and professionalism. Treatment helps clarify the difference between necessary clinical care and anxiety-driven actions, allowing physicians to practice in alignment with evidence-based standards rather than fear. The goal is not lower standards, but restoring proportion, efficiency, and confidence in clinical decision-making.
Will participating in an IOP significantly disrupt my schedule?
Physician-focused IOP care is designed with professional demands in mind. Treatment typically offers flexible scheduling options, including partial-day programming and telehealth when clinically appropriate, allowing many physicians to continue working while engaging in care. At Austin Anxiety and OCD Specialists we provide daytime, evening, and weekend scheduling options.
How do physicians manage OCD symptoms at work while in treatment?
IOP treatment focuses on practical, clinically appropriate strategies that translate directly into the workplace. These may include setting limits on checking and documentation, tolerating uncertainty within evidence-based standards, addressing over-responsibility, and using cognitive tools to reduce mental replay without compromising patient safety.
Will seeking treatment affect my privacy or professional standing?
Confidentiality is a core component of ethical treatment. Our IOP ensures privacy, discretion, dignity, and adherence to professional regulations.
Do I have to participate in group therapy sessions with other clients who may know me?
No, you do not have to be in an OCD therapy group with other clients unless you specifically choose to participate in optional support sessions. At Austin Anxiety & OCD Specialists, the IOP is built around individual therapy with a licensed therapist and treatment is tailored to your goals and needs. Optional group or support for loved ones is available for those who find peer support beneficial, but it is not required, and your care remains confidential and individualized.
Meet the IOP Team at Austin Anxiety and OCD Specialists
A meaningful Intensive Outpatient Program (IOP) experience is built on trust, clinical expertise, and thoughtful, compassionate care. Our IOP team is composed of clinicians with advanced training in OCD, including complex and high-acuity presentations, and with a deep understanding of how OCD can uniquely affect physicians and other high-responsibility healthcare professionals. We recognize the pressures of medical decision-making, the weight of responsibility, and the ways OCD can intertwine with conscientiousness, perfectionism, and patient-safety concerns. Each therapist on our OCD IOP team brings a steady, evidence-based approach, meeting clients where they are while supporting sustainable, real-world progress that respects both clinical standards and professional identity.
Dr. Samantha Myhre, PhD
Assistant Clinical Director & IOP Coordinator
Dr. Myhre treats anxiety and OCD using evidence-based, mindfulness-informed approaches that emphasize insight, self-compassion, and behavioral change. As IOP Coordinator, she works closely with clients and the IOP treatment team to ensure care is structured, individualized, and responsive to each person’s needs. Her collaborative style supports confidence-building and practical skill development throughout treatment.
Ann Elise Taylor, LCSW, PMH-C
Ann Elise Taylor specializes in adult and perinatal mental health, with extensive experience treating anxiety disorders, OCD, and trauma-related concerns. Drawing from CBT and ACT, she provides steady, supportive care that helps clients navigate periods of heightened stress, restore emotional balance, and build resilience both during and after IOP.
Ayla Bridges, LMFT
Ayla Bridges works with children, adolescents, adults, and families managing OCD, anxiety, and related behavioral challenges. Using CBT and ERP, she helps clients gradually face fears, develop emotional awareness, and increase confidence in navigating new or uncomfortable situations, while also supporting loved ones in understanding the treatment process.
Ansimone Youssef, PsyD
Dr. Youssef focuses on adolescents and adults experiencing OCD, anxiety, and depression. Her culturally responsive, individualized approach emphasizes psychological safety, collaboration, and pacing treatment in a way that feels both supportive and effective.
Casey James, LPC
Casey James treats OCD and anxiety across the lifespan, with a strong emphasis on evidence-based care, including ERP. She brings a thoughtful, structured approach to treatment, helping clients challenge avoidance patterns, reduce compulsive behaviors, and build tolerance for uncertainty in a way that aligns with their values and daily responsibilities.
Katie Tripp, LCSW
Katie Tripp works with individuals experiencing anxiety, OCD, and related disorders, providing care that is both compassionate and goal-oriented. She integrates CBT and ERP-informed strategies to help clients make meaningful progress while maintaining a sense of safety, dignity, and agency throughout treatment.
A Final Word to Physicians Considering IOP Treatment for OCD
OCD among physicians is common, often hidden, and can be exhausting. Intrusive thoughts, compulsive behaviors, and perfectionistic tendencies are amplified by the demands of practicing medicine, but effective treatment is available. An Intensive Outpatient Program (IOP) can provide structured, evidence-based care tailored to the schedules, responsibilities, and unique pressures of physicians and other healthcare professionals.
With early intervention, professional guidance, and supportive strategies, physicians can manage OCD symptoms, maintain high-quality patient care, and preserve personal well-being. Freedom is possible, and evidence based treatment for OCD can allow physicians to regain focus, energy, and confidence in both professional and personal life.
If you would like to learn more about Intensive Outpatient Program (IOP) treatment for OCD, or if you are ready to schedule an IOP consultation with our IOP Coordinator, Dr. Samantha Myhre, please contact us at hello@austinanxiety.com or call 512-246-7225.