The concept of the "impaired physician" is an oxymoron. Physicians are by definition bearers of health, which can lead to overlooking the possibility of them contracting an illness that reduces their diagnostic and therapeutic abilities, with a consequent danger to their patients' health. The clinical reasons for which a radiologist may constitute a danger to patients can be divided into two categories: infectious blood-borne diseases, which can be transmitted to the patient during interventional radiology procedures; and neurodegenerative and psychiatric disorders, including alcohol and drug abuse, which temporarily or permanently impair the faculty of judgement. All radiologists have a duty to periodically verify their own state of health and seek help as soon as possible when they fear it may be a danger. This individual responsibility towards one's own patients is flanked by the health and safety requirements provided by European regulations for radiologists who are employers, directors or department heads. The occupational health physician plays a key role in identifying and managing the impaired radiologist.