Physician health programs refer addicted doctors to some of the nation’s most respected drug treatment centers, many of which offer specialized abstinence-based programs for addicted professionals and staff who are experienced in treating health care providers. Although these treatment programs vary in their approach, there are certain features that have been correlated with successful outcomes, including:
A multidisciplinary team gathers a detailed substance use history, complete medical history, physical examination, screening for memory and cognitive impairments, and information from family, friends, coworkers and other parties. A comprehensive evaluation will also identify any co-occurring psychiatric or medical diagnoses that may influence treatment success.
Based on the findings of the evaluation, the staff designs an individualized treatment plan that meets the specific needs of the addicted doctor. In general, treatment occurs on a residential basis and includes detoxification, education about addiction, individual and group therapy, family counseling, 12-Step meetings and profession-specific peer support groups, life skills training, and relapse prevention planning.
While in treatment, physicians participate in a number of therapeutic activities designed to help them understand and accept their addiction, maintain sobriety, repair relationships, prevent relapse, and facilitate their return to productive employment. Because of the public health consequences of relapse, most addicted doctors are treated more aggressively and for longer periods than the general population (90 to 180 days compared to 30 days).
Support Groups for Impaired Physicians
Support groups, in the form of both 12-Step meetings and profession-specific meetings (such as Caduceus meetings), can be a powerful component of treatment. They provide physicians with additional opportunities to confront denial, overcome feelings of shame, and learn from the experiences of other addicted professionals and people in long-term recovery. Support groups also play an important role in the physician’s support network during and after treatment.
In addition to threatening harm to the physician and their patients, addiction negatively impacts doctors’ spouses, children and other family members. Studies suggest that outcomes improve when family members are involved in the treatment and rehabilitation process.
What sets physician health programs apart is their emphasis on long-term monitoring. Following discharge from an inpatient program, physicians may commit to an outpatient program and ongoing monitoring which includes random drug testing, reports from a worksite monitor, documented group therapy attendance, stress management, and other recovery-oriented activities for five years or more. Once stabilized, the PHP will work with the recovering doctor to determine whether return to practice is appropriate.
In most cases, return to practice is contingent upon the physician completing a performance-based assessment of their competency to complete job-related tasks and signing a contract detailing the expectations for continued recovery and professional conduct. Failure to adhere to the contract’s terms often results in a return to treatment and/or a report to the state licensing board.
A Dire Need
The importance of obtaining treatment for addicted physicians cannot be overstated. Drug abuse has been directly correlated with physician suicide, along with accidental injury, job loss and legal problems. Beyond harm to the physician, patients, hospitals and clinics are put at risk of incompetent care and malpractice. Identifying a problem and taking action are the first steps toward preventing these risks.