Who Can Participate in a Physician Health Program?
While originally developed in the late 1970s for the benefit of addicted doctors, PHPs have gradually broadened their focus to include other health care professionals (such as dentists, veterinarians and pharmacists) and other ailments (such as other psychiatric disorders, disruptive behavior, professional boundary issues, physical disabilities and cognitive disorders).
Do All States Have PHPs?
In recent years, PHPs have come under fire by groups that believe addicted doctors should be punished rather than rehabilitated. As a result, many states have seen the elimination of programs designed to aid addicted doctors. All but four states – California, Georgia, Nebraska and Wisconsin – have physician health programs. In non-PHP states, addicted doctors must find the motivation and resources to seek out treatment on their own, leading many to hide a substance abuse problem until it is extremely advanced and increasing the likelihood of loss of license, professional disciplinary action and patient harm.
Who Should Contact a PHP?
There are different ways to get involved with a physician health program. Doctors can self-report or report a colleague, and employers are encouraged to refer physicians suspected of a substance abuse problem. For 55 percent of doctors enrolled in a PHP, involvement is formally mandated by a licensing board, hospital, malpractice insurance agency or other organization. Family members and patients can also report an addicted physician.
Does Long-Term Monitoring Produce Lasting Change or Merely Compliance?
It does both. At first it is likely that addicted physicians comply with treatment and monitoring to protect their license and career. What often happens is that the support of peers and gradual process of healing shift physicians’ motivation from simply obeying the rules to wanting to change their lives.
Can Recovering Doctors Return to Work?
Approximately 75% to 85% of recovering doctors are able to remain abstinent and return to work. Before completing treatment, physicians undergo an assessment to determine their ability to return to work. While some physicians are able to return to practice immediately following treatment, others may need outpatient treatment or a specific period of abstinence. In some cases, the physician may need to consider a different specialty or type of practice, or adjust their hours or shift. Only a very small percentage of physicians will not return to medical practice.
Are There Special Considerations for Addicted Anesthesiologists?
Anesthesiologists are overrepresented in physician health programs (likely because of ease of access to controlled substances) and are much more likely to abuse powerful opioids such as fentanyl and sufentanil. Although their return to work tends to be more controversial, recent studies show that anesthesiologists monitored by physician health programs have high success rates and excellent outcomes.