Physician Impairment due to Substance Use Disorders

John B Schorling, MD, MPH


November 20, 2009

Case Conclusion

Once the drug use was detected, Dr. Z was immediately removed from clinical duties and placed on leave. His supervisor contacted the local hospital physician wellness program. The chairperson met with him and recommended treatment at a residential facility specializing in the care of physicians with substance dependence. Given that the alternative would have been the loss of his clinical privileges, Dr. Z agreed, and an admission was arranged. He also enrolled in the state physicians' health program, and a report of his impairment was made to the Board of Medicine because his state has a mandatory reporting requirement. He successfully completed the 3-month residential treatment program. Following this, Dr. Z signed a 5-year contract for aftercare with the state physicians' health program that included seeing a therapist and a primary care physician, attending regular support groups and 12-step programs, having a worksite monitor, and regular drug testing. He was cleared to return to work with work-hour restrictions, and he resumed his practice. Dr. Z continued to be productive but no longer felt compelled to take on extra work. The Board of Medicine issued a stay of disciplinary action that was based on no evidence of actual patient harm. There will be no official record of his impairment as long as he remains abstinent and complies with his aftercare program. Dr. Z has been able to do this and has had no evidence of relapse.


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