The Impaired Physician

How Impaired Physicians Can Be Helped

Neil Chesanow

Disclosures

February 24, 2015

In This Article

More Than Just Treatment for Addiction

PHPs also differ in the scope of services offered. "Some PHPs strictly adhere to substance abuse disorders, which about 10%-15% of physicians will have a problem with at some time," says psychiatrist and addiction medicine specialist Doris C. Gundersen, MD, president of the FSPHP and associate medical director of the Colorado PHP in Denver. "Some of the larger programs, such as those in Colorado, Washington, Massachusetts, and North Carolina, address all health problems."

The Colorado PHP, for example, monitors chemical dependency, mental health problems, behavioral health problems, sexual misconduct and/or boundary violations, physical illness, and stress management. The stress and associated emotional issues addressed may arise from burnout; malpractice litigation; life-stage/developmental issues; career transition; or family issues, such as divorce.

"Here in Massachusetts, with about 35%-40% of the doctors who come through, a major piece of their difficulty is alcohol and drugs," Dr Adelman says. "With about 25%-30%, it's psychiatric problems. Most of the rest would fall into two areas: problems performing in the workplace, and occupational stress and burnout. There's also a fifth category: neurocognitive and medical problems."

Regardless of their scope of services, however, PHPs tend to function similarly. They don't provide services themselves. Instead, they serve as overseers, referring physicians to appropriate specialists for evaluation and treatment—which may include residential treatment in the case of doctors with severe substance use disorders—as well as monitoring, which can last for 5 years, and, at least initially, is frequent.

"We are health-conscious organizations interdigitated between the physician and the larger systems in which he or she works," Dr Earley explains. "We do intake calls, triage of individuals, and referrals. We also oversee treatment to ensure it's of high quality. And then we do longer-term care through monitoring."

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