Physician Health Programs for Addicted Doctors
Drug addiction runs rampant among medical professionals. USA Today reports, “Across the country, more than 100,000 doctors, nurses, and technicians and other health professionals struggle with abuse or addiction, mostly involving narcotics such as Oxycodone and Fentanyl.” What sets doctors and nurses apart from other professionals is their accessibility to highly addictive drugs. With highly sought-after drugs within reach, the temptation to use them can quickly start and continue an addiction.
Most doctors are reluctant to seek addiction treatment because they fear people will find out, which could lead to not only criticism but also licensure problems. There’s also debate among many medical professionals that addiction treatment is ineffective, which compounds the risks of exposure.
The reason addiction treatment does not work for many medical professionals is that they didn’t seek the right type of addiction treatment.
Why Doctors Need a Different Type of Addiction Treatment
Doctors may have the same disease as others who are abusing drugs, but their thought processes are different. Addiction isn’t just a physical dependency on a chemical introduced into the body, there’s also a mental, emotional, and for many people, spiritual dependency.
When addiction treatment is generalized to cover a large population of people who differ in how they think, feel, and believe, it is ineffective. The counseling and education do not apply to them, so they walk away from treatment without the tools they need to remain drug-free.
For doctors, the stakes are higher in the event of a relapse after treatment. A doctor who relapses puts their patients at risk, as well as themselves. Therefore, accountability must be a part of the treatment plan for addicted doctors seeking treatment. This accountability occurs naturally if the doctor is referred to the PHP by a practice partner or the licensing Board, but must be encouraged to be voluntary otherwise. When they understand that voluntary accountability leads to much better outcomes, many agree.
The Answer to Treating Addiction in Medical Professionals
The goal of treatment for doctors addicted to drugs is to improve long-term outcomes and promote lifetime recovery. The current system isn’t working, which is why there needs to be a new standard of addiction treatment through Physician Health Programs (PHPs).
PHPs are not run like traditional addiction treatments. They are not disciplinary or linked with law enforcement in any way. They are also not associated with licensing organizations.
PHPs provide active care managers to oversee long-term care, which includes assessment, treatment, drug testing for accountability.
Doctors will work with caregivers, doctors, and counselors to cover all areas of addiction recovery. Caregivers provide consistent monitoring and support, doctors focus on the physical aspects of the addiction, and counselors work on the mental, emotional, and spiritual side of drug dependency.
The success of PHPs depends on the incentives for compliance with the program, as well as the consequences of non-compliance. Incentives include higher recovery rates and advocacy, when needed, with 3rd parties. Consequences may include relapse, loss of job, expenses associated with additional treatment and potential legal fees. Most people enter treatment due to outside influence, whether or not they feel they are “ready” or have “hit bottom.”
After voluntarily entering the PHP, if the physician fails to adhere to the PHPs’ recommendations or returns to alcohol or drug use, they face potential loss of the safe harbor of the program. In other words, they may start down a path toward sanctions on their medical license.
The known consequences of non-compliance with PHPs may seem counterproductive in encouraging doctors to enter PHPs, but in reality addicted doctors who enter PHPs usually do so because of the dramatically increased recovery rates the programs demonstrate. When physicians know their lives and careers depend on their success in the PHPs, they are more likely to follow the recommendations that produce the best outcomes.
PHPs are also for physicians who desperately want to stop the cycle of addiction, but doubt the effectiveness of traditional treatment modalities due to trying it before or general knowledge. When physicians are ready to end their addiction, they know PHPs will hold them to that decision.
The Goals of PHPs Beyond Recovery
PHPs are not only available for physicians ready to treat their addiction but they also:
- Assess and evaluate potential problems
- Identify and treat comorbid conditions
- Provide long-term contingency monitoring
These aspects of PHPs can help reduce the rates of physician addiction by catching the disease in the early stages, treating possible causes of addiction (such as mental illness), and keep physicians in recovery for life.
What to Expect with PHPs
Evaluation and intervention begin the process of working with PHPs. After identifying, most physicians start with quasi-residential treatment, even though outpatient treatment is available.
Following quasi-residential or outpatient treatment, physicians receive support from Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or similar programs. Many physicians are required to have worksite monitoring, and agree to drug testing four times a month the first year and then 20 tests a year, each year afterward.
Results of PHPs
A longitudinal study conducted on PHPs reveals they are effective in helping physicians recover from addiction. Out of 904 physicians admitted to 16 PHP programs with 802 in the 5-year follow-up, 64.2% or 515 physicians completed the contract, and 16.4% or 132 physicians extended the contract. Only 19.3% or 155 failed to complete the contract. At the 5-year follow-up, 78% of the participants still had their licenses or were working.
Why PHPs Work
PHPs work because they promote abstinence-based treatment with serious consequences for non-compliance. While most people believe this would turn physicians off from the programs, that is not the case because the results are impressive with:
- Lower rates of use
- Higher rates of long-term success
- Lower rates of failure
Part of the success of PHPs is the “Behavioral Triage” aspect of the treatment. It is only for physicians who need it to stay clean and sober, and they must choose it. The goals of the participating physicians and PHPs align in achieving success over the addiction.
Traditional addiction treatment for physicians doesn’t work as well because:
- There is infrequent or no drug testing, and most of the tests are scheduled instead of having frequent, spontaneous drug testing.
- Delayed responses to positive or missed tests and missed appointments cause people not to take them seriously, while PHPs responses are immediate.
- Traditional treatment is short term for a long term problem.
- Treatment programs either underuse or don’t use the 12-step programs, which have been shown repeatedly in studies to be highly effective in long-term recovery.
The Future of Addiction Treatment for Doctors in PHPs
The new PHP paradigm clearly impacts drug and alcohol addiction among doctors, offering positive solutions to a difficult problem. Offering this addiction recovery to doctors allows them to participate in their own recovery and take back control over their lives, along with keeping their career intact, as long as they follow through with the contract. The PHP recovery model deserves the support of professionals and the public for the dramatic positive impact on Public Health. PHPs also serve as a model to emulate in the treatment of addictive disorders in all people. If it’s good enough for a doctor, we should pay attention.
How BoardPrep Recovery Can Help
As an approved provider for many PHP programs across the Nation, BoardPrep stands ready to guide each doctor in considering PHP participation as part of their recovery process. Some doctors come to us without prior knowledge or involvement with PHPs. PHP participation is always voluntary and ultimately the personal choice of each person whether or not to participate. With over 20 years of PHP experience, the trusted advisors at BoardPrep know the best approach for each doctor in our care. For more information, please contact the BoardPrep Clinical Director for a confidential consultation.