In 2017, a team of researchers led by Dr. John S. Rose of the University of California, Davis Health System, analyzed the data from a 5-year longitudinal cohort study[1] conducted to evaluate the effectiveness of U.S. physician health programs (PHPs) in treating physicians with substance use disorders (aka addiction to alcohol and/or drugs). The purpose of this analysis was to determine how successful PHPs were in aiding the recovery of family medicine physicians (FMPs) with substance use disorders, in comparison with non-FMP physicians.[2]
To offer some initial background, it would be good to note past research has identified the rate of addiction in physicians to be about the same as the general population (10-15%).[3] Given the implications of this statistic—in terms of the potential for physician impairment due to substance abuse—and to most effectively address a variety of public health and safety concerns, many states have established PHPs to, per the American Society of Addiction Medicine (ASAM), provide “a non-disciplinary, confidential conduit for professionals to access comprehensive evaluation, any necessary treatment, and monitoring of health status.”[4]
PHPs, then, share the dual role of helping addicted physicians attain sobriety and maintain their personal recovery, as well as “providing assurance to colleagues, hospitals, insurers, licensing boards and the general public that these physicians can practice safe care.”[5]
Generally speaking, the processes used by PHPs include clinical assessment, referral for treatment, and support and monitoring after treatment, usually for a period of five years.
Based on the outcomes of the study by Rose, et al, the results can be viewed as evidence that the combination of identification, intervention, formal treatment, professional support and monitoring by physician health programs is effective in rehabilitating most of the addicted family medicine physicians, over at least five years.
From a public safety perspective, the data indicate that “most family medicine physicians who could not or would not stop their misuse of substances were detected early during the course of formal treatment, and this usually resulted in voluntary or involuntary cessation of practice.”[6] And from a policy perspective, it was concluded that “affected physicians are well advised to enter the supervision of a physician health program voluntarily, and that regulatory boards are well advised to continue supporting these programs.”[7]
On the basis of this study’s results, and considering available alternatives, PHPs seem to provide the best available measures for protecting patients and for recovering physicians’ careers.
In a public policy statement issued on Feb. 6, 2020 by the American Society of Addiction Medicine, (ASAM), it was concluded that “the interest and safety of the public are best served when state regulatory agencies, PHPs and, when involved, clinicians with expertise in the treatment of addiction in healthcare professionals work in concert to develop a confidential process allowing for early intervention, evaluation, treatment and return to practice with subsequent monitoring of the professional with addiction.”[8]
And given the results of the study by Rose, et al noted in this article, the reported outcomes for substance use disorders in family physicians who are PHP participants present a hopeful picture of success for those who want to recover from their substance use disorder and return to work in service of their patients and the community.
[1] https://www.bmj.com/content/337/bmj.a2038
[2] https://pubmed.ncbi.nlm.nih.gov/28067757/
[3] Bennett, J., & O’Donovan, D. (2001). Substance misuse by doctors, nurses, and other healthcare workers. Current Opinion in Psychiatry, 14, 195–199.
[5] https://www.bmj.com/content/337/bmj.a2038
[6] Ibid.
[7] Ibid.
