Pubdate: Tue, 23 Sep 2003 Source: Charleston Daily Mail (WV) Copyright: 2003 Charleston Daily Mail Contact: http://www.dailymail.com/ Details: http://www.mapinc.org/media/76 Author: Therese Smith Cox, Daily Mail Health Reporter Effort Helps Doctors PEER GROUP HELPS PHYSICIANS RECOVER FROM DRUG ABUSE Just before Thanksgiving 1989, the lifeless body of a 29-year-old physician was discovered in a doctors' lounge at Ruby Memorial Hospital in Morgantown. An autopsy revealed the anesthesiologist, Dr. Thomas Cianciolo, died of asphyxiation after injecting a hallucinogenic drug. The medical examiner also found traces of a second anesthetic drug with morphine-like effects. Stunned family members sued, saying hospital staff negligently overlooked signs of drug abuse in the third-year resident in training. "He would be here if somebody didn't look the other way," Cianciolo's mother said in a deposition. The case ultimately was settled for an undisclosed amount. Even then, some states had proactive programs aimed at helping drug-abusing doctors. Nearly 14 years later, all have such programs except Nebraska and West Virginia, said Dr. Brian McDevitt, a Mingo County family practitioner and medical director of the West Virginia Professional Advocacy Group Effort. "We are so far behind other states," McDevitt said. McDevitt said hospitals and the state Board of Medicine don't do enough to help rehabilitate impaired physicians. His private organization advocates for and monitors recovering health professionals, including physicians, pharmacists and nurses. "WV-PAGE strives to facilitate and promote the health and well-being of impaired professionals through a supportive, non-threatening program run by peers," the group's brochure says. "Early intervention is advantageous, before serious consequences occur." Indeed, success is possible if the physician seeks help and sticks with the recovery process, said Dr. C.R. Sullivan, an addiction specialist at Chestnut Ridge Hospital, part of West Virginia University Hospitals. "A recovering physician is sometimes the best doctor you're going to find," Sullivan said. "I know several who are absolutely terrific doctors. The bigger issues are those still trying to keep hidden. It's a constant issue. The problem is those you don't know about." Sullivan said 7 percent to 10 percent of physicians end up with drug or alcohol problems. Dr. David Dodd, director of the Tennessee Medical Foundation's Physician Health Program, said some physicians turn to chemicals for relief from emotional turmoil. "Many physicians are so idealistic and perfectionistic and work-addicted in the name of healing everyone else that they don't know how to handle their personal and emotional lives," Dodd told the American College of Physicians Observer. "Much of this is a byproduct of the obsessive-compulsive traits engendered by the education and training process of medicine." Many doctors in West Virginia keep their substance abuse secret and don't seek help, fearing repercussions from the state Board of Medicine, McDevitt said. "Nationally, West Virginia has the reputation for being very punitive," McDevitt said. "Unfortunately, because of their beliefs, they act in a way that is harmful to physicians, rather than in a way that's understanding and compassionate." By state law, a physician may go to the Board of Medicine and sign a voluntary and confidential agreement to go inactive and enroll in a treatment program, said Ron Walton, executive director. If the physician fulfills requirements - often monitoring by another doctor and attendance at 12-step meetings - he will receive no discipline and may regain his license. The state Board of Osteopathic Medicine has a similar policy. Currently, the medical board is monitoring five physicians with voluntary agreements. The osteopathic board has just released two physicians on the agreements, spokeswoman Cheryl Schreiber said. On license renewal applications for both boards, physicians must disclose if they have received treatment for substance abuse problems. The Federation of State Medical Boards of the United States, composed of 70 separate boards of medicine, reports 77 physician health programs - those for impaired physicians - exist. Of those, 22 are directed by boards themselves; state medical associations sponsor 31; and there are 24 others not associated with either. Lisa Robin, vice president of leadership and legislative services for the federation, said boards of medicine should help impaired physicians get well. "This is a problem in our society," Robin said. "It falls under the disciplinary areas of the board to manage all sorts of problems licensees would have. Managing impaired physicians is one area of responsibility." For years, the West Virginia State Medical Association offered its members help in recovery through a special committee. But since the long-time chairman, Dr. Thomas Haymond, died a few years ago, the committee has not been active. "Doctors are human just like everyone else," Executive Director Evan Jenkins said, noting that patient care is paramount. As part of its review of hospitals, the Joint Council for the Accreditation of Healthcare Organizations mandates that hospitals offer a process to encourage physicians to get help. Hospitals have an obligation to protect patients from harm, the council's standard says. "The purpose of the process is assistance and rehabilitation, rather than discipline, to aid a physician in retaining or regaining optimal professional functioning, consistent with protection of patients," the standard says. Though it has not been implemented yet, Charleston Area Medical Center has a new physician wellness program, which places a mentor with the physician asking for help. The process stresses assistance and rehabilitation rather than punishment. "They can self-report without fear of losing their privileges," said Dr. Glenn Crotty, CAMC's chief operating officer. McDevitt stressed that doctors with substance abuse problems are sick, not bad. "The Board of Medicine doesn't go after a physician with diabetes or high blood pressure, or gambling problems, or depression," McDevitt said. "We have to recognize that stress levels they work under right now are critical. Impairment percentages in the population are going up. People are not learning how to cope with the stress. They're seeking another way." McDevitt said some physicians are impaired but never detected. "Statistics say 10 percent of physicians need to be monitored," he said. "In order to have that, you need to have a diversion program that is trusted and utilized." The state Board of Medicine recently disciplined a local physician for a matter other than substance abuse. But the physician said he has struggled with alcohol and asked the board to start a proactive physician health program to help him and others. "They say they don't have the money," the physician said. "I say they can't afford not to." - --- MAP posted-by: Richard Lake