Pubdate: Wed, 14 Jul 2004 Source: USA Today (US) Copyright: 2004 USA TODAY, a division of Gannett Co. Inc Contact: http://www.usatoday.com/news/nfront.htm Details: http://www.mapinc.org/media/466 Author: Terrance M. Bedient Bookmark: http://www.mapinc.org/rehab.htm (Treatment) CONFIDENTIALITY WORKS BEST There are sound reasons for not reporting physicians with substance-abuse problems to the state licensing board unless they refuse to stop working, refuse treatment or both. Eliminating the opportunity to receive confidential assistance would discourage physicians from seeking treatment. Delaying medical care would negatively affect not only physicians' health, but, more importantly, the health of their patients. Doctors who enter treatment should be able to do so confidentially under the auspices of a well-structured physician-health program. Such programs, which exist in most states, monitor recovery closely and act immediately to remove a problem physician from service. Instead of waiting until patient harm occurs, these programs best serve the public through pre-emptive action to bring a physician's substance abuse into remission early in the disease process. When doctors are diagnosed with a substance-abuse disorder, some decide to retire from medicine. Of those who want to continue in medicine and seek treatment through New York's physician-health program, about 95% remain abstinent. This is extraordinary compared to recovery rates for the general population: Of those who voluntarily attend a treatment program, fewer than 50% remain abstinent. Part of the success of doctors in New York's program can be attributed to the fact that they sign contracts to continue treatment for five years. Reporting all recovering physicians to licensing authorities is not the solution. Such reporting would further stigmatize this disease and delay physicians from receiving treatment until their disorders have progressed to a serious stage. Unfortunately, many state laws define physician substance abuse as misconduct, and if a licensing board learns of the abuse, it is obliged to discipline a physician even if there is no evidence of impaired judgment or patient harm. The public is best protected by encouraging confidential treatment at the earliest possible time, without recrimination. Terrance M. Bedient is director of the Committee for Physician Health, a service of the Medical Society of the State of New York. - --- MAP posted-by: Thunder