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. 
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