Physician Health Programs are Essential for Protecting Public Health

There’s been a lot of recent attention on the problem of substance use in the medical community, particularly in the wake of the pandemic. And rightfully so. Even before COVID-19 caused overwhelming heartbreak and workloads for doctors, nurses and other health professionals, alcohol and prescription drug misuse among these groups far exceeded that of the general population. 

In fact, nearly 70% of doctors admit they had misused prescription medicine to cope with stress and physical or emotional pain. I know because I was once one of them. As a family medicine doctor back in the early 2000s, I first turned to drinking and then to opioid drugs to cope with the stress. Soon, I spiraled out of control and began writing fraudulent prescriptions to supply myself with thousands of opioid pills a month. 

Getting Help Changed My Life—and My Career

By the time the DEA burst into my small practice, I was barely functional and suicidal. If I’m being honest, getting caught probably saved my life—and maybe the lives of some of my patients—because it put me on a path to treatment and, eventually, toward the career that I love so much today: working as an addictionologist to help others win their battle over addiction.

Because I know exactly what it’s like to be a physician with a drug problem, I also know what it’s like to live in fear every day that I’ll either harm someone by practicing under the influence, or that I’ll be caught and lose my practice, my license, and everything I’ve worked so hard to achieve. But today, I’m living proof of the tremendous success that physician health programs (PHPs) have in helping dedicated medical professionals overcome addiction so that we can continue doing what we love and protect the public. 

Physician Health Programs Aid Recovery

While patients might hear the statistics on the number of medical professionals who struggle with addiction and be afraid their doctor or nurse might be in recovery, the truth is they may be in much safer hands than with one who isn’t. In fact, providers who participate in a PHP are guaranteed to be sober and in good psychiatric health.

Physician health programs (formerly known as impaired professionals programs) are rigorous protocols offered in 47 out of 50 states that are specifically designed to help protect the public health and keep good practitioners on the job by treating their addiction and managing their recovery. PHPs are completely different from a conventional recovery program in that they have rigorous evaluation, testing and follow-up protocols that last up to 5 years. And PHP providers work closely with each state’s board of medicine to manage the entire program.

Medical providers are first referred to PHPs through one of several means: their hospital/employer, coworkers, friends/family or interaction with the criminal justice system, quite often after a DUI or other infraction. As part of treatment, every provider undergoes a stringent fitness for duty assessment (mental health evaluation providing feedback about an employee’s mental fitness to perform a specific job) and diagnostic evaluation by an addiction medicine physician that includes psychiatric testing, and a complete toxicology screening of blood, hair, and nails. 

Based on these findings, the provider is recommended for a specific detox, cognitive behavior therapy and inpatient or outpatient treatment program. Once that program is completed, the provider undergoes another fitness of duty evaluation. If deemed fit, the professional may return to their practice only after signing a 3- to 5-year contract with the PHP, committing to routine toxicology screenings, weekly facilitated group meetings and other long-term interventions.

Fitness of duty evaluations are performed regularly, along with 2 to 4 random toxicology tests per month. A workplace sponsor is assigned to monitor the provider’s progress and submit monthly or quarterly reports documenting the professional’s conduct and sobriety. 

As a PHP graduate myself, I can personally attest that these programs are accessible, affordable, and overwhelmingly successful. They’re discreet and easy to manage alongside the demands of a busy medical career.

Getting Help is the Only Way to Save Your Career

While many medical professionals are reluctant to admit they have a substance use disorder out of shame or fear of losing their career and ruining their reputation, PHPs actually do just the opposite: They save medical providers’ careers. In fact, several studies have shown PHPs have a remarkably high success rate, including 84% for emergency physicians, who are historically more at risk than those in most other specialties. 

The truth is, a PHP may be the only option a provider has to save their career. Continuing to practice under the influence of drugs or alcohol is obviously risky, and it’s only a matter of time before substance use becomes a problem. At best, impaired professionals risk disciplinary action, job loss, license revocation, and career-ending reputation damage. At worst, they could harm someone permanently, or make a fatal error. Admitting you need help is nothing compared to living with that guilt for the rest of your life. 

For any physician, physician assistant, nurse practitioner, LPN or RN who’s struggling with addiction, entering a PHP to get the help you need is the smartest, most responsible investment you can make in your career.

Charles Smith, DO, is an addictionologist at the Recovery First Treatment Center, an American Addiction Centers facility.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.