Class Action Lawsuit Hits Michigan Professional Health Program

The Health Professional Recovery Program (HPRP) is a Michigan organization established to give health professionals a discreet, non-disciplinary avenue to handle substance abuse disorders and mental health problems. A lawsuit was recently filed in federal Court by three mid-level providers claiming damages against this organization alleging constitutional violations, financial conflicts, lack of oversight, and due process. The HPRP is designed to track treatment of health professionals referred to them and is administered by a private contractor. The plaintiffs assert that the administrators of the program are overruling treatment decisions by doctors and coercing people into selected treatment facilities that are additionally charged with supplying the first evaluation of the need for treatment. These facilities are costly and usually not covered by insurance because these programs are deemed not medically necessary.

Several other programs designed to assist in the treatment of health professionals with mental health or substance abuse problems have also come under fire for coercion and monetary double dealing. A concerning pattern seems to have emerged in which these agencies that were initially using  volunteer boards directed at helping doctors return to practice safely now contain doctors who are closely tied to treatment facilities or drug testing firms. A chain of recent posts on SERMO, the world's largest physician-only social network, got a great deal of attention. It's clear that there have been a lot of abuses and also a lack of due process for participants in these sorts of situations. Physicians can also be subject to polygraph tests, a practice most Americans would never accept. The term "disruptive physician" is an easy method to target those who speak out against the system.

Are you aware of a colleague that has self-reported or has been reported for substance or mental health issues? Maybe you've experienced a period of mental health crisis in your own life. How did you handle reporting demands? What rightsshould physicians have?

Impaired Physicians: Whose Responsibility is it?

Addiction affects approximately 10% of the general population at any one time. Doctors are affected by addiction at a comparable rate. Addiction affects all facets of a person’s lifestyle – marriages are ruined, private lives crumble, and work performance suffers. It is the work performance that troubles people the most since an impaired physician may cause a whole lot of injury to others. Physician health plans (PHPs) have been in place in many states to aid doctors afflicted with substance abuse. They're able to give treatment and assistance to help the physician maintain his/her career. They also can offer future follow-up and monitoring of the physician. PHPs have a wonderfully high success rate for doctors around 80-90% long lasting success. The reasons for this large achievement rate involve highly motivated patients, rigid adherence, and long-term follow-up and monitoring. However, the use rates for these PHPs is quite minimal, most likely because of worry about these organizations reporting back to state licensing boards, concern with disciplinary action, losing one’s license, and career damage. Since PHPs do not generally report back to licensing boards such fears are unfounded.
Physicians often ignore or do nothing if they suspect there is a colleague suffering from substance abuse for concern with damaging his/her career. Physicians can also be very cautious to turn to a PHP by themselves. Generally, colleagues, businesses, or couples are the people to start the treatment. Luckily, following the development of PHPs, significant serious preventable events due to impaired physicians has dropped greatly and many physicians are referred to PHPs for before a major event can occur. If a major event does occur, the AMA established precedence a long time ago stating: “it is the physician’s ethical responsibility to take cognizance of a colleague’s inability to practice medicine adequately by reason of physical or mental illness including alcoholism and drug dependence.”

Please let us know what experiences you have had with repercussions of not reporting a physician who is impaired due to alcohol or drugs.