Programs used frequently to treat physicians with substance abuse or mental health problems have fallen under criticism due to a relative lack of oversight.
In 47 states, physicians suspected of workplace impairment or erratic behavior are likely to be referred to a Physician Health Program (PHP), writes J. Wesley Boyd, M.D., Ph.D., in Medxpress. In his experience, these services tend to operate with a lot of power and little oversight. They also tend to recommend costly services provided by evaluation centers with which the PHPs have financial ties. For example, a recent audit of a PHP in North Carolina noted poor oversight, lack of due process for physicians and the potential for financial conflicts of interest. In Michigan, healthcare staff involuntarily subjected to unnecessary substance abuse treatments have launched a class action suit against the state’s PHP.
When physicians disagree with a PHP’s recommendations, they have few options, according to Boyd. That’s because PHPs generally report noncompliance to state medical boards, which puts doctors’ licenses on the line if they raise objections.
On the other end of the spectrum, stories about physicians who continue to practice despite previous instances of behavioral issues or drug abuse have generated calls for greater transparency surrounding the disciplinary process, as FiercePracticeManagement has previously reported.
Given the stigma attached to seeking mental health treatment, doctors need to trust that evaluations and recommendations they receive are fair, says Boyd. To be effective, the evaluation process must be “transparent, fair, free of bias, not driven by a profit motive and have legitimate avenues of appeal if the physician feels he or she has been treated unfairly,” he writes. In order to make the system more consistent from state to state, he calls for a set of national standards implementing more frequent and stringent oversight, as well as the severing of financial ties between treatment centers and PHPs.