Tuesday, December 18, 2007

Doctors in Rehab Still Practicing Medicine

Interesting report on MSNBC today about doctors in rehab in California who are allowed to obtain confidential drug and alcohol treatment while continuing to provide patient care. Here's the url: http://www.msnbc.msn.com/id/22314486/

Oregon has a similar program of confidential drug and alcohol treatment for physicians. Here is the url for the Board of Medical Examiners summary of the program: http://oregon.gov/BME/healthprog.shtml. The statutes codifying the Oregon program are ORS 677.615-677.677.

The MSNBC article notes that many drug and alcohol treatment professionals and the American Medical Association support these types of programs. According to the AMA, allowing an impaired physician to continue treating patients encourages impaired doctors to seek treatment. Of course, the article also notes that California is ending its program because a review revealed that the confidential program failed to protect patients. And it also failed to encourage doctors to receive treatment.

The California experience provides hard data that undermines the AMA's position. My perspective is surely colored by representing patients, but even so, there is something horrifying about a patient not knowing about a doctor's impairment.

If you have any doubt about this in the abstract, consider a fairly simple hypothetical question. Would you want a surgeon who is addicted to drugs performing surgery on your child? If the answer is, "Of course not," then it's easy to see the problem with the confidential approach that allows impaired doctors to continue treating patients.

The AMA should be advocating for quality of care, and the California experience makes clear that the current system delivers lower quality care. An impaired doctor can be dangerous to patients. If the impairment is kept confidential, the very least that should happen is that the doctor should take a leave so that patients have confidence in their physician. Alternatively--and it's a radical alternative--remove the confidentiality so that patients can choose. I imagine the radical alternative would horrify the AMA and the Oregon Board of Medical Examiners. I could see that reaction. But if you're not going to give patients the information they need to protect themselves, then you surely should take the impaired physician out of circulation.

David F. Sugerman
Paul & Sugerman, PC

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