Addicted Doctors Still Treating Patients

[167649]

Anyone seen this big story that has been airing on CNN this week? It regards the highly controversial programs which admit physicians with substance abuse problems, and treats them anonymously while they are still allowed to continue their practice:

http://www.cnn.com/2008/HEALTH/03/31/kaye.addicteddoctors/index.html?eref=ib_topstories#cnnSTCText

The argument is that patients should know when their physicians have subtance abuse problems, and doctors who are enrolled in the treatment programs should be known to the public, or stripped of practice rights until they finish treatment.

CNN is clearly biased towards abolishing these programs. But I think the program does way more help than harm. Without it, physicians with these problems wouldn't seek treatment at all. Either way, their issues would be unknown to their patients, but in this case the profession wouldn't know about them either, and the doctor isn't getting any help.

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[146233]

I'm not sure I agree with these programs either, but I haven't thought about it very long. Look at all the people we incarcerate for drug abuse each year. It's simply staggering. Why should physicians be exempt from jail or prison time that many others must endure? They can get "treatment" in there.

That said, I'm also not sure I agree that physicians with substance abuse problems should be published, as if through some sex offender-esque registry. I'd prefer some sort of intensive supervision, if the physician is to practice at all.

 

[BluePhoenix]

I don't think doctors should be allowed to continue treating patients while dealing with a substance abuse problem. If it's a problem to the extent that they need help, it means that they aren't capable of controlling their behavior. The consequences of their actions can be huge for them, the hospital, and especially the patient. They should be allowed a leave of absence or something, to allow them to go seek treatment...and eventually allow them back once they've got the situation stabilized and under control. Here at the clinic, they can send you home if you've had 1 drink within 8 hours of your shift and you're not eligible to return for at least 8 hours....regardless of what your job is...tech, doctor, researcher. We're all adults here, if you can't control yourself, then you've got no business anywhere near a patient, I don't care how "able" you think you are.

 

[167649]

I agree with both of you (to an extent). I support that during the duration of the program they should take a leave of abscence and shouldn't practice. And if the physician is found to have practiced while under the influence, the abuse has affected practice in any way, or they refuse treatment, they shouldn't practice at all and suffer any legal consequences if it is deemed a crime was committed.

The issue i'm not sure about is should patients know about it when the physicians voluntarily admit themselves to the treatment program. I think patients have a right to know if they refuse to go into treatment, or they were caught practicing while intoxicaed or have a DUI etc. But the entire point of anonymous treatment is that the doc isn't afraid to seek help. Otherwise, facing huge career consequences, a lot of them who have these problems wouldn't seek help at all and I think more people would get hurt.

The movement and what CNN is pushing, from what I understand, is to ban the anonymous programs completely, not reform them.

 

[DeadCactus]

I'm all for these programs. A physician isn't going to give up their career (or even take a significant leave) to seek treatment and by the time they lose their career due to their problem, they'll have done far more harm than they would while enrolled in such a program.

We can pretend physician's should not get any special treatment, but at the end of the day that individual and society as a whole have invested far too much into a physician's skills for us to do anything short of everything we can to ensure those skills continue to be put to competent use. At the end of the day, these programs are more likely to reduce the number of physicians with chemical or mental problems than stricter programs would...

 

[BluePhoenix]

While I don't think we need to plaster the names of doctors seeking treatment all over the internet, I do think that someone should be notified. Odds are, if you're seeking treatment for a substance abuse problem...people know about it. Despite how much you THINK that you're keeping it under control and no one knows...people do. Why is it so hard to expect these doctors to act like professionals? They have an important job. If you can't handle your own behavior, you have to no reason to be at work and you need to take time off. If you need a daily breathalyzer test everyday when you get to work to show that you're not tipsy, then that's what you should get. Doctors need to take some responsibility for their actions. Just because you're a doctor doesn't make you so special that we should treat you with kid gloves and make sure no one knows you're wasted on the job...if anything, as you have people's lives in your hands, you should be treated more harshly due to your position.

 

[MattD]

Um, it's not like docs are getting a pass from the legal system. If a doc gets caught buying crack off an undercover cop, he's going to jail, not rehab. There are anonymous substance abuse programs available to people of all professions, that you can enroll in if you need the service. The docs who are 'forced' to go to rehab aren't 'sentenced' by the legal system, they're sent by their employers, or licensing bodies. It's not like the state board of licensure can send these docs to jail.

So I guess the real philosophical question for you guys is, should use of or addiction to 'drugs' be an offense reportable to authorities for prosecution? If so, then docs will need to report any patient who admits to or tests positive for drug use so they can be arrested, other docs included. If not, why should physicians be singled out for incarceration based on ANY report of addiction? That's rather unfair targeting, doncha think? In addition, should a physician automatically lose his/her career because they develop an addiction? Even if they've never been impaired or caused an injury while actually practicing? If not, these programs will help docs just like they help all other addicted individuals with getting control of their life. If so, good luck getting a doc to voluntarily seek treatment, and frankly, good luck getting people to report their colleagues. That's much more likely to lead to bad results.

 

[McPoyle]

Um, it's not like docs are getting a pass from the legal system. If a doc gets caught buying crack off an undercover cop, he's going to jail, not rehab. There are anonymous substance abuse programs available to people of all professions, that you can enroll in if you need the service. The docs who are 'forced' to go to rehab aren't 'sentenced' by the legal system, they're sent by their employers, or licensing bodies. It's not like the state board of licensure can send these docs to jail.

So I guess the real philosophical question for you guys is, should use of or addiction to 'drugs' be an offense reportable to authorities for prosecution? If so, then docs will need to report any patient who admits to or tests positive for drug use so they can be arrested, other docs included. If not, why should physicians be singled out for incarceration based on ANY report of addiction? That's rather unfair targeting, doncha think? In addition, should a physician automatically lose his/her career because they develop an addiction? Even if they've never been impaired or caused an injury while actually practicing? If not, these programs will help docs just like they help all other addicted individuals with getting control of their life. If so, good luck getting a doc to voluntarily seek treatment, and frankly, good luck getting people to report their colleagues. That's much more likely to lead to bad results.

You beat me to the point, these physicians are not necessarily breaking any laws simply by being an alcoholic, and should they ever get caught breaking a law would be subject to the same criminal penalty as anyone else. Look up things like drug court which offer treatment in exchange for criminal penalties.
As far as the anonymity goes, ya they should be able to deal with this privately, as much as people want to believe otherwise, its really none of our business what their medical history looks like.

 

[foster033]

I'm not sure I agree with these programs either, but I haven't thought about it very long. Look at all the people we incarcerate for drug abuse each year. It's simply staggering. Why should physicians be exempt from jail or prison time that many others must endure? They can get "treatment" in there.

Yeah, cause we've proven that drug treatment in prison works so well

 

[Lecter]

it's not abuse if you have a prescription!

 

[167649]

Um, it's not like docs are getting a pass from the legal system. If a doc gets caught buying crack off an undercover cop, he's going to jail, not rehab. There are anonymous substance abuse programs available to people of all professions, that you can enroll in if you need the service. The docs who are 'forced' to go to rehab aren't 'sentenced' by the legal system, they're sent by their employers, or licensing bodies. It's not like the state board of licensure can send these docs to jail.

So I guess the real philosophical question for you guys is, should use of or addiction to 'drugs' be an offense reportable to authorities for prosecution? If so, then docs will need to report any patient who admits to or tests positive for drug use so they can be arrested, other docs included. If not, why should physicians be singled out for incarceration based on ANY report of addiction? That's rather unfair targeting, doncha think? In addition, should a physician automatically lose his/her career because they develop an addiction? Even if they've never been impaired or caused an injury while actually practicing? If not, these programs will help docs just like they help all other addicted individuals with getting control of their life. If so, good luck getting a doc to voluntarily seek treatment, and frankly, good luck getting people to report their colleagues. That's much more likely to lead to bad results.

We both agree the answer is no. But I do think it should be a crime to practice while under the influence, or to practice when substance abuse off work could have a negative influence on your practice, because that is extremely dangerous for patients (and for the reputation of the physician). I think that having penalties for those things, along with an anonymous treatment program, would be ideal. Physicians who have abuse problems would be encouraged to take a leave of abscence from practice (or risk consequences) and go into the program, which would be anonymous and pose no risk to their career. Better for patients, better for doctors.

 

[pride4jc727]

I was really disturbed by that Dr. Brian West who was board certified in plastic surgery. That one lady who had a volleyball in her abdomen, which was really her intestines...I just felt so bad for her and how she died from cancer only because she was getting treatment for the surgical incompetancy. This prevented her from getting the cancer treatment she needed to survive. But yes, as someone who is currently applying to medical school, that is just unbelievable and reproachable.

 

[lsumedgirl]

But I think the program does way more help than harm. Without it, physicians with these problems wouldn't seek treatment at all. Either way, their issues would be unknown to their patients, but in this case the profession wouldn't know about them either, and the doctor isn't getting any help.

Excellent point, and I'm surprised that CNN didn't present that side of the argument. The exact reason that the programs exist are to encourage physicians to seek help. It seems as though there's this idea that "physicians aren't supposed to get sick," and this seems to include mental health issues; so there's a huge stigma attaached to standing up and saying, "Hey, I'm having a problem and I need help." But as many studies have shown, a very high percentage doctors have some sort of mental health issues (i.e. depression), and in some cases, substance abuse.

I think they should look at it this way: Would you rather have a physician who has a substance-abuse problem and is keeping it secret? Or, would you rather have one who admits there is a problem, and is working towards recovery?

 

[167649]

Excellent point, and I'm surprised that CNN didn't present that side of the argument.

You are really surprised CNN presented with a bias? It was worse on tv, the anchors kept saying "The whole thing is just outrageous, OUTRAGEOUS." I think they may have given the counter argument maybe 10 seconds out of the the 30 minute report.

 

[Begaster]

I'm not sure I agree with these programs either, but I haven't thought about it very long. Look at all the people we incarcerate for drug abuse each year. It's simply staggering. Why should physicians be exempt from jail or prison time that many others must endure? They can get "treatment" in there.

Uh, AA-type groups for drug abuse don't entail calling the police on you either.


Quite frankly, if you make the penalties for admission of substance abuse harsh, nobody is going to come forward and seek help. If you want to minimize the dangers of substance abuse, you need to keep it anonymous.

 

[metalgearHMN]

Aren't we all forgetting something?

House is a great doctor, and he is addicting to pain meds..

Therefore, based on this irrefutable precedent, I think we should allow MDs to practice even if they are addicted.





On a more serious note, if any of you read the story, the Dr. got a DUI on the way to see his patient so obviously he's an idiot and shouldn't be allowed to practice. Luckily he was pulled over, instead of running some one over or actually attempting to treat the women while under the influence. I think I speak for everyone when I say, what a noob.

EDIT: I do agree that the penalties shouldn't be very harsh because then no one will come forward for help. I know it's a sad catch-22 but what are you gonna do?

 

[Lecter]

CNN: "Substance abusing doctors given a free pass, oh noes! More with Anderson Cooper at 10:30!"

Real life: "Some GPs with alcohol problems sought help that they wouldn't otherwise seek if doing so threatened their careers."

 

[Perrotfish]

But I think the program does way more help than harm. Without it, physicians with these problems wouldn't seek treatment at all. Either way, their issues would be unknown to their patients, but in this case the profession wouldn't know about them either, and the doctor isn't getting any help.

Well, I think the alternative is to limit these kinds of programs to allowing the physicians anonamyous treatment, but only as an inpatient while on a leave of absense from work. I know someone who had to seek similiar treatment, and need to do it without jepordizing their career, and that is exactly what they did. There is a reasonable argument that treating people for current substance abuse issues while they are currently treating patients is unethical, in that it provides an alternative for physicians who might otherwise have taken that leave of absense to recover.

 

[Maxprime]

We do have kind of a glut of physicians in this country. We should provide as few incentives as possible to treat them if they have substance abuse problems - makes sense to me. Let's think of ourselves here - I mean, it's not like spending years and years working an insane schedule in an increasingly frustrating system with decreasing repayment while trying to help people has put undue stress on physicians. Right?

 

[GeoPetersen]

Without confidentiality, why would any Physician seek treatment? This story is proof in itself. It was also mentioned that their was no evidence his drinking had anything to do with these patient's surgeries. I found this website about the Plastic Surgeon on the CNN blog:

http://standingup4truth.blogspot.com

 

[GeoPetersen]

Without confidentiality, why would any Physician seek treatment? This story is proof in itself. The reporter mentioned that their was no evidence drinking had anything to do with these patient's surgeries. I found this website about the Plastic Surgeon on the CNN blog:

http://standingup4truth.blogspot.com