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Keeping an eye on troubled physicians

It's not surprising that doctors sometimes have substance abuse or mental health problems, and it is equally unsurprising that the medical profession would rather deal with these physicians internally. Troubled doctors are sometimes monitored by what's called a Physician Health Program. Colorado is one state that has one, and a leader of that program says reduces the risk of malpractice claims by 20 percent.

With PHP, doctors are constantly watched during treatment and after to make sure their behavior changes and they can practice without undue risk to patients. The challenge, according Denver psychiatrist Dr. Michael Gendel, is getting troubled physicians to self-refer. Gendel is the medical director of the Colorado PHP. He says about 40 percent of program participants check themselves in, and another 20 percent enroll after colleagues or others "encourage" them because of behavioral issues. The rest come in for a variety of other reasons.

Gendel's risk reduction claim is based on a study of PHP participants. He found that about a third of physicians have treatable psychiatric problems, another third have significant psychosocial problems that influence their behavior, and the remaining third are there for other reasons such as difficulty getting along with others, disruptive behavior, or personal issues. Many in treatment find their professional skills improve, especially communications skills, and they are motivated to practice more conservatively and get consultation sooner. Insurance companies say poor communications - not getting along with the patient or family members -- is a major cause of malpractice suits.

From the outside, it's hard to see any downside to a PHP program but still, there is resistance. Dr. Anna Reid, president of the Canadian Medical Association who has benefitted from a PHP herself, says, "People are afraid of being monitored...that's just human nature." "We need to educate people that the resources are out there," she said, "and we need to use them early."

Source: Medscape News, "Malpractice claims decline among docs in monitoring program," Kate Johnson, Nov. 1, 2012

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