Agree or disagree

100-word min.

A physician who previously had a substance abuse addiction but did not have their license revoked, or a physician who became a medical provider after battling a substance abuse addiction should be able to continue practicing so long as they are rehabilitated, vision and mind no longer impaired. Physicians should be able to make sound medical decisions and in order to that they need to be sober, think clearly, and function normally. The Federation of State Medical Boards (FSMB) mandates physicians and medical providers to abstain from using substances, including not just drugs but also alcohol. According to research however, 10-15% of physicians do suffer from substance abuse addiction at some point in their career. It seems alcohol is the most common substance abuse addiction among physicians.

I couldn’t find the exact law or ethics regarding physician substance abuse addiction in New York state, but I was able to learn about the Medical Society of the State of New York’s Committee for Physician Health Referrals (CPH). This is a program designed to help physicians who are battling substance addiction and/or mental health issues. CPH is a referral program for such physicians and as I read through the site that these physicians could referred to the New York State Department of Health’s Office of Professional Medical Conduct if they have slurry speech, unkempt appearance, bleary eyes, bizarre behavior, mood swings, poor concentration, complaints by patients and/or medical professionals, patient neglect, etc. Once referred, physicians will be monitored, and hearings will be conducted. My understanding is substance abuse addicted physicians in New York will first receive professional assistance if they have not harmed patients or clients.

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Sources:

Reviewed by Michael Kaliszewski, P. D. L. U. F. 8. (2021, February 8). Substance abuse in doctors – statistics & treatment options. American Addiction Centers. https://americanaddictioncenters.org/medical-professionals/substance-abuse-among-doctors-key-statistics.

The Federation of State Medical Boards. (n.d.). policy on Physician Illness and Impairment: Towards a Model that Optimizes Patient Safety and Physician Health. https://www.fsmb.org/siteassets/advocacy/policies/policy-on-physician-impairment.pdf.

Agree or disagree

100 word min count response

Should a physician who has/had a substance abuse addiction be permitted to retain their license to practice medicine?

This is a hard topic that I feel can’t really be answered with a yes or no answer. There are so many different aspects of the individuals, and the circumstances that would need to be taken into consideration.  First I think it’s important to note that according to the National Institute of Health about 10 to 20 percent of physicians are projected to  develop a substance use disorder during their careers, this rate is similar or exceeds the rate of the general population. That’s kind of a sobering thought when you think about all that doctors do, are responsible for, and the amount of basic blind trust that we as patients give doctors. I say blind trust because when we are looking for a doctor, all we really have to go on is a picture with a short bio provided, and in reality you don’t know how recent it is, so basically we know nothing about the doctor. For example I met with an orthopedic surgeon that was referred to me for carpal tunnel and I later read his bio and saw his picture that was with it, and it must’ve been done about 30 years ago.  My point is how relevant or correct is that bio today? When there is a case of substance abuse regarding a physician I definitely believe that there needs to be a mandatory recovery program. It seems to me that it would have to be pretty strict and there could be no margin for inconsistencies regarding participation on the part of those enrolled in the program. I think that once it is discovered that the physician does have a substance-abuse problem their practice needs to be suspended until they enroll in a recovery program. I also think that there should be a specific recovery and treatment program for those that are in the medical profession. Once they’re enrolled in that program and they start making progress then I think that depending on what the addiction was, how it affected their practice, and if there was any negative outcome for a patient as a direct result of that addiction, they would start with privileges suspended and then gradually work back to receiving privileges, depending on what their practice was. All of these decisions regarding the physician would need to be done on a case by case basis. Of course in the situation where the death of a patient occurred as a result of that addiction they should not be allowed to return to practicing medicine. I also think that periodic random drug testing should be mandatory especially if they are going to be allowed to practice medicine. The frequency of the random drug testing would depend on the unique circumstances of the individual but I would think at least twice yearly.

2. What are the laws or ethics in your state on this subject?

Here in Washington state, drug and alcohol addiction is considered to be a disability. As long as the individual is an a drug or alcohol rehab recovery program or,  if they have been through a drug or alcohol recovery program and, are not currently using illegal drugs they are protected under the Washington law against discrimination. ( RCW 49.60).  Here in Washington there is also a recovery and monitoring program called WRAMP (Washington Recovery and Monitoring Program). It is not a treatment program but, it is a program that is for credentialed healthcare professionals who’s practice has been impaired by substance abuse. They focus on early identification and treatment of medical professionals that have alcohol or other drug problems.Their goal is to ensure of public health and safety from a physician with an impaired practice, they also encourage and promote recovery among healthcare professionals with substance abuse and, they also want to retain skilled highly trained practitioners by bringing those professionals back to their practice safely. In order to help reach those goals they contract with and monitor individuals for compliance with treatment and recovery goals. Included in this is comprehensive evaluations from a certified use disorder treatment provider, and all recommendations of treatment are followed these include random drug testing. The recommendations include going to professionally facilitated peer support groups and other recovery orientated groups, and worksite monitoring to ensure that the professional is safe to return to practice. They also include other services such as training in identification and intervention at the worksite, case consultation for human resources, employee assistance programs, or professional associations. Also included is education and outreach.

Resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704134/

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