The Physician Health Program: A Replicable Model of Sustained Recovery Management

Abstract

Physician Health Programs (PHPs) in the USA have evolved over the past 3 decades as models of recovery management. They encourage early referral, sophisticated evaluation, and active long-term monitoring and care management of troubled physicians, especially those with substance-related disorders. There are many benefits to these unique programs. Early detection of potentially impaired physicians not only protects patients but also saves physicians’ careers. Additionally, when addressing these problems clinically, rather than awaiting a crisis necessitating disciplinary action, complex and prolonged legal battles are avoided. PHPs safeguard both patients and physicians, and in the process they have developed one of the most successful models of recovery management. The strongest incentive for early referral is the opportunity for confidential care and advocacy for physicians who cooperate with their PHPs. PHPs have proven successful with reports of 5-year abstinence rates of 79%, return to work rates of 96%, and virtually no evidence of risk or harm to patients from participating physicians. Can the principles used by PHPs be transferred for use by other patients? Compared to other patients with addictions, physicians are an affluent and usually highly motivated group; however, there is evidence that their addictions are as severe as or worse as those of the general population. Certainly their access to drugs of abuse is greater than the general population. Many elements of PHP care management can be transferred, in whole or in part, to others offering the promise of substantial improvements in long-term outcomes.