Outcome Study of Substance Impaired Physicians and Physician Assistants Under Contract with North Carolina Physicians Health Program for the Period 1995-2000

Ganley, Oswald H.; Pendergast, Warren J.; Wilkerson, Michael W.; Mattingly, Daniel E.

doi:10.1300/j069v24n01_01

Cited by 24 publications

(17 citation statements)

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“…In fact, several studies demonstrate the effectiveness of PHP monitoring and doctor outcomes [19,[25][26][27]. For example, a seminal study by McClellan and colleagues examined outcomes for doctors presenting to a PHP with substance abuse issues.…”

Section: Discussionmentioning

confidence: 99%

Physician health programmes and malpractice claims: reducing risk through monitoring

Brooks

Gendel²,

Gundersen³

et al. 2013

Occupational Medicine

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Background Physician health programmes (PHPs) are peer-assistance organizations that provide support to physicians struggling with addiction or with physical or mental health challenges. While the services they offer are setting new standards for recovery and care, they are not immune to public debate and criticism since some have concerns about those who are enrolled in, or have completed, such programmes and their subsequent ability to practice medicine safely. AimsTo examine whether medical malpractice claims were associated with monitoring by a PHP using a retrospective examination of administrative data. MethodsData on PHP clients who were insured by the largest malpractice carrier in the state were examined. First, a business-model analysis of malpractice risk examined relative risk ratings between programme clients and a matched physician cohort. Second, Wilcoxon analysis examined differences in annual rates of pre-and post-monitoring claims for PHP clients only. ResultsData on 818 clients was available for analysis. After monitoring, those enrolled in the programme showed a 20% lower malpractice risk than the matched cohort. Furthermore physicians' annual rate of claims were significantly lower after programme monitoring among PHP clients (P < 0.01).Conclusions This is the only study examining this issue to date. While there are a variety of reasons why physicians present to PHPs, this study demonstrates that treatment and monitoring is associated with a lowered risk of malpractice claims and suggests that patient care may be improved by PHP monitoring.

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Section: Discussionmentioning

confidence: 99%

Physician health programmes and malpractice claims: reducing risk through monitoring

Brooks

Gendel²,

Gundersen³

et al. 2013

Occupational Medicine

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“…[6][7][8] There have been fundamental changes in graduate medical education, including institution of the 80-hour work week and increasing requirements for faculty supervision. Although numerous state medical societies and physician health programs have published their outcomes for treatment of physician substance impairment and these results are generally favorable, [9][10][11][12][13][14][15] resident impairment by substance use remains largely undiagnosed and untreated.…”

mentioning

confidence: 99%

Substance Use in Emergency Medicine Training Programs

McBeth

Ankel

Ling

et al. 2008

Academic Emergency Medicine

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Objectives: To explore the prevalence of substance use among emergency medicine (EM) residents and compare to a prior study conducted in 1992.Methods: A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national in-service examination. Data regarding 13 substances, demographics, and perceptions of personal patterns of substance use were collected.Results: A total of 133 of 134 residencies distributed the surveys (99%). The response rate was 56% of the total EM residents who took the in-service examination (2,397 ⁄ 4,281). The reported prevalence of most illicit drug use, including cocaine, heroin, amphetamines, and other opioids, among EM residents are low. Although residents reporting past marijuana use has declined (52.3% in 1992 to 45.0% in 2006; p < 0.001), past-year use (8.8%-11.8%; p < 0.001) and past-month use (2.5%-4.0%; p < 0.001) have increased. Alcohol use appears to be increasing, including an increase in reported daily drinkers from 3.3% to 4.9% (p < 0.001) and an increase in number of residents who indicate that their consumption of alcohol has increased during residency (from 4% to 12.6%; p < 0.001).Conclusions: Self-reported use of most street drugs remains uncommon among EM residents. Marijuana and alcohol use, however, do appear to be increasing. Educators should be aware of these trends, and this may allow them to target resources for impaired and at-risk residents.ACADEMIC EMERGENCY MEDICINE 2008; 15:45-53 ª

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“…Anesthesiologists who regularly work with opioid drugs are frequently reported to constitute a disproportionately large number of physicians represented in impairment programs 7,10 . Polysubstance abuse has also been recognized as highly prevalent in an impairment sample 11 . For all these reasons, it is important that studies on this population be undertaken in a systematic manner.…”

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confidence: 99%

“…Although other psychosocial modalities are now gaining acceptance, as evidenced in major studies such as Project MATCH, 13 the twelve‐step approach is employed widely in general addiction rehabilitation throughout the United States. The approach is typical of physician impairment programs as well, as cited in numerous published reports 10–12,14–16 . Gallegos et al 10 had made this apparent commitment to the twelve‐step fellowship explicit:…”

mentioning

confidence: 99%

“…Little operational definition was given on their status during monitoring or how abstinence was determined. Outcomes have been classified in a variety of ways in more recent reports, often on a sample of cases that are still under monitoring 7 and employing terms that are unclear in their definition, such as “without incident” (65%) 11 or “stable and working well within the program” (90%) 14 . Specific factors associated with twelve‐step meeting attendance are also not typically reported.…”

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confidence: 99%

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Substance‐Abusing Physicians: Monitoring and Twelve‐Step‐Based Treatment

Galanter¹,

Dermatis²,

Mansky³

et al. 2007

American J Addict

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This study was designed to provide an independent evaluation of the oversight and rehabilitation of substance-impaired physicians. Records of 104 physicians who had completed their monitoring period by the New York State Committee on Physicians' Health were selected at random from CPH files. They had been followed for an average of 41.3 months. Practice characteristics and substance use before admission, as well as workplace monitoring, twelve-step attendance, urine toxicologies, and relapse incidence after admission are reported. Significant intercorrelations among these variables were ascertained by logistic regression. The utility of twelve-step-based rehabilitation as part of a treatment plan for sustaining abstinence and averting relapse is discussed.

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Outcome Study of Substance Impaired Physicians and Physician Assistants Under Contract with North Carolina Physicians Health Program for the Period 1995-2000

Cited by 24 publications

References 1 publication

Physician health programmes and malpractice claims: reducing risk through monitoring

Physician health programmes and malpractice claims: reducing risk through monitoring

Substance Use in Emergency Medicine Training Programs

Substance‐Abusing Physicians: Monitoring and Twelve‐Step‐Based Treatment

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