Physician health programmes and malpractice claims: reducing risk through monitoring

Abstract

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.

Getting back on track: a systematic review of the outcomes of remediation and rehabilitation programmes for healthcare professionals with performance concerns

“…PHPs in the USA were developed keeping in mind that early detection of potentially impaired physicians protects patients and saves physicians’ careers, and legal battles may be avoided by addressing these performance problems from a clinical perspective, instead of waiting for a crisis that necessitates disciplinary action 50. Brooks et al 51 found that physicians who were enrolled in a PHP showed a 20% lower malpractice risk after monitoring than a matched cohort. The high prevalence of Canadian studies on outcomes for dyscompetence in our review could perhaps be explained by the pioneering position Canada has had in peer assessment programmes.…”

Empirical comparisons of malpractice claims of different medical specialties

“…Another non-punitive approach to reducing malpractice payments was reported by Brooks et al [5]. Under examination was the use of Physician Health Programs (PHPs), peerassistance organizations that provide support to physicians struggling with addiction, or with physical or other mental health challenges.…”

Physician Death by Suicide: Problems Seeking Stakeholder Solutions

“…The Federation of State Physician Health Programs developed in recognition of a need highlighted by the American Medical Association (AMA) for objective and consistent monitoring and treatment of physicians with a wide range of health conditions. Data from CPHP suggest that physicians who had been monitored by CPHP for any reason had lower malpractice risk than the general population of physicians in Colorado [61]. When this finding is combined with the previous data on the decrease in the number of mandated referrals and increase in number of voluntary referrals when confidential services were made available, the way forward would seem clear.…”