Physician Health Programs: The US Model

Carr, Gary D; Hall, P. Bradley; Finlayson, A. J. Reid; DuPont, Robert L.

doi:10.1007/978-3-319-55583-6_12

Cited by 7 publications

(4 citation statements)

References 36 publications

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“…In response to reports of poor mental health and increased suicide rates as well as a growing concern for doctors’ wellbeing in the early 1980s, several Physician Health Programs (PHPs) were institutionalized in the US with the aim of preventing malpractice behaviours, mainly in the context of offering treatment of drug and alcohol misuse. PHPs have evolved into effective treatment programs; the success rates found in PHPs significantly exceed those of other addiction care practices [ 14 , 21 , 22 ]. Based on these PHPs, low-threshold collegial services emerged to provide peer support to doctors.…”

Section: Introductionmentioning

confidence: 99%

Understanding peer support: a qualitative interview study of doctors one year after seeking support

Horne

Veggeland

Bååthe

et al. 2023

BMC Health Serv Res

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Background Doctors’ health is of importance for the quality and development of health care and to doctors themselves. As doctors are hesitant to seek medical treatment, peer support services, with an alleged lower threshold for seeking help, is provided in many countries. Peer support services may be the first place to which doctors turn when they search for support and advice relating to their own health and private or professional well-being. This paper explores how doctors perceive the peer support service and how it can meet their needs. Materials and methods Twelve doctors were interviewed a year after attending a peer support service which is accessible to all doctors in Norway. The qualitative, semi-structured interviews took place by on-line video meetings or over the phone (due to the COVID-19 pandemic) during 2020 and were audiotaped. Analysis was data-driven, and systematic text condensation was used as strategy for the qualitative analysis. The empirical material was further interpreted with the use of theories of organizational culture by Edgar Schein. Results The doctors sought peer support due to a range of different needs including both occupational and personal challenges. They attended peer support to engage in dialogue with a fellow doctor outside of the workplace, some were in search of a combination of dialogue and mental health care. The doctors wanted peer support to have a different quality from that of a regular doctor/patient appointment. The doctors expressed they needed and got psychological safety and an open conversation in a flexible and informal setting. Some of these qualities are related to the formal structure of the service, whereas others are based on the way the service is practised. Conclusions Peer support seems to provide psychological safety through its flexible, informal, and confidential characteristics. The service thus offers doctors in need of support a valued and suitable space that is clearly distinct from a doctor/patient relationship. The doctors’ needs are met to a high extent by the peer-support service, through such conditions that the doctors experience as beneficial.

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Section: Introductionmentioning

confidence: 99%

Understanding peer support: a qualitative interview study of doctors one year after seeking support

Horne

Veggeland

Bååthe

et al. 2023

BMC Health Serv Res

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“…Since their inception in the 1970s, physician health programs (PHPs) can be found in forty-seven states in the US. While there is controversy surrounding how these programs operate (25), PHPs were intended to identify and help physicians who are struggling with medical, mental health, and cognitive disorders (26). The most common cause of referral for a physician to a state PHP is a neurologic disorder (48% of referrals) (6).…”

Section: Introductionmentioning

confidence: 99%

A rationale and framework for addressing physician cognitive impairment

Del Bene,

Geldmacher,

Howard

et al. 2023

Front. Public Health

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Medical error is costly, in terms of the health and wellbeing of the patient, their family, and the financial burden placed on the medical system. Reducing medical error is paramount to minimizing harm and improving outcomes. One potential source of medical error is physician cognitive impairment. Determining how to effectively assess and mange physician cognitive impairment is an important, albeit difficult problem to address. There have been calls and attempts to implement age-based cognitive screening, but this approach is not optimal. Instead, we propose that neuropsychological assessment is the gold standard for fitness-for-duty evaluations and that there is a need for the development of physician-based, normative data to improve these evaluations. Here, we outline the framework of our research protocol in a large, academic medical center, in partnership with hospital leadership and legal counsel, which can be modeled by other medical centers. With high rates of physician burnout and an aging physician population, the United States is facing a looming public health crisis that requires proactive management.

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“… 16 McLellan and colleagues 13 found that 80.7% of 802 PHP participants successfully completed their 5‐year agreements, with 78.7% continuing working with no license restrictions. Though debate exists over the potentially coercive nature of PHP care, 17 , 18 many PHP components have been integrated into other forms of SUD treatment and care management. 19 For example, sustained post‐treatment monitoring and support have become standard features in efforts to extend acute care into recovery management models nested within larger recovery‐oriented systems of care.…”

Section: Introductionmentioning

confidence: 99%

Essential components of physician health program monitoring for substance use disorder: A survey of participants 5 years post successful program completion

et al. 2022

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Background and Objectives: Physician health programs (PHPs) have demonstrated efficacy, but their mechanism of influence is unclear. This study sought to identify essential components of PHP care management for substance use disorder (SUD), and to assess whether positive outcomes are sustained over time.Methods: Physicians with DSM-IV diagnoses of Substance Dependence and/or Substance Abuse who had successfully completed a PHP monitoring agreement at least 5 years before the study (N = 343) were identified as eligible. Of the 143 (42%) that could be reached by phone, 93% (n = 133; 86% male) completed the anonymous online survey.Results: Virtually all PHP program components were rated as being at least "somewhat helpful" in promoting recovery, with the plurality of respondents rating almost all components as "extremely helpful." The top-rated components were: signing a PHP monitoring agreement, participation in the PHP, formal SUD treatment, and attending 12-step meetings, with each receiving a mean rating of at least 6.2 out of 7. Notably, 88% of respondents endorsed continued participation in 12-step fellowships. Despite the significant financial burden of PHP participation, 85% of respondents reported they believed the total financial cost of PHP participation was "money well spent."Discussion and Conclusions: Components of PHP monitoring were viewed as acceptable and helpful to physicians who completed the program, and outcomes were generally sustained over 5 years. More studies are needed to confirm these preliminary findings.Scientific Significance: This study documents the perceived cost-benefit of participation in a PHP among a small sample of program completers.

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Physician Health Programs: The US Model

Cited by 7 publications

References 36 publications

Understanding peer support: a qualitative interview study of doctors one year after seeking support

Understanding peer support: a qualitative interview study of doctors one year after seeking support

A rationale and framework for addressing physician cognitive impairment

Essential components of physician health program monitoring for substance use disorder: A survey of participants 5 years post successful program completion

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