Physician Health Program

The Medical Society of the District of Columbia believes that it is a physician’s ethical responsibility to take cognizance of a colleague’s inability to practice medicine adequately by reason of physical or mental illness, including alcoholism or drug dependence.  Accordingly, in 1980, the Medical Society of the District of Columbia established its Impaired Physicians Program.

The Physician Health Committee, which has primary responsibility for the Program, consists of practicing physicians, some of whom are in recovery, and who collectively represent a variety of specialties and backgrounds.

What is an impaired physician? 

An impaired physician is one who has an illness or disability that interferes with the performance of professional duties and responsibilities.  Some impairments include alcoholism and other drug dependencies, habitually abusing drugs, mental illness, psychosexual disorders and disabilities associated with aging.

How Does the Medical Society’s Physician Health Program Work?

The Program is based on a system of caring confrontation, referral for prompt and proper diagnosis and treatment, and ongoing monitoring.  It is important for concerned individuals to understand that while impairment is often apparent to others, it is frequently denied, minimized or concealed by the physician.  Denial on the part of the physician and his or her loved ones is almost universal.

Expressions of concern regarding the suspected impairment of physicians practicing in the District of Columbia are accepted from any source.  There is no requirement that the physician be a member of the Medical Society.  Callers are required to identify themselves to the Program staff and to provide sufficient information with which to determine if further investigation is warranted.  The names of reporters and the contents of the report are held in strict confidence.  Great care is taken to insure that the physician has no knowledge of the identity of the reporter.  If details of the case would tend to implicate a particular person as being the reporter, that information is held in confidence as well.  Some details, for example, are details that only a spouse or colleague would know.

Once a report has been received, a discreet investigation is conducted to confirm the accuracy of this information.  Generally, if confirmation is obtained from at least one other source, and there is sufficient reason to believe that the information from these sources is accurate, the Physician Health Committee will initiate the intervention process.  The physician is advised in writing of the concern that has been registered and invited to attend a meeting with representatives of the Committee to discuss these concerns.  This meeting stresses the importance of voluntary compliance with the efforts of the Committee, expresses the Committee’s deep concern about the physician’s health and ability to practice medicine safely and emphasizes the confidential nature of the process.

Following this preliminary meeting, the Committee may determine that no impairment exists and will close the case without prejudice to the physician.  Should the Committee find that there is sufficient evidence of impairment, the physician will be referred for psychiatric and/or medical evaluation as appropriate.  The evaluator is requested to provide a diagnosis and to recommend a treatment plan.  This plan forms the basis of the impaired physician’s written Treatment Program Agreement (TPA) with the Committee.  In addition to containing elements recommended in the treatment plan, additional conditions may be added depending upon the particular needs and circumstances of the individual physician.  In cases where immediate diagnosis is not possible, a monitoring regimen may be prescribed for a period of time until a diagnosis can be established.  The physician must sign the TPA and abide by its provisions.  When the physician accepts help, therapeutic arrangements are instituted promptly.  The physician may choose a physician/treatment provider recommended by the Committee or may choose his or her own, subject to approval by the Committee.  The physician must consent to having the Committee communicate with the physician/treatment provider, who is expected to provide regular reports on the physician’s participation in treatment, progress, prognosis and ability to remain in active medical practice.  The Committee may refuse advocacy in cases where the proposed treatment is not within the generally accepted medical standards for treatment of the physician’s condition.

The Committee monitors the physician’s recovery for a period of five years after treatment has been instituted.  This monitoring consists of a face-to-face meeting between the impaired physician and a Committee member assigned as monitor.  Monitoring sessions occur monthly for the first year, at least every three months for the second year and every three to six months for years three through five.  There may also be instances where the physician will be required to practice medicine in a supervised environment for a period of time.

In those cases where it is appropriate for the physician to continue or re-enter the practice of medicine, the Committee serves as an advocate for those who are in stable recovery.  If the physician is experiencing difficulties with privilege renewal at a hospital, for example, the Committee will not only advocate for the physician, but will provide ongoing progress reports.

If an impaired physician refused to seek therapy, interrupts therapy prematurely or violates any terms of the TPA, the physician/treatment provider and/or the Committee will insist upon compliance.  Should this fail, the case could be referred to the Medical Society’s Board of Directors with a recommendation that the matter be referred to the Board of Medicine, the physician licensing agency for the District of Columbia.  Committee advocacy on behalf of the impaired physician will terminate if the case is referred to the Board of Medicine. In case of relapse on the part of an alcoholic or chemically dependent physician, a course of inpatient treatment may be required.

I don’t Want to Harm the Physician.  How Can I Be Sure that Calling Your Program is the Right Thing to Do?

Immediate family, close friends, professional associates, partners, peers and patients often facilitate progression of the impairment and delay diagnosis and treatment because they fear that making a report to the Physician Health Committee will have adverse social, economic or legal consequences for the physician.  However, delay only increases the likelihood of damage to the physician’s health, reputation and livelihood.  The goals of the Physician Health Program are to protect the public health, to assess the nature and seriousness of physician impairments and to help them obtain treatment while protecting their dignity, preserving their anonymity and sparing them embarrassment.  While the Program’s foremost objective is to protect the public health, it has the added objective of helping physicians continue as productive members of their profession once they have obtained appropriate treatment and rehabilitation. This approach not only preserves a valuable community asset, but encourages physicians and their families to seek help rather than driving them underground for fear of punitive measures.

The Physician Health program depends very heavily on those around the physician, including family, colleagues and patients to report suspected impairment.  Help us help these physicians.  Call today for answers to your questions or for assistance with a specific situation.

For more information, contact Barbara Allen at 202-558-3003 or the Physician Health Program at 202-466-1800, extension 103.

Doctors in Distress

Confidential Help Available

Concerned about a colleague, or yourself, a family member, who may have an alcoholic, chemical dependent, mental/behavioral problem?  MSDC offers the Confidential Assistance Line ,202-558-3003, a service for physicians, medical students, residents, their families and colleagues.  This service is completely confidential and using it will not result in any form of disciplinary action or referral to any disciplinary body.  The goal is treatment not discipline.  Leave a message and your call will be returned as quickly as possible..