State Physician Health Programs Scurry to Avoid Legal Action, Doctors Outraged

A  lawsuit was filed in Federal Court in March against the organization that monitors impaired professionals for the Michigan State Board of Medicine, alleging constitutional violations, financial conflicts, lack of oversight, and due process.  Three mid-level providers are claiming damages as a result of actions taken by the Health Professional Recovery Program (HPRP), originally established to provide health professionals with a confidential and non-disciplinary approach  to dealing with substance abuse disorders and mental health issues.

The HPRP, administered by a private contractor, was initially designed to monitor treatment of health professionals referred to them by providers.  But plaintiffs claim the program’s administrators are overruling treatment decisions by board-certified and licensed physicians in favor of coercion of individuals into a small group of selected treatment facilities that are also charged with providing an initial evaluation of the need for treatment. Treatment facilities are expensive, and in most cases, insurance companies don’t consider these admissions to be medically necessary.

In one case cited in the court filing, the plaintiff was told she would have to stop taking pain medication prescribed by her treating physician for a period of two years. This decision was made after a short evaluation during which the evaluator did not contact the treating provider, and when the plaintiff refused to agree, her nursing license was summarily suspended. Her suspension was later dissolved in court. This is one small example, but it’s telling, Last time I checked, doctors had the right to choose a healthcare provider. It is surprising that the Michigan Medical Board would support a policy that essentially declares many of their own licensees inadequate to provide a treatment plan.

Unfortunately, this is not the only professional health program faced with backlash for financial double dealing and coercion. North Carolina physicians’ complaints promoted the North Carolina State Auditor to investigate oversight by the medical board in that state, and she found evidence of lack of oversight and the appearance of conflict of interest. Money flowed directly from the “impaired physician program” to their “approved providers” in the form of scholarships for the doctors they referred.

A common pattern has emerged in the treatment of doctors for mental illness or substance abuse. Agencies that were originally installed as volunteer boards aimed at helping doctors return to practice safely have been populated with a new group of professionals – doctors who are closely tied to treatment facilities or drug testing companies who frequently have their own history of substance abuse issues.

A recent string of posts on SERMO, the world’s largest physician-only social network, received a lot of attention. It is clear there have been a lot of abuses, sharing of confidential information, and lack of due process for participants. Many object to the religious overtones of every program that is “approved” for doctors by the Federation of State Physician Health Committees, the parent organization that has formed to keep all state committees notified of talking points. Physicians are currently subjected to polygraph tests, a practice most Americans would never accept. The term “disruptive physician” is an easy way to target those who speak out against a system that has become adversarial.

There are 400 suicide deaths annually among US physicians. Many of these doctors suicide when under investigation or contract with the committees originally designed to help them return to health. Other doctors are afraid to speak out, for fear of reprisal, particularly when in a contract with their PHP.

Have you heard of a colleague who has self-reported or has been reported for mental health or substance issues? Perhaps you have experienced a period of mental health crisis in your own life. How did you handle reporting requirements? What rights should doctors enjoy?