In many states, physicians who have been identified as impaired can continue to retain their licenses by entering into an agreement with the state physicians health program.

Physicians health programs are distinct from the medical board, healthcare systems, and credentialing bodies. The PHP is available to investigate alleged physician impairment.  If impairment is diagnosed, the PHP can enter into an individualized contract with the physician.  The physician agrees to comply with treatment and appropriate monitoring of the physician’s health through laboratory testing, including drug and alcohol testing, reports from the physician’s treating providers and contact with PHP physicians, nurses, and counselors. If appropriate, the PHP can recommend inpatient residential care or attendance at therapy or AA/NA meetings.

In addition. PHP program contracts can include practice restrictions. The PHP contract can include special requirements that impaired physicians must comply with to retain their licenses.  These can involve increased levels of supervision, work hour restrictions, restrictions on the setting of work, such as the operating room, or the handling or prescribing of controlled substances. The contract can include provisions to change the type of care that the physician receives based on the clinical progress of the impaired physician. Violations of the contract by the impaired physician can be handled by the treatment team or the PHP can choose to terminate the contract and refer the impaired physician to State Medical Board.

In a similar fashion, the State Medical Board, when investigating licensing violations by physicians, can choose referral to PHP for possible remediation instead of disciplinary action.

About the author;

David Steinman, MD, DFAPA, is a board certified psychiatrist and a consultant and expert witness in matters relating to physician impairment.  More information is available at www.davidsteinmanmd.com  He can be reached at davidsteinman@alumni.upenn.edu