MSSNY’s Committee on Physician Health: A caring approach based on the medical profession’s tradition of health

Susan Eisner, MPH CASAC, Education Outreach Coordinator, Medical Society of the State of New York and Joan McInerney, MD MBA FACEP, Chairman, Department of Emergency Medicine, Nassau University Medical Center

The mission of the Committee for Physician Health is to promote quality medical care by providing confidential assistance to physicians, resident physicians, medical students and physician assistants suffering from substance use disorders or other psychiatric disorders. The Committee monitors the treatment and clinical practice of program participants and provides advocacy and support as well as outreach activities, including prevention and education.

Services Offered by the Committee for Physician Health:
• Outreach and CME Education
• Intervention and Confidential Assessment
• Referral to Specialized Treatment
• Monitoring to Ensure Recovery Process
• Consultation: Legal and Department of Health/ Office of Professional Medical Conduct
• Legal Referral
• Policy Development and Forms Review
• Advocacy: Employment, Licensure, Etc.
• Assistance on New 2001 JCAHO Standard

The Committee for Physician Health
The Committee for Physician Health (CPH) exemplifies the medical profession’s long-standing tradition of concern for colleagues who are suffering from disorders that could impair a physician’s health and ability to practice medicine. The CPH program recognizes that mental illness, substance abuse, and chemical dependency are diseases that can be successfully treated. Compassionate intervention can help save an individual’s career and possibly his or her life. The program is nonjudgmental, confidential, and supportive of individuals who may or may not be able to help themselves.

Recognizing Patterns of Impairment
The Committee for Physician Health was founded to help physicians affected by substance abuse, addiction, mental health problems, and cognitive disorders. Early in the course of these diseases, physicians exhibit problems with family and friends or face other interpersonal difficulties. As the disease progresses, the physician’s ability to practice medicine is impaired.

The Referral Process
Anyone can make a referral to CPH. Most referrals (75%) come from colleagues or physicians seeking help for themselves, Nurses, other healthcare professionals, workers, friends, and family members concerned enough to help also initiate referrals. If you call CPH about a colleague, your phone call will be held in the strictest confidence. The identity of a referral source is never revealed unless the caller agrees. Once a referral is made, program staff members gather information to better define the extent of the disease. The CPH Medical Director and/or local physicians may meet with the referred physician to candidly discuss reports of unusual behavior and determine if a problems exits.

Individual Treatment Plans That Work
Individual program plans are developed under the supervision of the CPH Medical Director, and are planned with the case managers, the referred physician, and those involved in treatment. The CPH program relies on a variety of inpatient and outpatient services for detoxification, rehabilitation, and psychiatric care, in addition to attendance at self-help or peer support groups. The Committee for Physician Health can also provide emotional support and other assistance for the colleagues and families of physicians in the program.

Continued Help During Recovery
Having encouraged physicians to seek help, CPH monitors the physician’s recovery from chemical dependency for a minimum of five years. The monitoring process helps to document wellness and to ensure that the physician is making progress in recovery. It also provides a basis for future advocacy.

The Assurance of Confidentiality
The confidentiality of the CPH program participants, referral sources and CPH records are protected by New York State and Federal laws. Anyone who makes a referral or volunteers to work with CPH participants shall not be liable for actions taken in good faith and without malice. CPH does not refer physicians to the New York State Department of Health’s Office of Professional Medical Conduct as long as the physician agrees to participate, stays with the program, is helped by treatment, and does not present an imminent danger to the public.

Possible Indications of Impairment:
• Unkempt appearance, poor hygiene
• Trembling, slurred speech
• Complaints by patients and nurses
• Arguments, bizarre behavior
• Irritability, depression, mood swings
• Neglect of family, isolation from friends
• DWI arrest or DUI violations
• Financial and/or legal problems
• Difficult to contact; won’t answer phone or return calls
• Dwindling medical practice
• Missed appointments, unexplained absences
• Rounds at irregular times
• Loss of interest in professional activities, social or community affairs
• Inappropriate treatment or dangerous orders
• Excessive prescription writing
• Noticeable dependency on alcohol or drugs to relieve stress
• Unexplained accidents or injuries to self

Who does it help?
CPH helps physicians with alcohol or drug abuse/ dependencies, mental illness, or other potentially impairing disorders. It is open to all New York State physicians, physicians retired from practice, residents, medical students, and physician assistants.

What does it offer?
Education, assessment, intervention, and referral to individualized treatment programs, monitoring for at least two years, advocacy if needed, and general support in facing the consequences of disease. CPH can offer reassurance to hospital administrators, business partners, and others, that the physician is being properly monitored and that reemergence of the disease will be dealt with appropriately.

Assistance for Physicians with Disruptive Behaviors
Disruptive behavior is defined as a consistent pattern of unprofessional, uncooperative and contentious behavior which creates a hostile working environment and interferes with the ability of others to deliver quality patient care. Physicians with disruptive behavior may seek the assistance of CPH when faced with difficulties in the hospital or with an employer. Those with behavioral health disorders are eligible to receive CPH services.

Assistance with New JCAHO Standard on Physician Health
JCAHO has adopted a new Hospital Medical Staff Standard (MS 2.6) on Physician Health. The new standard requires that the medical staff (1) manage physician health matters separately from disciplinary matters, (2) establish a process for handling potential physician impairment, and (3) train physicians and other hospital staff members to recognize physician impairment. Nationwide, JCAHO endorses the utilization of a statewide system, which in New York State is MSSNY’s Committee for Physician Health (CPH). CPH is available to assist your medical staff with JCAHO compliance and may be contacted by phone at (800) 338-1833 or by email at terry@cphny.org.

How are referrals made?
Please call the toll free number (in New York State only) 1 (800) 338-1833 or our office at: (518) 436-4723

The Committee for Physician Health
99 Washington Avenue, Suite 1111
Albany, NY 12210
Fax: (518) 436-7943
Email: terry@cphny.org
All calls are confidential!

How do I schedule an educational presentation on physician impairment & CPH?
For Downstate call
Susan Eisner, MPH, CASAC
Education Outreach Coordinator
(631) 269-7048

For Upstate call
Daryl Mason
(800) 338-1833, ext. 220