Physician Health Program for California
In September, Governor Jerry Brown signed SB1177 authorizing the Medical Board of California (MBC) to establish the Physician and Surgeon Health and Wellness Program “for the early identification of, and appropriate interventions to support a physician and surgeon in his or her rehabilitation from, substance abuse.” (See a full copy of the legislation HERE.)
According to the schedule announced at that meeting, the Medical Board must complete three separate steps in order to open a program: 1) regulations adopted for operations of the program, 2) an RFP issued and an administering agency selected, 3) a second set of regulations adopted to set the fee that will be charged to each participant.
CPPPH Model Physician Health Program
CPPPH has published its vision of an ideal physician health program for California. We envision a program designed to encourage and assist all organizations, institutions and entities where physicians practice or affiliate in their efforts to maintain the health of their physician population. Its services should be available to assist the citizens of California, the regulatory board, associations, hospitals, clinics and individual physicians. California’s ideal physician health program (PHP) should identify, provide, or support clinically-based health services for physicians with physical, mental health or addiction issues which, if undetected or not appropriately treated and monitored, could compromise the physician’s ability to practice medicine safely.
Program Components — A well designed PHP would include elements shown to be effective.
- Education throughout the medical community
- Orientation to the role and function of physician health committees
- Consultation to physician health committees and all with the responsibility for physician health, public safety and the maintenance of quality of care Advocacy for activities that promote wellness
- Activities designed to support case finding Intervention Evaluation, both initial assessment and continuing evaluation as needed, including evaluation for the resumption of patient care responsibilities
- Design of treatment and monitoring plan Referral to initial treatment
- Referral to on-going treatment Monitoring Case management Quality assurance activities
- Guidelines for what criteria the different physician health services should meet
- A process for determining if an organization’s or group’s services meet the guidelines
Policies and procedures for the operation of a physician health program
A PHP would provide consistency and continuity in approaching and managing physician health across the state. Referrals into the program would be accepted from all sources. Eligibility for the program would be for persons with substance use, mental health disorders or physical illness when a clinical evaluation determines that the condition can be monitored and treated with the resources available to the program. The length of time a person is required to be in the program would be in the range of 3-5 years, based on the severity of illness and clinical recommendation.
The program would not report information about a participant to any person or organization other than the referring person or entity unless there has been failure to comply with the agreement and it was determined that the physician was a danger to the public. The program would have the resources necessary for appropriate quality assurance activities. The administering entity and the program it operates would be subject to periodic audit. The results of the audit would be reported to all funding sources, all program participants, the full medical community, an oversight body, and the legislature.
References consulted in the development of the CPPPH model adopted by the Board of Directors of CPPPH, Inc. on April 25, 2011:
- Model Physician Health Program Act, March 2009 American Medical Association
- Public Policy Statement of the American Society of Addiction Medicine on Healthcare and Other Licensed Professionals with Addictive Illness, April 2011
- Policy on Physician Impairment, April 1995 Federation of State Medical Boards
- Guidelines for Physician Health Programs, 2008 Federation of State Physician Health Programs
- Guidelines for Hospital Medical Staff Committees on the Well-being of Physicians, 2009 California Medical Association