The State Medical Board of Ohio has a mission to protect the public. One of our goals is to rehabilitate the licensees when possible. We have a deep concern about our physician members who are in probationary status in a substance abuse diversion program. Oftentimes these physician members are restricted from taking recertification boards, are excluded from insurance products and are being charged higher insurance premiums. During multiple meetings of medical specialty groups, the Federation of State Medical Boards and the American Medical Association, there is emerging a greater understanding of these problems. It is important for medical boards to contact specialty societies within their state and nationally to provide more enlightenment as to the extent of this problem and to encourage the societies to continue to work on solutions.
Medical boards that have diversion programs, in which impaired individuals are being monitored for relapse, may make those licensees the safest practitioners we have. Relapse detection will get the probationer out of practice and ensure patient safety. People who are not monitored and may have a hidden substance abuse problem could be more danger to their patients than those who have been discovered and who are on probation. Statistically we know 10 percent of people have alcohol abuse problems. We typically have only one percent of our licensees on a probationary status, while some others have self-identified or are ex-probationers maintaining their sobriety. It is our experience that 80 percent of our clients are successful in maintaining sobriety or abstinence from drugs once in our probation program. In addition, some physicians may have psychiatric difficulties that are under surveillance by the board and also are on probation. These individuals usually maintain their drugs better and are obligated to have psychiatric counseling and care on a regular basis to ensure they are well monitored. It is these physicians and such other practitioners as P.A.s, anesthesia assistants and other licensees who are quite capable of going back into the job market and taking good care of their patients.
The economic and public benefits of rehabilitation are obvious in a time when physician supply is marginal. The key is ensuring good screening and continued compliance. We must maintain the confidence of the public and interested organizations that we can and do monitor our clients as well as possible. If physicians are restricted from taking their specialty recertification exams or cannot get into an insurance panel, it is our experience they may accept jobs in clinics that are known pill mills or align themselves with clinics or other jobs that are beneath their professional capabilities. Maintaining the dignity, pride and self-esteem of these practitioners is essential to their continued recovery. It is incumbent upon medical boards and those specialists within their boards to contact their specialty societies to encourage them to continue the process they have begun. Hopefully they can modify their policies so we can restore these practitioners to the practice they are capable of maintaining. Working with both the malpractice and the medical benefit insurers/payers also is an essential next step in allowing our board licensees the ability to practice once they have acknowledged and are dealing with their psychiatric or substance abuse problems. The boards in turn must ensure their relapse detection and reaction is credible. Probationary agreements must be prescriptive to ensure surveillance will protect patients and encourage rehabilitation. Our next goal is to make sure we get all physicians who need it into a good diversion and probationary program.