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CSMC's Physician Well-Being Committee Fills Program's Void

California Medical Board discontinues Diversion program

By Cynthia C. Nast, M.D.
Chair, Well-Being Committee

In May 2008, the California Medical Board discontinued its Diversion program, which treated physicians with substance abuse and mental health problems in a confidential manner. Hopefully, this program will be reinstated in some form within the future, although this is not likely before 2011. Recently a bill to establish a Patient Protection and Physician Health Committee within the California Department of Public Health was sent for Governor Schwarzenegger's signature. However, the governor did not support this bill, expressing his belief that the licensing agency (MBC) must be directly involved in monitoring physician participation in diversion programs "to protect patients and enable timely enforcement actions." Therefore, at this time, California is one of only five states without a physician health (Diversion) program.

In the meantime, the Cedars-Sinai Well-Being of Physicians Committee (WBC) has stepped in to fill the void and has a procedure in place to assist physicians with substance abuse issues in obtaining treatment from qualified addiction specialists. The WBC does this in a confidential and supportive manner, fulfilling its mission to assist physicians in need and helping them to safely practice medicine at Cedars-Sinai. Referrals to the WBC may be made by a Medical Staff physician in need of assistance (self-referral), by the departmental clinical chief or chair, from the credentialing committee, or from the Medical Staff office.

The California Medical Board Diversion program was intended to help impaired physicians, who have not caused patient harm, to undergo appropriate treatment and return to the practice of medicine with confidentiality and dignity. Approximately 75 percent of physician impairment is a result of alcohol and/or drug addiction, although impairment can also be a result of psychiatric disorders and other types of medical illness. Studies demonstrate that physicians are as likely to develop a substance use disorder compared with socio-economically matched professionals.

The lifetime incidence of substance abuse disorders in physicians ranges from 8 to 15 percent, with alcohol being the most commonly abused substance. Some data indicate that physicians, however, may be at increased risk for developing prescription drug abuse, secondary to accessibility. Prescription drugs of abuse include opioids, benzodiazepine, other sedative-hypnotics and stimulants. Once a physician is identified as having a substance-abuse problem, referral for comprehensive assessment, specialized treatment and monitoring is recommended. Fortunately, if a physician is able to remain in treatment and monitoring, the prognosis for recovery and return to work is very good.

If you are facing a problem with substance abuse, please contact the Well-Being of Physicians Committee for further information or assistance. You can access our CSMC Intranet website by clicking on "Service Departments" and then "Physician Well Being." You also can call Cynthia C. Nast, M.D., chair of the Well-Being Committee, at (310) 423-6658 or Denise Brent, manager of Quality Services, at (310) 423-6217. We are committed to providing you with assistance, on a confidential basis, in finding an established treatment program and attaining recovery.