Medical Staff Pulse Newsletter

FDA lowers recommended dose of zolpidem products

Pharmacy focus

The U.S. Food and Drug Administration is notifying the public of new information about zolpidem, a widely prescribed insomnia drug. FDA recommends that the bedtime dose be lowered because new data show that blood levels in some patients may be high enough the morning after use to impair activities that require alertness, including driving.

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Re-entry program gives doctors a chance to return to medicine

Sandy Kaushal, MD, graduated medical school in 2002 and became a pediatrician. But six years later, pregnant with her second child, she decided to take a break from medicine.

Kaushal said it was a family decision for her to stay home and be there for her children while they were babies.

This year, with both her children in school, Kaushal was ready to return to medicine. But returning to the profession is not as simple as rehanging the shingle. Doctors, like Kaushal, who want to rejoin hospitals, are finding credentialing committees have toughened the standards for re-entry.

Cedars-Sinai is one of only a handful of hospitals in the country with a re-entry program. The program is for doctors who have left the practice of medicine for more than two years for nondisciplinary reasons, have not seen any patients during that time, and want to get back into medicine. The program was structured by Leo Gordon, MD. He said half of the people who've gone through the program are women.

"The women left to start families, and after approximately six years, when their children are in school, they want to return to the practice of medicine," Gordon said. Others who've gone through the program are doctors who left because of illnesses, doctors who left to start businesses and doctors who retired and want to come back.

According to a New York Times article that highlights Cedars-Sinai's re-entry program, studies have shown twice as many doctors now take time off as compared to a decade ago.

At Cedars-Sinai, those who join the program usually spend three months at the medical center in their respective fields, and they partake in all educational activities in that department. They go on rounds, do presentations and keep a detailed log of all cases they are watching. At the end of the three months, they have a rigorous exit interview to assess their clinical competence in the areas to which they have been exposed.

So far, 14 doctors have gone through the program, and all have received staff jobs. The medical center is getting about five calls a month from doctors interested in re-entry.

The rules for re-entering the medical profession vary from state to state, some requiring a written exam, others a re-entry program, and in many cases it's entirely up to the hospital. Kaushal was able to find a job at a California hospital, but the credentialing committee wouldn't accept her without a re-entry program. So she enrolled in the re-entry program at Cedars-Sinai.

Kaushal said the program was tailor made for her. She rounded with other doctors in the Maxine Dunitz Children's Health Center as part of the team, participated in patient discussions, and was involved in patient care. She said having a re-entry program was "a wonderful experience, good for my self-confidence and made me feel ready to go back to work."

Charles Simmons, MD, chair of the Department of Pediatrics and the Ruth and Harry Roman Chair in Neonatology, said the program is a win-win for the medical profession. "It enables doctors to make choices that perhaps weren't available years ago, and with a growing shortage of physicians, it helps hospitals bring competent physicians back into the field."