Physician Health and Rehabilitation Committees:
Advocacy Through Assistance and Monitoring.

Chemical and mental impairment for physicians is a growing concern in the State of Texas. What is most unfortunate is the realization that the physician’s declining health, whether from chemical addiction or mental illness, has reached a point where it is believed that the only alternative is to report the physician to the Texas Medical Board. Each year, the Texas Medical Board receives over two thousand (2,000) complaints regarding Texas physicians, resulting in over three-hundred (300) disciplinary actions. . Of those disciplinary actions, approximately eighteen (18%) percent are directly related to concerns over chemical addiction, or mental impairment. Often times, the concerns and the corresponding allegations are indeed false. Unfortunately however, in many cases they are not.

There is help available for ANY Texas physician suffering from chemical or mental impairment. There is no need for physicians to face these issues on their own, or to wait until the consequences of the disease are such that it adversely affects the physicians’ personal and professional life. For physicians practicing in Texas, help is available through the Texas Medical Association (TMA), and the Texas Osteopathic Medical Association (TOMA). TMA, working through numerous county medical societies, has established approximately fifty (50) committees whose sole purpose is to intervene upon, to monitor, and to advocate for impaired physicians. A similarly designed and state wide operated program is available through TOMA. The committees for both associations are universally referred to as Physician Health and Rehabilitation (PHR) Committees. Physicians who are either in recovery themselves, are mental health providers, or specialize in the area of addictionology, staff each PHR Committee.

Each of these PHR Committees are uniquely staffed, and able to offer their assistance through immediate intervention or monitoring. A physician my contact the PHR Committee directly to request assistance or a physician may be referred/reported by a colleague, a co-worker, or even a concerned family member. The identity of the person reporting to the committee is kept confidential. If an intervention is deemed necessary, members of the PHR Committee will contact the physician directly, and confront him or her with the concerns expressed.

Although each case is unique, advocacy from the PHR Committee usually begins with the physician agreeing to immediately stop the practice of medicine, submitting to an inpatient evaluation, and completing any inpatient treatment, which is usually recommended as part of that evaluation. Once completed, the PHR Committee will offer the physician a standard monitoring contract. These contracts are typically for a five (5) year period.

Assistance from a PHR Committee is available to physicians suffering from chemical or mental impairment whether the Texas Medical Board is investigating them or not. Advocacy from a PHR Committee is beneficial when the physician is under investigation as the Texas Medical Board almost always requires participation in such committees as a part of its monitoring. To request advocacy, physicians can contact their local county medical society, the Texas Medical Association, or the Texas Osteopathic Medical Association.

The advocacy contract in the case of a physician suffering from chemical dependence, will require that the physician comply with any aftercare requirements specified by any treatment facility attended, attendance of alcoholics anonymous or narcotics anonymous, regularly attending the committee’s caduceus meetings, seeing a treating psychiatrist / addicitionologist, and random drug screens. In the case of mental impairment, the advocacy contract typically will require that the physician have a treating psychiatrist, and that the physician regularly meet with his or her treating psychiatrist with reports to the committee.

Physicians under the advocacy of a PHR Committee are not required to report that participation to the Texas Medical Board, although reporting is generally encouraged. When the Texas Medical Board is also monitoring a physician, the PHR Committee will provide the Medical Board with quarterly reports, describing the physician’s participation, and abstinence. The committee will also provide advocacy on behalf of the physician to any hospitals where the physician has or is seeking privileges, as well as to employers, partners, or other associations, as needed.

Both the Texas Medical Association and the Texas Osteopathic Medical Association consider the Physician Health and Rehabilitation Committees to be highly effective, and a necessary program for physicians suffering from chemical or mental impairment. Participation in the activities of the committee is strictly voluntary. In addition, there is no cost to the individual physician other than the cost of any required treatment and drug screening. The associations do not require that the physician be an active member to request advocacy. If advocacy is needed, and/or requested, membership is immediately offered.

Each of the men and women who make up these committees volunteer their time and individual expertise. Physicians who accept advocacy can be assured that the members of the committees are well aware of the issues which impaired physicians face, and they are readily available to lend assistance. Most physicians find the regular caduceus meetings to be extremely beneficial in that they are able to discuss their individual concerns and fears with physician colleagues who are also addressing, or have already addressed, those same issues.