Physicians' Recovery
DCMS committee helps members return to practice

I’m an alcoholic,” said my friend Jack (not his real name), as we sat in the hotel lounge at a surgical meeting. All the other surgeons were having an alcoholic drink, but not Jack. He was drinking orange juice. Jack was a few years ahead of me in residency, so I had not known him well socially. However, I had heard a lot of stories about his partying and drinking. Jack had been in practice for about five years. I wondered how someone could go from just liking to party to becoming an alcoholic in such a short time. In retrospect, I realize he may have been an undiagnosed alcoholic, even as a resident.

A few years later, “Robert,” a physician with whom I shared a lot of patients, abruptly took a leave of absence. When he returned to practice, he came to see me. “I was addicted,” he began, and said he had been to an inpatient treatment facility. He told me all about the disease and his treatment. I was dumbfounded that he would share this information with me; it took great courage to admit this to a referring physician. I was struck by his absolute honest and forthright handling of the issue of his returning to practice. At the conclusion of his story, Robert said that if I trusted him to be involved with the care of my patients, he would like to work with me again. He said if I ever had any question about his sobriety or conduct, he gladly would submit to drug testing on the spot! Because of his honest and open approach to his disease, I felt very comfortable having him involved in my patients’ care.

More than 10 years later, Robert’s recovery continues to be rock solid. It has been gratifying to watch his return to being an excellent caregiver, giving back to the community the benefits of the many years of his schooling and training to be a physician.

While president of the medical staff at Medical City Dallas Hospital, I attended a national medical staff leadership conference. One session was on alcohol and drug addiction among medical personnel. I don’t recall the speaker’s exact numbers, but I vividly remember his opening remarks.

“It is estimated that 10 percent of medical personnel have a problem with alcohol or drug abuse,” he said. “But let’s assume only 8 percent of physicians around the country have a drug or alcohol abuse problem. Let’s assume your medical staff is twice as good as the national average. That would mean only 4 percent of your medical staff has a drug or alcohol problem. Now multiply 4 percent times the number of physicians on your active staff, and you’ll see how many physicians on your staff you might expect to have this problem.”

We had about 700 active staff members, only two or three physicians of whom I suspected had a problem. It didn’t matter how much I lowered the expected percentage, it still meant quite a few physicians with drug or alcohol problems were not on my radar screen! Our medical staff bylaws showed the only way we had to deal with these physicians was through standard disciplinary channels.

Clearly, we had created a huge disincentive to admitting to the problem and seeking help. So we formed a Physicians’ Health and Rehabilitation Committee. That committee has been effective in getting such physicians into treatment and supervising them when they return to practice.

When the AMA recognized chemical dependency as a disease in 1978, DCMS President John Eisenlohr created the Impaired Physicians’ Committee (now the Physicians’ Recovery Committee) under the leadership of Drs Wayne Gossard and Stephen Cobb. Many early members of the committee served for 10 to 20 years—until they retired from practice or died. Over its 24-year existence, that committee has helped hundreds of physicians get into treatment and stay in recovery. I was privileged to serve as chair of the committee for four years when Dr Gossard retired. Now that committee is chaired by Vella V. Chancellor, MD.

The success rate for inpatient treatment for physicians with drug and/or alcohol addiction is near 85 percent, much higher than in the general population. Because physicians are at great risk of losing their license to practice medicine and, thus, their ability to make a living and support the addiction if their job performance suffers, they will protect their ability to perform their medical duties to the bitter end. When we find physicians impaired in their performance at the hospital, they truly are at the end of the road. Helping these physicians get into treatment and watching them return to successful practice is as satisfying as seeing your patient recover from a life-threatening illness and lead a long and productive life.

If you learn that a physician has become impaired by drug or alcohol addiction, don’t look down your nose at his “lack of self-control.” Refer that person to the Physicians’ Recovery Committee (call DCMS at 214-948-3622). You may not only prevent harm to the physician’s patients, you also may save the physician’s life.

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