Headlines such as these often catch the public’s interest, but the popular press is more interested in scandal than stories of recovering medical professionals, noted Gregory E. Skipper, MD, speaking at the second annual David E. Smith, MD Symposium in San Francisco this past weekend.
Skipper, director of professional health services at Promises Treatment Centers, presented on the state of physician health programs (PHPs), designed to connect doctors who have addiction issues to treatment and to help them avoid losing their licenses. Skipper has worked with such programs in Alabama and Oregon. He highlighted a handful of states with the unfortunate distinction of not having a PHP: South Carolina, Delaware, Nebraska, Wisconsin, North Dakota and, most surprisingly, California, long known as being progressive in addiction treatment. Skipper pointed out that every state has a similar program for lawyers.
David E. Smith, MD, founder of the legendary Haight Ashbury free clinic in San Francisco and the conference's host, agreed with Skipper's assessment that the Golden State is ill-served by not having a PHP, which was allowed to sunset after opponents pointed out problems with the program. Skipper and others are attempting to resurrect the California program, to no avail so far.
In contrast, the state offers a leading program for nurses, one of the few such programs in the country that addresses both addiction and mental health issues, noted presenter Carol Stanford, MPH, manager of the California program. The nurses diversion program has attracted interest from Australia and the Netherlands and can partially trace its genesis to the efforts of Smith’s wife, Millicent, who created the first support program for nurses at Haight Ashbury in 1980. The nurse who inspired Millicent Smith to found the program was in the conference audience.
Diversion programs for medical professionals do face political pressures, as some policy makers, likely influenced by popular perceptions of addiction, prefer a punitive rather than care-oriented approach. In her presentation, Stanford noted that such programs need to have their finger on a state's political pulse to ensure their survival.
"There's no 'we win you lose'" for those opposing these programs, she pointed out. "It's either lose-lose or win-win," and in California's case, symposium attendees and speakers agreed that the state needs to reinstate its PHP.