Documents you can download and links to selected websites
What is on this page:
- Sample Documents
»Addiction, Treatment, Monitoring, Recovery
»Physician Health and Wellness
- Policy Statements
- Guidelines for Evaluations of Health Care Professionals [PDF]
This CPPPH guideline describes all the elements involved in getting a clinical evaluation, including the qualifications of those who conduct evaluations, the preparation to be completed in advance, and the recommended contents of the report. This document focuses on evaluations that are used to determine diagnoses, assess severity, identify appropriate clinical interventions, assess patient safety, and/or determine what steps should be taken to protect public safety, and the physician’s personal health and career.
- Guideline for Selecting Physician Health Services [PDF]
(intervention, treatment, monitoring, etc.)
These CPPPH guidelines are addressed to hospital medical staffs and medical groups and all who have professional responsibilities for physician health and patient safety. They are designed to help you make informed choices among possible providers of different kinds of services.
- What Well-Being Committees Should Consider in Selecting Providers of Services
- Criteria to Look For
- Guidance from the Federation of State Medical Boards on Physician Impairment [PDF]
In this 2011 policy statement document, the Federation of State Medical Boards provides guidance to state medical boards for how to include Physician Health Programs in their efforts to protect the public. It represents a vision for medical boards to effectively assist impaired licensees as well as those with potentially impairing illness based on best practices.
- CMA Guidelines for Physician Well-Being Committees [PDF]
(September 2013 Edition)
This comprehensive 29-page document prepared by CMA Legal Department covers all pertinent areas starting with medical staff bylaws and The Joint Commission Standard MS2.6, continuing through committee policies and procedures, through monitoring, confidentiality and peer review protections.
- Federation of State Physician Health Programs Physician Health Program Guidelines [PDF]
(December, 2005 Edition)
The sections of this 29-page guideline document are:
- General Guidelines
- Substance Abuse Disorders
- Managementof Other Psychiatric Disorders
- Medical Board of California Manual of Model Disciplinary Orders and Disciplinary Guidelines 2011 [PDF]
- Finding Meaning in Medicine: Guideline for Forming Support Groups, Rachel Naomi Remen, MD. A “starter kit” for how to begin a FMM group is available from the Institute for the Study of Health and Illness (ISHI) website. [Choose "All Healthcare Professionals" then choose "Start Your Own Support Group."] Groups tend to grow organically, using these guidelines.
- Sample release of information form – Authorization for Use and Disclosure of Health Information (CHA – 2009) [PDF]
- Sample Agreement between a physician and an organization that does monitoring - Pacific Assistance Group Agreement Substance Use Disorders [PDF]
- Sample Agreement between a physician and an organization that does monitoring - CAPHP Monitoring Agreement Substance Use Disorders [PDF]
- Policies and procedures as well as many forms developed and in use by the medical staff health committee at Stanford. www.medicalstaff.stanfordhospital.org/well-being/
- Samples of forms in use by the UC Davis Medical Staff Well-Being Committee. www.ucdmc.ucdavis.edu/medstaffwellbeing/
This section provides the full text if CPPPH has the publisher’s permission. For other articles, we provide a link the full text on the publisher’s website.
Addiction, Treatment, Monitoring, Recovery
- New York Times: Medicine’s Search for MeaningThis long opinion piece reviews a medical school elective course called “The Healer’s Art” that “is taught annually at 71 schools in the United States (half of the nation’s medical schools) and schools in seven other countries. … And while it is described as a simple elective — a 15-hour course given in five three-hour sessions — many of the doctors who teach it, and the students who take it, see it as part of a movement.” Several California hospitals have started related efforts. One example is Finding Meaning in Medicine which we mentioned in the July issue of this newsletter.“Because it has strong links to the quality of care,” says Dr. Tait Shanafelt of the Mayo Clinic, “promoting wellness is a shared responsibility of individual physicians as well as the hospital or practice group.” You can read the whole NYT article HERE.
- Physician health programmes and malpractice claims: reducing risk through monitoring Occupational Medicine. April 19, 2013
From Occupational Medicine April 2013, this study demonstrates that treatment and monitoring are associated with a lowered risk of malpractice claims and suggests that patient care may be improved by PHP monitoring. Data on 818 clients were examined. After monitoring, those enrolled in the program of treatment and monitoring showed a 20% lower malpractice risk than the matched cohort. Furthermore physicians’ annual rate of claims were significantly lower after program monitoring among PHP clients (P < 0.01). CPPPH does not have permission to post the article, but readers can see the full abstract with this link.
- Prognosis for the recovery of surgeons from chemical dependency: a 5-year outcome study
Retrospective 5-year longitudinal cohort study discusses how Rates of relapse, monitoring contract completion, and return to medical practice may differ between surgeons and nonsurgeons being monitored for diagnosed substance use disorders.
- Setting the standard for recovery: Physicians’ Health Programs
Robert L. DuPont, MD; A. Thomas McLellan, PhD; William L. White, MA; Lisa J. Merlo, PhD, Mark S. Gold, MD. Journal of Substance Abuse Treatment 36 (2009) 159-171
Description of 16 physician health programs and the elements that make up their management of cases with outcome data about physicians in treatment and monitoring.
- Impaired healthcare professional
Marie R. Baldisseri, MD, FCCM, Critical Care Medicine 2007 Vol. 35, No. 2 (Suppl.)
11 page review of the available data on substance use disorders in healthcare professionals: prevalence, risk factors, treatment options, and reentry issues. 72 references
- Antidotes to Physician Burnout: Fostering Physician Resiliency, Well-Being, and Holistic Development
Medscape. Apr 19, 2013
This 6-page Medscape article (with 15 references) is a general discussion of burnout issues and a description of the program in place at Florida Hospital, an Orlando-based 8-campus hospital system with 2000+ members of the medical staff.
- Physician Resilience and Burnout: Can You Make the Switch Family Practice Management January/February 2013
© 2012 American Academy of Family Physicians
The author details the impact of “burnout” on physicians. It is estimated that burnout starts during medical training and continues throughout a physician’s career and is linked to four qualities that are inherent to most physicians: service and sacrifice, excellence, curative competence, and compassion. The author suggests resiliency training and a new curriculum for students as a possible solution.
- Why are MDs Burning Out in Record Numbers? [PDF] Medscape. Nov 27, 2012
In this Nov. 2012 Medscape interview, a former president of the American College of Physicians, Paul Griner, MD, discusses the risks and consequences of burnout and describes a mentoring program in his institution at Danbury Health Systems in Connecticut to address which addresses it.
- Responding to Behaviors that Undermine a Culture of Safety [PDF]
This 9-page article from NORCAL Mutual Insurance Company (2010) uses an illustrative case study to provide information about appropriate responses to disruptive behavior and effective management.
- Disruptive Physician Behavior: Use and Misuse of the Label [PDF]
Journal of Medical Regulation (2011) Vol. 98, No. 1
This article provides in-depth information about disruptive physician behavior, including discussion of the causes and contributing factors, strategies to manage such behavior, formulation of medical staff policies, and appropriate and inappropriate use of the disruptive label.
Physician Health and Wellness
- AMA Action Plan for Reducing Risky Drinking [PDF] includes a 2-item screening instrument suitable for use in a medical staff newsletter or communication.
- Confronting Physician Depression and Suicide in Physicians, A Consensus Statement
JAMA. 2003;289(23):3161-3166. doi:10.1001/jama.289.23.3161.
- The Goals of the Medical Board’s Wellness Committee Gregg, L., MD. See page 7 of the MBC Newsletter Jan. 2008
- To Best Care For Your Patients, Take Care of Yourself Current Psychiatry Vol. 11, No. 03 / March 2012
- History of Finding Meaning in Medicine Groups (Rachel Remen, MD) and The Gathering of Physicians (Matthew Zwerling, MD) [PDF]
- Physician Health and Wellness
Sara Taub, et. al., for the Council on Ethical and Judicial Affairs of the American Medical Association; Occupational Medicine 2006;56:77-82 doi:10.1093/occmed/kqj025
6 page article with the objective to develop ethical guidelines regarding physician health and wellness based on the AMA’s Council on Ethical and Judicial Affairs recommendations (based on the AMA’s Code of Medical Ethics), an analysis of relevant Medline indexed articles, and comments from experts. The report’s recommendations were adopted as policy in December 2003.
- Physicians Under Stress: Recognition and Support [PDF] Rosenstein, A., MD. See page 8 of the MBC Newsletter July 2011
- The Suicide Prevention and Depression Awareness Program at the University of California, San Diego School of Medicine
Academic Medicine. March 2012 – Volume 87 – Issue 3 – p 320–326
- The Disabled Physician: Problem-Solving Strategies for the Medical Staff
Daniel A. Lang, MD, American Hospital Association Publishing, Inc., 1989
141 page discussion, from the point of view of the medical staff and the hospital, of all aspects of medical staff policies and procedures. Includes several illustrative case studies.
- Physician Magazine, the new official publication of the Los Angeles County Medical Association recently devoted an entire issue to physician wellness. View the magazine here. June 2013
Links to Other Websites
- The website of the Federation of State Physician Health Programs is the source of all their publications. www.fsphp.org
- The website of the physician health program for the state of Massachusetts contains a wealth of information, much of it applicable to all programs, some applicable only to MA. Physician Health Services, Inc., a Massachusetts Medical Society corporation
- The website of Stanford Hospital shows policies and procedures as well as many forms developed and in use by their medical staff health committee. www.medicalstaff.stanfordhospital.org/well-being/
- The website of UC Davis Medical Staff Well-Being Committee describes the committee and gives samples of forms in use. www.ucdmc.ucdavis.edu/medstaffwellbeing/
The Federation of State Medical Boards updated its policy related to physician health programs in April 2011. The import of this statement is that it comes from the organization that represents the 70 medical and osteopathic boards of the United States that are responsible for licensure and discipline. The FSMB mission is to lead by promoting excellence in medical practice, licensure, and regulation as the national resource and voice on behalf of state medical and osteopathic boards in their protection of the public.
This 2011 document is intended to promote better collaboration among all stakeholders in addressing issues of physicians with potentially impairing illness. It provides guidance, based on best practices at this point in time, to state medical and osteopathic boards for including PHPs in their efforts to protect the public and effectively assist impaired licensees as well as those with potentially impairing illness.
- Public Policy Statements and Recommendations from the American Society of Addiction Medicine (ASAM) [11 different statements; click on titles below]
In April 2011, ASAM published eleven policy statements, each of which provides a comprehensive discussion of one aspect related to physician health programs.
- Healthcare and other Licensed Professionals with Addictive Illness – An Overview
- Illness versus Impairment in Healthcare and other Licensed Professionals
- Discrimination and the Addicted Professional
- Coordination between Treatment Providers, Professionals Health Programs and Regulatory Agencies
- The Evaluation, Treatment and Continuing Care of Addiction in Healthcare and Other Licensed Professionals
- Credentialing in Healthcare and Other Licensed Professionals with Addictive Illness
- Confidentiality in Healthcare and Other Licensed Professionals with Potentially Impairing Illness
- Public Action by State Medical Licensure Boards and Comparable Regulatory Agencies Regarding Healthcare and Other Licensed Professionals with Addictive Illness
- Public Safety and the Healthcare and Other Licensed Professional with Addictive Illness
- Recovering Physicians, Medical Licensure Boards, Specialty Board Certification and Professional Society Membership
- Relapse in Healthcare and Other Licensed Professionals