California Public Protection & Physician Health, Inc.

Documents you can download and links to selected websites

What is on this page:

• Guidelines
• Sample Documents
• Articles
• Links
• Policy Statements

Guidelines

• Guidelines for Selecting Physician Health Services 2013 [PDF]
  (intervention, treatment, monitoring, etc.)
  These 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
  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
  This comprehensive 21-page document prepared by CMA Legal Department covers all pertinent areas starting with medical staff bylaws and JCAHO 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 (December, 2005 Edition)
  The sections of this 29-page guideline document are

• General Guidelines
• Substance Abuse Disorders
• Managementof Other Psychiatric Disorders
• Evaluations
• TreatmentPrograms

• Medical Board of California Manual of Model Disciplinary Orders and Disciplinary Guidelines 2011

• CSAM Recommendations for Contents of Evaluation Reports and the Qualifications of Physicians Who Conduct Evaluations of Health Care Professionals (March 2008)
  The sections of this 8-page document are:

• The list of items that should be in the report of a basic substance abuse evaluation and additional items that should be included when an extended evaluation is indicated
• The list of information that should be provided in advance to the evaluator
• The qualifications of the physicians who conduct evaluations

Sample Documents

• Sample release of information form – Authorization for Use and Disclosure of Health Information (CHA – 2009)
• Sample Agreement between a physician and an organization that does monitoring - Pacific Assistance Group Agreement Substance Use Disorders
• Sample Agreement  between a physician and an organization that does monitoring - CAPHP Monitoring Agreement Substance Use Disorders
• 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/

Articles

• Physician Resilience and Burnout: Can You Make the Switch [PDF]
  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.

• 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

• 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.

• 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.

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/

Policy Statements

• Policy Statement on Physician Impairment from the Federation of State Medical Boards (FSMB)

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