Feature

Physician health programs under fire

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3568 (Published 30 June 2016) Cite this as: BMJ 2016;353:i3568
  1. Jeanne Lenzer, associate editor, The BMJ
  1. jlenzer{at}bmj.com

Jeanne Lenzer asks whether bias and profit are forcing some doctors into unnecessary treatment programs for impaired physicians

Doctors are substantially more likely than the general population to be depressed and to commit suicide.1 Yet critics charge that the support systems put in place to help physicians in the United States are failing them and possibly driving some to suicide.2 3 4 5 6 7 8

Of the 850 000 practicing physicians in the US, 300-400 commit suicide each year. The physician suicide rate is similar for both sexes, but male physicians are 70% more likely to commit suicide than men in the general population, while female physicians are 250-400% more likely than other women.1

Physician health programs, which provide support and monitoring for doctors with mental health issues and alcohol or drug problems, exist in 47 states and the District of Columbia. But critics charge that some programs are punitive, unmonitored, and deprive doctors of due process rights, preventing them from challenging diagnoses they disagree with.2 4 5 6 7 8 Some doctors say their medical license was suspended or revoked without evidence of professional impairment, tarnishing their reputation and ending their career. Simply answering “yes” to an employment or licensing question about past treatment for depression can be enough to trigger what one doctor described as a “Kafkaesque nightmare.”6

At the center of the controversy are agreements between the programs and medical boards allowing state boards to revoke a doctor’s license to practice medicine if he or she is “non-compliant” with evaluation and treatment. Advocates say that licensing boards must retain control over the programs in order to ensure physician compliance and protect patients from unsafe doctors. They cite success rates of around 80%.9

However, these figures fail to account for what may …

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