Article

Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States

Treatment Research Institute, 600 Public Ledger Building, 150 S Independence Mall, Philadelphia, PA 19106, USA.
BMJ (online) (Impact Factor: 16.38). 02/2008; 337:a2038. DOI: 10.1136/bmj.a2038
Source: PubMed

ABSTRACT To evaluate the effectiveness of US state physician health programmes in treating physicians with substance use disorders.
Five year, longitudinal, cohort study.
Purposive sample of 16 state physician health programmes in the United States.
904 physicians consecutively admitted to one of the 16 programmes from September 1995 to September 2001.
Completion of the programme, continued alcohol and drug misuse (regular urine tests), and occupational status at five years.
155 of 802 physicians (19.3%) with known outcomes failed the programme, usually early during treatment. Of the 647 (80.7%) who completed treatment and resumed practice under supervision and monitoring, alcohol or drug misuse was detected by urine testing in 126 (19%) over five years; 33 (26%) of these had a repeat positive test result. At five year follow-up, 631 (78.7%) physicians were licensed and working, 87 (10.8%) had their licences revoked, 28 (3.5%) had retired, 30 (3.7%) had died, and 26 (3.2%) had unknown status.
About three quarters of US physicians with substance use disorders managed in this subset of physician health programmes had favourable outcomes at five years. Such programmes seem to provide an appropriate combination of treatment, support, and sanctions to manage addiction among physicians effectively.

4 Followers
 · 
602 Views
  • Alcoholism Treatment Quarterly 06/2014; 32(2-3):237-247. DOI:10.1080/07347324.2014.907053
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background There have been few studies on the prevalence of substance use disorders (SUDS) in the physician population at large nor have any studies compared the prevalence of SUDS in American physicians by specialty.Methods We conducted a national study of SUDS in a large sample of U.S. physicians from all specialty disciplines using the AMA Physician Masterfile. Substance Use Disorders (SUDS) were measured using validated instruments.ResultsOf the 27,276 physicians who received an invitation to participate, 7,288 (26.7%) completed surveys. 12.9% of male physicians and 21.4% of female physicians met diagnostic criteria for alcohol abuse or dependence. Abuse of prescription drugs and use of illicit drugs was rare. Factors independently associated with alcohol abuse or dependence were age (OR = .985; p < .0001), hours worked (OR = .994; p = .0094), male gender (OR = .597; p < .0001), being married (OR 1.296; p = .0424) or partnered (OR 1.989; p = .0003), having children (OR .745; p = .0049), and being in any specialty other than internal medicine (OR 1.757; p = .0060). Specialty choice was strongly associated with alcohol abuse or dependence (p = .0011). Alcohol abuse or dependence was associated with burnout (p < .0001), depression (p < .0001), suicidal ideation (p = .0004), lower quality of life (p < .0001), lower career satisfaction (p = .0036), and recent medical errors (p = .0011).Conclusion Alcohol abuse or dependence is a significant problem among American physicians. Since prognosis for recovery of physicians from chemical dependency is exceptionally high, organizational approaches for the early identification of problematic alcohol consumption in physicians followed by intervention and treatment where indicated should be strongly supported. (Am J Addict 2014;XX:1–9)
    American Journal on Addictions 11/2014; 24(1). DOI:10.1111/j.1521-0391.2014.12173.x · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The negative impact of an impaired health care executive or physician on an organization can be significant. This article reviews the literature on impaired health care executives and physicians. Case studies are provided, and recommendations are made for boards of directors, senior management, executive coaches, and employee assistance professionals to consider when faced with impaired leaders or professionals.
    Journal of Workplace Behavioral Health 01/2013; 28(1):1-12. DOI:10.1080/15555240.2013.755445

Preview

Download
13 Downloads
Available from