Will Lawmakers Protect Doctors Or Patients In New Legislation?

If California lawmakers plan to move forward with creating a state-sponsored "diversion program" for treating substance-abusing doctors, it should not be a secret country club for addicted doctors who want to hide from the consequences. 

While the details haven't been fleshed out, SB 1177, by Senator Cathleen Galgiani, would authorize the Medical Board to establish a "Physician and Surgeon Health and Wellness Program" for the early identification and appropriate interventions to support physicians in any rehabilitation from substance abuse, physical or mental illness, burnout, or other similar conditions.

Galgiani should make sure that any state-run program views patient safety as more important than physician confidentiality and that doctors lose their license if they are terminated from the program. Unfortunately, the California Medical Association (CMA), which is involved in the legislation, is likely to be the biggest obstacle in protecting patients. The association has pushed for the program to allow physicians caught abusing drugs and alcohol to choose a secret rehab program in order to avoid discipline.  

Should doctors with substance abuse problems get to use a state program like a revolving door to avoid discipline? Seven years ago, a similar California state program was shut down after numerous investigations and audits showed that the diversion program let substance-abusing doctors off the hook for failing to comply with rehabilitation terms and failed to monitor substance abusers. That program prioritized keeping a doctor’s addiction secret over the safety of his patients. This failed road is not one that Californians should again walk down, particularly as substance abusing physicians have the ability to prescribe their own drugs to feed their own addiction – a privilege other professions do not enjoy.
 
California has a serious physician substance abuse problem. The California Medical Board estimates that 18% of doctors will have a substance abuse problem at some point during their careers, and 1-2% are abusing drugs or alcohol at any given point in time. Thousands of Californians are placed in harm’s way every time one of those drug or alcohol-addicted doctors goes to work.
 
Anedoctal evidence shows the danger: a Sonora family doctor arrested for overprescribing controlled substances is now accused of working “so high on narcotics” that she would nod off during appointments and pass out in the office; a drug-addicted Newport Beach doctor had his license suspended after being caught stealing narcotics from patients; and a Laguna Beach pain management doctor lost his license five years after stealing his patients’ identities to prescribe drugs to himself. 
 
Since the system is so opaque it's unclear how many patients are being harmed – patients like Lloyd Monserratt. He was a UCLA grad, a rising star in California politics, a Latino Vote Director for the DCCC, a Director at NALEO, a Chief of Staff to a LA City Councilmember and LAUSD School Board Member, and a consultant to elected officials.  He and his fiancée were planning their wedding. But his promising life ended at age 36 because no one at a hospital noticed he was dying of a full-body infection caused by a gross surgical error. His surgeon was later found to have a record of past arrests including felony crack cocaine possession. 
 
In August, the California Medical Board brought in doctors from Arizona and Colorado to testify about their states’ programs to confidentially treat substance abusing doctors. Supporters of diversion programs argue that it’s in the best interests of patients to get addicted doctors into treatment. But doctors with substance abuse problems are free to enter one of countless existing rehab programs now, why allow them to avoid any penalties?

At the Board's October meeting, Consumer Watchdog testified that if the legislation does move forward, patient safety should be paramont, and doctors who fail out of the system should lose their license. If complaints of possible substance abuse are reported, they must be made a priority and any enforcement should be handled expeditiously. Most importantly, any program should not in anyway be connected to the CMA or anyone connected to the previous diversion program. Allowing the CMA or their allies to be associated with any program would shred the credibility of the plan from the beginning. 

Last year, lawmakers tried to create program that pretended to fix the problem, but didn't. This time, will they sanction a program that lets doctors keep their addiction problems secret and avoid consequences when they fail or protect the public?

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