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Idaho tracks increasing number of doctors treated for addiction, mental illness
[December 25, 2008]

Idaho tracks increasing number of doctors treated for addiction, mental illness

BOISIE, Idaho, Dec 25, 2008 (McClatchy Newspapers - McClatchy-Tribune News Service via COMTEX) --
The number of physicians undergoing specialized, long-term treatment for addictions, mental illnesses and other problems that could put patients in peril is on the rise in Idaho.

A total of 27 practitioners - mostly doctors, but also some physician assistants - are being monitored or are receiving care through the Physician Recovery Network. The program recorded eight admissions this year, but the overall numbers remain low - just 104 people have sought help in the past 20 years, according to a recent update at an Idaho Board of Medicine meeting.

Growing numbers reflect the state's growing population of licensed physicians. There are about 1,000 more doctors in Idaho today - around 4,000 - than there were a decade ago.

But Idaho doctors face increasing pressure from insurers, the government and even patients, the board's chairman, Dr. Stephen R. Marano, said.

"I think the stress may be an added factor," said Marano, an Idaho Falls neurosurgeon. Doctors succumb to stress at just about the same rate as people in other professions, he said. "It's part of the reality of life."

The medical profession also is less likely than it used to be to shield every troubled colleague from public scrutiny, he said.

The doctors get help through the Physician Recovery Network, run by a committee appointed by the Board of Medicine and the Idaho Medical Association.

At least one of the professionals disciplined this year, physician assistant Vernon McCready, said patients can be assured that the doctors in the recovery network are a safe bet - they have to meet extensive testing and other requirements as part of their recovery.

To help and monitor the practitioners, the committee contracts with Southworth Associates, a private Idaho firm that administers similar programs for dentists, lawyers and other professionals.

The doctors usually go to one of a handful of out-of-state treatment centers with a record of accomplishment in treating impaired doctors. The centers are at least 90 percent successful, experts said, much higher than for the outpatient treatment generally available in the Treasure Valley.

Inpatient treatment is expensive, and the impaired doctor is responsible for almost the entire bill, which can run from $5,000 to $10,000 or more a month, said Ron Hodge, associate executive director of the medical association.

Treatment typically is two or three days of medical evaluation, followed by 90 days of living at centers.

Next is follow-up treatment that can last five years. During that time, many doctors return to seeing patients, but must follow rules that include random drug testing, mandatory AA meetings, counseling and other requirements.

"We really tighten down on a physician once a physician returns to practice," Hodge said. "We set up a monitoring network, if you will." If doctors fail the program, they risk losing their license to practice medicine.

"They have a lot at stake," Marano said. "They put a lot of time and energy into their training."
"Historically, our programs are modeled after the ones used by airline pilots," said Nancy Kerr, executive director of the Board of Medicine.

Patients deserve to know that the doctor who treats them in an office or on an operating room table is clean and sober, said John Southworth, coordinator of Southworth Associates.

But addictions do not spare doctors.
"This disease doesn't care who you are or what your profession is," Southworth said.
The board keeps the Physician Recovery Network at arm's length to preserve the privacy of doctors. It gets involved only if the board has ordered doctors into treatment or doctors relapse or fail drug tests when they come back home.

Of the doctors and small number of physician assistants who have been through treatment, nearly half went voluntarily. That may include doctors who were the subjects of "benevolent coercion," as the medical association Web site puts it, by relatives, practice partners, hospital administrators or others.

The board's recently released statistics show that the No. 1 drug of abuse is alcohol, which was abused by 49 of the doctors who have entered treatment. Hydrocodone, a narcotic pain-killer that goes by brand names including Lortab and Vicodin, is a distant second, with 10 doctors entering treatment because of it.

Over the years, the largest number of doctors in the program, 26, were family medicine physicians, followed by nine internal medicine specialists, and seven each of anesthesiologists, physician assistants and general-practice doctors.

(c) 2008, The Idaho Statesman (Boise, Idaho).
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