Many state medical societies are members of the Federation of State Physician Health Programs, whose goal it is to encourage states to create and maintain confidential PHPs to monitor and rehabilitate drug- addicted and alcoholic physicians. However, California is currently not one of the member states. California’s own diversion program was disbanded last year. Given the sheer number of licensed doctors in the state, failure to have an effective diversion program for doctors in crisis is most troubling.

In 1980, California created a physician Diversion Program, one of the first of its kind. The goal of the program was to “divert” doctors from the disciplinary path, if their wrongdoing stemmed from substance abuse impairment, while protecting the public from physician malpractice. Rather than taking a role in actively treating doctors who suffered from substance abuse issues, the program monitored participation in outside addiction treatment centers and treatment programs. In essence, each participant was monitored by a case manager, who ensured that the doctor was complying with program requirements, getting treatment for the addiction, and not practicing medicine while under the influence of drugs or alcohol. Funding for administration of the program, almost $1.5 million annually, came from doctors’ license renewal fees. From 1980 to 2008, California’s doctor diversion program had nearly 1800 participants.

Entrance into the diversion program happened either voluntarily through non-disciplinary related self-referral or as an alternative to discipline during an investigation or during probation. Only those participating as a condition of probation (roughly 15%) were not protected by the strict confidentiality rules. Patients were not entitled to know that his or her doctor was being monitored for substance abuse.

Each participant signed a contract that required them to adhere to several conditions including being evaluated by a committee, undergoing random drug testing, enrolling in an in-patient addiction treatment center, undergoing psychiatric care, attending group therapy and AA sessions, and being subject to monitoring visits at their place of employment. The Diversion Program’s medical board case managers were charged with monitoring the compliance.

Only those doctors who were deemed unsafe to practice medicine were ineligible to work. If a drug test came back positive, the evaluation committee would determine whether there had been a relapse. If so, it had the option of terminating the physician or ordering further in-patient treatment (this was normally the case for a first offense). Patients were not notified of the doctor’s status, even after he or she had violated the terms of the program. This confidential aspect of the program would prove to be its most controversial.

Doctors were required to participate in the program for a minimum of five years, with three years being the minimum sobriety period required for consideration of release from the contract. If a doctor was ejected from the program prior to completion, the Enforcement Program was notified so that disciplinary charges could be filed. Ultimately, the program was unable to adequately monitor plan participants to the satisfaction of state regulators.

Millie Anne Cavanaugh, Esq. is a former insurance defense attorney now specializing in immigration. She is licensed to practice law in California and Massachusetts. The information contained herein is provided for informational purposes only, and should not be construed as a solicitation for your business or as legal advice on any subject matter. You should not act or refrain from acting on the basis of this information without seeking independent legal advice.