Confidential Rehab for Doctors Under Fire
> 12/20/2007 2:39:57 PM

Doctors are trusted members of one of the most respected professions, but, while their rigorous training can prevent technical errors, it cannot wipe away the mental health vulnerabilities common to all people. 10%-15% of doctors face substance-abuse difficulties at some point in their lives, and many patients would understandably be troubled if the person treating their problem had a serious problem of their own. However, doctors in most states do not have to reveal their addiction, because they can enroll in confidential rehab programs while continuing their work. This confidential treatment has faced increasing criticism in recent years as a number of lawsuits were filed over alleged negligence by doctors enrolled in the program. The issue came to a head last week when the Medical Board of California voted to abolish their program.

The president of the California board, Dr. Richard Fantozzi, cited his deep discomfort with secrecy when asked to explain his vote: "To hide something from consumers, something so blatant... it's unconscionable today." The program is slated to expire on June 30, and no substitute has yet been put forth, meaning that the state may revert to the zero-tolerance policy that held before 1980.

While zero-tolerance may seem wise for a profession that makes life and death decisions, governments should assiduously work out all of the implications of such a policy before abandoning their programs. If doctors know that they will lose their license if they admit they have a substance problem, then most won't discuss their problem with anyone or seek help. They may continue to suffer through their job undetected for years until a dramatic blunder brings their substance abuse to light. This concept of the danger of stigmatization is often overlooked by large organizations. For example, we have written frequently about how the army's ill-treatment of soldiers who seek help for mental illness causes many of them to bury their problems until it is too late.

California is looked to as a front-runner on many health and environment issues, so other states may start scrutinizing their own confidential rehab programs. Hopefully, everyone will think carefully about the consequences of punishing and outing even those doctors who would be willing to work on their problem.

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