Outcomes of a monitoring program for physicians with mental and behavioral health problems.
OBJECTIVE
Most states have programs that provide structured monitoring for physicians with substance use disorders (SUDs). In recent years, the Massachusetts Medical Society's Physician Health Services (PHS) program has used a similarly structured approach to monitor physicians with other mental and behavioral health (MBH) problems. The objective of this study was to determine the outcomes of the PHS monitoring programs for SUDs and MBH problems, compare their overall success rates, and identify correlates of success.


METHODS
Data were extracted from the PHS administrative database for physicians presenting between January 1, 1993 and May 31, 2003. Variables included gender, age, specialty, type of monitoring contract (SUD vs MBH), and state licensing board involvement. Dates of contract openings and closings were used to categorize cases as successful completion, relapse, or other.


RESULTS
Of 58 physicians with MBH contracts, 43 (74%) completed successfully, 7 (12%) relapsed, and 8 (14%) did not complete for other reasons. Of 120 total physicians with SUD contracts, 90 (75%) completed successfully, 10 (8%) relapsed, and 20 (17%) did not complete for other reasons. Successful completion of SUD contracts was significantly associated with licensing board involvement (84% vs 66%, p = 0.04). Survival analysis indicated that time to relapse was significantly shorter for women compared to men on both MBH and SUD contracts (log rank test for equality of survival distribution p < 0.001 for MBH and p = 0.001 for SUD).


CONCLUSIONS
This study suggests that physicians with MBH problems can be monitored in a similar fashion as physicians with SUDs, and with similarly positive outcomes. However, greater attention should be given to services for women in physician health monitoring programs.
Knight
John R
JR
Harvard Medical School, Children's Hospital Boston, Boston, MA 02115, USA. john.knight@childrens.harvard.edu
Sanchez
Luis T
LT
Sherritt
Lon
L
Bresnahan
Linda R
LR
Fromson
John A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D032982:Contracts; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008007:Licensure, Medical; D008297:Male; D008404:Massachusetts; D008511:Medicine / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000534:rehabilitation*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010815:Physician Impairment; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013038:Specialization; D019966:Substance-Related Disorders / Q000534:rehabilitation