title: Physician health programmes and malpractice claims: reducing risk through monitoring.
abstract: BACKGROUND
  Physician health programmes (PHPs) are peer-assistance organizations that provide support to physicians struggling with addiction or with physical or mental health challenges. While the services they offer are setting new standards for recovery and care, they are not immune to public debate and criticism since some have concerns about those who are enrolled in, or have completed, such programmes and their subsequent ability to practice medicine safely.
  
  
  OBJECTIVE
  To examine whether medical malpractice claims were associated with monitoring by a PHP using a retrospective examination of administrative data.
  
  
  METHODS
  Data on PHP clients who were insured by the largest malpractice carrier in the state were examined. First, a business-model analysis of malpractice risk examined relative risk ratings between programme clients and a matched physician cohort. Second, Wilcoxon analysis examined differences in annual rates of pre- and post-monitoring claims for PHP clients only.
  
  
  RESULTS
  Data on 818 clients was available for analysis. After monitoring, those enrolled in the programme showed a 20% lower malpractice risk than the matched cohort. Furthermore physicians' annual rate of claims were significantly lower after programme monitoring among PHP clients (P < 0.01).
  
  
  CONCLUSIONS
  This is the only study examining this issue to date. While there are a variety of reasons why physicians present to PHPs, this study demonstrates that treatment and monitoring is associated with a lowered risk of malpractice claims and suggests that patient care may be improved by PHP monitoring.
authors.affiliation: University of Colorado Denver, Aurora, CO, USA. elizabeth.brooks@ucdenver.edu
authors.forename: E
authors.initials: E
authors.lastname: Brooks
authors.forename: M H
authors.initials: MH
authors.lastname: Gendel
authors.forename: D C
authors.initials: DC
authors.lastname: Gundersen
authors.forename: S R
authors.initials: SR
authors.lastname: Early
authors.forename: R
authors.initials: R
authors.lastname: Schirrmacher
authors.forename: A
authors.initials: A
authors.lastname: Lembitz
authors.forename: J H
authors.initials: JH
authors.lastname: Shore
mesh_terms: D000328:Adult; D003120:Colorado; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice / Q000191:economics / Q000706:statistics & numerical data*; D008875:Middle Aged; D009786:Occupational Health Services / Q000458:organization & administration / Q000592:standards*; D010815:Physician Impairment; D011787:Quality of Health Care; D012189:Retrospective Studies; D012306:Risk; D013221:State Health Plans
keywords: Mental health; monitoring; occupational health; physician health programmes; physicians; substance abuse.