title: A Call for National Standards and Oversight of State Physician Health Programs.
abstract: OBJECTIVE
  Many physicians are referred to state physician health programs (PHPs) for evaluation, monitoring, and treatment of mental health and substance use disorders. If the physician agrees to cooperate with the PHP and adhere to any recommendations it might make, the physician often can avoid disciplinary action and remain in practice. Despite their considerable power, many PHPs operate with little oversight.
  
  
  METHODS
  I review recommendations that a co-author and I previously made regarding oversight of PHPs and then review some of the findings from a recent performance audit of the North Carolina Physicians Health Program by the North Carolina Auditor's Office.
  
  
  RESULTS
  Physicians who might object to the conclusions and recommendations of PHPs in many states do not have the ability to appeal and lack due process. Additionally, given that many of the evaluation and treatment centers to which PHPs refer their clients also sponsor meetings of PHPs, there is significant potential for conflict of interest in the standard operations of PHPs.
  
  
  CONCLUSIONS
  National standards should be put in place for the day-to-day operation of PHPs and include avenues for appealing decisions and recommendations by them. Also, PHPs should be routinely audited to ensure the soundness and fairness of their practice.
authors.affiliation: Department of Psychiatry, Harvard Medical School/Cambridge Health Alliance and the Center for Bioethics, Harvard Medical School, Cambridge, MA.
authors.forename: J Wesley
authors.initials: JW
authors.lastname: Boyd
mesh_terms: D033161:Government Regulation; D006801:Humans; D008603:Mental Health; D009657:North Carolina; D010815:Physician Impairment / Q000523:psychology*; D010820:Physicians; D011785:Quality Assurance, Health Care / Q000592:standards; D012017:Referral and Consultation; D013221:State Health Plans / Q000592:standards*; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000628:therapy