The program kept his problem confidential. His practice told the hospital where he worked at the time that he was on leave of absence for an illness. Less than four months later, he returned to work.
“I was certain as soon as I told someone about my problem I would get immediately fired and lose my medical license,” Loyd said. “Little did I know I was in one of the best states in the country for physician health programs.”
Most states—California, Nebraska and Wisconsin are the exceptions—have physician health programs that hospitals can work with to evaluate, refer and monitor impaired physicians. But hospitals don't always make use of the programs when they should.
Loyd has seen instances where a hospital heard about an impairment issue and took disciplinary action instead of helping the physician. One hospital he worked at fired a talented cardiothoracic surgeon with a painkiller addiction.
“Looking back on it, it really made me angry because the surgeon was one of the best surgeons in the state and probably is to this day,” Loyd said. He is now recovered and practicing at a different hospital.
Experts say it's in hospitals' best interests to be proactive in helping potentially impaired physicians get help. It could lower the risk of malpractice claims, for instance. Doctors who went through a Colorado physician health program showed a 20% lower risk of malpractice claims than other doctors, according to a 2013 study published in the journal Occupational Medicine.
Physicians are valued commodities at many hospitals. “We have an obligation to our community to maintain our medical manpower,” McIlwain said. “It's a whole lot more efficient and effective to recognize and treat than it is to start all over again.”
Physicians spend too long in training, and hospitals invest too much in them to dismiss them so easily, some hospital leaders say. “It just comes down to recognizing that these people are tremendous assets for us and that once they get the recovery they need they can continue to be great assets,” said Dr. James Berry, chairman of the practitioners' health committee at West Virginia University Hospital in Morgantown and an addiction psychiatrist. “We would hate to see us lose their expertise and compassion and strong work ethic based on the fact they were suffering from a disorder that could be treated.”
Part of the Joint Commission's standard requires that hospitals educate physicians about wellness in hopes of avoiding actual impairment. “Illness can predate impairment, often by a period of years, so the goal is actually earlier detection, intervention and treatment of potentially impairing illnesses prior to overt impairment,” said Hall of the West Virginia Medical Professionals Health Program.
Some hospitals are taking that approach.
Mercy Regional Medical Center in Durango, Colo., recently began deploying spiritual-care counselors for doctors after upsetting events, such as the death of a patient. “Many times physicians feel they just need to go on with their work, just to see the next patient and never really deal with what they're experiencing,” said Dr. Bill Plauth, chief medical officer at Mercy.
The good news is that while doctors suffer from addiction at about the same rate as the general population, they have better success in recovering from substance-abuse disorders. After years of sweating through medical school and residencies, they have a lot at stake, said Terri Keville, a partner at law firm Davis Wright Tremaine.
Studies have shown abstinence rates of 78% to 90% for addicted doctors who go through physician health programs, which often monitor doctors for five years.
“Physicians, like other people in the general population, can develop a whole range of physical and mental and social problems in the course of their lives that can affect their work,” Keville said. “It is part of the human condition, and hospitals have to be prepared to deal with that.”