Programs let addicted docs practice

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Programs let addicted docs practice

By MARCUS WOHLSEN, Associated Press Writer Tue Dec 18, 9:10 PM ET

SAN FRANCISCO - Troubling cases in which doctors were accused of

botching operations while undergoing treatment for drugs or alcohol

have led to criticism of rehab programs that allow thousands of U.S.

physicians to keep their addictions hidden from their patients.

Nearly all states have confidential rehab programs that let doctors

continue practicing as long as they stick with the treatment regimen.

Nationwide, as many as 8,000 doctors may be in such programs, by one

estimate.

These arrangements largely escaped public scrutiny until last summer,

when California's medical board outraged physicians across the country

by abolishing its 27-year-old program. A review concluded that the

system failed to protect patients or help addicted doctors get better.

Opponents of such programs say the medical establishment uses

confidential treatment to protect dangerous physicians.

" Patients have no way to protect themselves from these doctors, " said

Fellmeth, who heads the University of San Diego's Center for

Public Interest Law and led the opposition to California's so-called

diversion program.

Most addiction specialists favor allowing doctors to continue

practicing while in confidential treatment, as does the American

Medical Association.

Supporters of such programs say that cases in which patients are

harmed by doctors in treatment are extremely rare, and would pale next

to the havoc that could result if physicians had no such option.

" If you don't have confidential participation, you don't get people

into the program, " said Bressler, the California Medical

Association's senior director for medical board affairs.

California's program ends June 30. If no alternative program is

adopted, the rules could revert back to the zero-tolerance policy in

place before 1980, when doctors who were found by the medical board to

have drug or alcohol problems were immediately stripped of their licenses.

No other state has followed California's lead. But the president of

California's medical board, Dr. Fantozzi, said that behind the

scenes, regulators nationwide share his ambivalence toward such programs.

" To hide something from consumers, something so blatant ... it's

unconscionable today, " Fantozzi said.

Between 10 percent and 15 percent of physicians nationwide will have a

substance abuse problem at some point in their lives, a rate similar

to that of the general population, according to widespread estimates.

An estimated 7,500 to 8,000 practicing doctors are probably in

confidential treatment, or about 1 percent of all physicians

practicing in the U.S., said Dr. Greg Skipper, head of Alabama's

program and a leader of an upcoming study on the issue.

Opponents of such programs are unable to cite any documented cases in

which doctors who were confidentially undergoing treatment botched

operations while drunk or high. But they say the very secrecy of the

programs makes it hard to assess the risks.

Nevertheless, some doctors have been accused of harming patients while

they were in treatment.

In Montana, a patient accused a doctor enrolled in the state's

treatment program of not following up on her abnormal test results,

delaying her cancer diagnosis by more than a year. Montana revoked Dr.

Schure's license last year after he flunked out of treatment

six times since 1994, according to board documents. The patient's suit

was settled for an undisclosed sum.

A North Carolina surgeon enrolled in the state's program for

alcoholism charged patients for one type of gastric bypass and then

performed a shortcut procedure that led to serious complications,

including stomach ulcers and vomiting, according to patients and a

medical board investigation.

It wasn't until Dr. Olchowski lost his license in 2005, years

after many of the incidents occurred, that his participation in North

Carolina's program became publicly known.

Opponents of California's program have focused on the case of Dr.

West, a Long Beach plastic surgeon who has been accused of

negligence by the state medical board and is fighting to keep his license.

In 1999, West performed a double mastectomy and breast reconstruction

surgery on Becky . The procedure left her with gaping,

infected wounds that wouldn't close and, ultimately, a grotesque lump

the size of a melon caused by organs spilling through an unhealed hole

in her abdomen.

Weeks before performing his final, futile procedure on her, West was

arrested for a drunken-driving accident.

After his conviction, West entered the diversion program for

alcoholism. A year later he performed a tummy tuck on a 37-year-old

woman that also healed poorly.

West ultimately flunked out of the treatment program after

investigators uncovered a pattern of relapses, binge drinking and

doctored urine tests that " demonstrate that he is a physician who has

been long and chronically impaired by alcohol, " according to a 2005

medical board complaint.

West's supporters say he has been made a scapegoat, asserting that he

is not to blame for his patients' complications and that the severity

of his drinking problem has been exaggerated by investigators. " I have

no information from any of my investigations that Dr. West has ever

cared for patients while under the influence of alcohol, " said his

attorney, Dominique Pollara.

West admitted no fault in settling 's malpractice lawsuit for

$250,000, Pollara said. The tummy-tuck patient lost her malpractice case.

Without the assurance of confidentiality, some say, addicted doctors

will go underground and continue to practice without getting any

treatment at all.

Jim Conway, a Venice, Calif., drug and alcohol counselor, said that

before confidential treatment programs, doctors would do whatever they

could to hide their addiction for fear they would lose their licenses.

At a Pomona hospital where Conway worked, an alcoholic obstetrician

came to work and delivered a baby while " dead drunk, " he said. In the

process, the doctor severed the newborn's spine.

" And that's how it will be if they just do a punitive approach, "

Conway said.

Dr. Giles, a Malibu physician, completed California's program in

2004 after five years in treatment for alcoholism and addiction to

prescription drugs.

" I was never intoxicated taking care of patients. It didn't get to

that — but would have if I didn't avail myself of that rope dropped

from the helicopter, " he said.

His experience in rehab was so transformative, he said, that he quit

practicing anesthesiology and opened the drug treatment center he now

runs.

Giles said allowing physicians to continue to practice while in

rehabilitation is crucial to the success of the treatment.

" Working actually helps them get better, " he said.

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