Physicians can need help too

By Peter D. ROGERS, M.D.

Vindicator

Approximately six months ago, a physician in his forties came into the offices of the Ohio Physicians Health Program. His wife had found us online and went to our website.

I saw the physician with one of our case managers the same day he called for an appointment. This young man, James, was experiencing a paralyzing depression and had been admitted several months before to a hospital in his home town because of suicidal thoughts. He had been admitted for five days and discharged without much improvement.

When we saw him, the blackness of his mood had returned. As we spoke to him it became clear to me that he was a suicide waiting to happen. My specialty is addiction medicine, not psychiatry. We asked James several times about acute suicidal thoughts. He denied them, and I believed him.

I called a psychiatrist at the Ohio State University Department of Psychiatry and told him about James, who was still in my office. The OSU psychiatrist made arrangements for James to be seen in the Psychiatric Department within days.

Although we kept in daily contact with James, his care was taken over, appropriately, by an OSU psychiatrist. The last time I saw James was about a month ago in the OPHP offices. His smile radiated hope and he gave me a warm, gracious hug.

There is no doubt in my mind that if James had not come into our office several months before he would have been dead by his own hand. Three beautiful children would have been without their father and a wonderful wife would have been a widow.

Every year, approximately 400 physicians in the United States kill themselves. That means it will take two graduating classes from the Ohio State University Medical School to fill the void left by physician suicides. Physicians have the same emotional, behavioral, psychiatric and substance abuse problems that everyone else has. The problem with physicians is that we spend our years in medical school and residencies learning how to take care of others. Precious little time is spent learning about self-care. As physicians we often do a lousy job taking care of ourselves. Less than 60 percent of physicians have their own primary care physician.

Emergency intervention

Several months ago, I received a call from a vice president of medical affairs (VPMA) at a hospital in Northeast Ohio. Several nurses had reported that a surgeon smelled of alcohol that day. She had been doing surgery at that hospital for over ten years and this complaint had never been registered before. However, it had been noted that at hospital social functions when she drank that her behavior had become “outrageous.” I was told she had several cases scheduled for the next day. I told the VPMA to cancel her cases and that I wanted to talk to her as soon as possible. I talked to Sarah late that evening. She tearfully told me that she thought she had a “problem” with alcohol and possibly needed help.

She was at my office at 9 a.m. the next day. We don’t make the diagnosis of chemical dependency in our offices. We send the physician to one of our approved treatment centers and let the medical director who must be board certified in addiction medicine make that diagnosis.

A physician who is diagnosed as being chemically dependent must spend a minimum of 28 days in residential treatment. Most need 60 to 90 days of residential treatment.

After Sarah finished residential treatment, we will monitor her for five years. One of our case managers will visit her regularly and talk to her, her husband, her sponsor in her 12-step recovery program and her monitor. The monitor is another health care professional who observes random urine drug screens for five years.

Chemical dependency is a disease. No one chooses to be an addict or alcoholic. We believe strongly that physicians who have this disease should be monitored throughout their recovery by health care professionals who understand the disease.

Most physicians are healthy people; but it is our mission to help protect the public from unhealthy physicians and get these physicians the help they need and be involved in their recovery for a minimum of five years.

We take our mission very seriously. We want to continue to earn the trust of the people of Ohio.

Peter D. Rogers, MD, MPH, FASAM, is a diplomate, American Board of Addiction Medicine, and president & Medical Director Ohio Physicians Health Program.