COMMITTEE FOR PHYSICIAN HEALTH

Frequently Asked Questions
About the Committee for Physician Health

CPH Services and Procedures

  1. What is the difference between CPH and the Office for Professional Medical Conduct (OPMC)?
    CPH is a confidential, clinically-based, non-disciplinary, advocacy program sponsored by MSSNY and funded by physician re-licensure fees, for physicians, physician assistants and students with substance abuse, psychiatric and cognitive disorders. Its goal is to medically treat participants and return them to the healthy, safe and productive practice of medicine. OPMC is a part of the New York State Department of Health that is an investigative, disciplinary body for physicians and physician assistants.
  2. What is the process when a referral is made to CPH?
    CPH encourages troubled physicians to self refer, though calls are also received from colleagues, family and hospitals. The focus is always clinical and is always on what is best for the health of the physician. Physicians receive a clinical evaluation and those with a diagnosis are placed in treatment. When medically cleared for duty, the physician returns to work while continuing in treatment. CPH continues to support and monitor the physician’s progress in recovery.
  3. What types of advocacy and other services does CPH provide?
    CPH provides a full array of services to participants and to hospitals and other facilities. At the outset CPH performs or assists with performing an intervention with a physician, who is then sent for a confidential evaluation and treatment if indicated. Monitoring to ensure recovery is put in place upon return to employment. CPH ensures fitness for duty and a smooth transition back to work. Legal referrals may also be made. In addition, CPH advocates for physicians in OPMC seeking re-licensure, as well as for those seeking insurance, employment, privileges, membership on HMO panels, etc. CPH assists hospital through consultation on regulatory issues, policy development and forms review, and assistance with the new JCAHO standard on Physician Health. Educational presentations with CME credit are also made to physicians and administrators that often include a physician telling a personal story of recovery.
  4. At what point does a physician enroll in CPH?
    Physicians with behavioral health issues are eligible to enroll in CPH as soon as a diagnosis is established from a clinical evaluation.
  5. Why does CPH place such emphasis on clinical evaluations?
    CPH is above all a clinical health program. With a diagnosis as a prerequisite for enrollment, physicians can be assured that the CPH program follows accepted clinical guidelines. This also eliminates the possibility of a caller causing mischief to a physician.
  6. Where do physicians go for treatment?
    The CPH Medical Director refers physicians to providers, which specialize in physician health. For physicians seeking treatment, confidentiality is key and CPH utilizes facilities and therapists who clearly understand this need. As with all medical treatment, the patient is responsible for payment. CPH has special arrangements with facilities who bill on a physician's ability to pay. Treatment modality and duration are individually determined based on need.
  7. Are physicians in CPH able to successfully return to work?
    Approximately ninety-five percent of physicians who desire to continue in medicine return to work.
  8. Do physicians with a substance use disorder relapse after leaving CPH?
    Substance use disorders are chronic illnesses, which will require life-long attention, similar to other chronic illnesses such as diabetes mellitus, hypertension or asthma. As with any chronic illness, there is a tendency to relapse without proper self-care. The support and structure that CPH provides physicians with behavioral health diagnoses minimizes this by helping them internalize needed recovery tools. In fact the literature suggests that physicians sustain better, long-term recovery though physician-monitoring programs like CPH.

Referrals to CPH

  1. Can referrals be made to CPH on the basis of concern but no solid evidence of impairment?
    A call to CPH based on concern without evidence of impairment is the best kind of referral. Waiting for clear-cut evidence of impairment before seeking assistance for a colleague may place patients at risk. It also places the physician at risk for loss of license. If the physician has an illness, receiving treatment earlier is better than later. Because physicians are trained to observe signs and symptoms of illness, CPH has developed a great deal of respect for "signs and symptoms" referrals, most of which are right on target.
  2. Does CPH ever receive mischievous calls from people trying to cause trouble for doctors?
    Briefly, almost never. Of 2000 referrals received since 1986, CPH staff can recall receiving only two mischief calls which were expeditiously dealt with by experienced clinicians.
  3. Does CPH accept anonymous calls?
    CPH handles all callers with respect but cannot act on an anonymous referral. Frequently, physicians call to express concern for a colleague and ask for guidance without using any names. As a "doctors helping doctors" program, CPH also often receives a referral from a concerned colleague who asks that his/her name not be used. Since CPH is a clinical program, all callers can be assured of confidentiality and CPH can effectively reach out to the troubled physician or physician assistant.
  4. How should one approach a colleague who may have a problem?
    Approaching a troubled colleague is as uncomfortable as it is difficult. Even the most caring colleague can expect to be met with denial and anger. Therefore, CPH has trained a team of professionals to help plan a successful approach to the colleague. Frequently, a concerned colleague will discuss the case with CPH and determine that CPH can handle the case alone. The simplest way a concerned person can help is to call CPH directly and have CPH do the intervention.
  5. If a physician is known to be drinking a lot outside the hospital but seems to function well professionally, should a referral to CPH be made?
    The physician may be showing early signs of a problem, which has not yet affected the ability to work. With an early referral to CPH, a clinical evaluation can determine if the physician's drinking is out of control. Early intervention can prevent the problem from worsening and prevent misconduct from occurring.

 Confidentiality

  1. Is the CPH program confidential?
    CPH confidentiality is so important to MSSNY that CPH was shut down for a brief period in the late 1970s until a state law was passed to protect the privacy of physicians in the program. Federal and state laws preserve the confidentiality of information and CPH requires written consent for release of any information about physicians. CPH records have stricter confidentiality protection than medical records or peer review records; e.g., CPH records are not discoverable in civil proceedings such as malpractice suits.
  2. How does CPH respond to requests for information about physicians in the program?
    Upon receipt of a request for information, CPH contacts the physician to determine if he/she desires to have information released. If so, the physician must provide written consent for the release of specific information. If the physician desires that no information be disclosed, CPH provides the requestor with a written response, which neither confirms nor denies the existence of any information in accordance with Federal confidentiality law.
  3. Is hospital administration or the medical staff informed of a physician’s progress in CPH?
    Hospital personnel are only given progress reports if the physician signs a release. Frequently, physicians desire CPH advocacy for employment, hospital privileges, insurance panels, etc. Proper consents must be in place before release of any information.
  4. Does CPH report physician information to the National Practitioner Databank?
    No. CPH provides no information to the National Practitioner Databank or any of the other state or federal data banks.
  5. Does CPH have any responsibility to refer physicians to OPMC?
    CPH and OPMC have distinctly different roles. CPH is a health program uniquely designed to help physicians recover from behavioral health disorders. OPMC has the mission of protecting public health. The law requires that CPH inform OPMC when a physician is considered an imminent danger to public health. Generally, a physician’s desire to avoid referral to OPMC assists in his/her recovery.

Reporting

  1. Does a referral to CPH exempt one from making a report to OPMC?
    No. CPH encourages physicians to self-refer or to seek help for colleagues BEFORE misconduct has occurred. In the absence of information, which reasonably appears to show that a physician is guilty of misconduct, no physician has any obligation to report a colleague to OPMC. When OPMC must be called, however, CPH should always also be called to ensure the physician receives proper treatment.
  2. Does a physician treating an impaired colleague have any obligation to report the impairment to OPMC?
    No. Public Health Law preserves the confidentiality of the physician-patient relationship in most cases, even when the patient is another physician. Accordingly, no physician shall be required to report any information to OPMC, which is learned solely as a result of rendering treatment to another physician. The treating physician may, however, encourage the patient-physician to self-refer to CPH for support in recovery.
  3. Does involvement with CPH affect medical malpractice coverage?
    According to MLMIC, CPH participation alone does not affect a physician's medical malpractice coverage or rates. However, other aspects of a physician's practice could cause a review such as license disciplinary actions, suspension of hospital privileges or adverse claims experience.