Double Standard?

Programs let addicted docs practice By MARCUS WOHLSEN, Associated Press Writer
1 hour, 3 minutes ago




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 Julie 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.

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"If you don't have confidential participation, you don't get people into the program," said Sandra 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. Richard 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. Robert 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. Steven 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. Brian 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 Anderson. 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 Anderson'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. Jason 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.

This made me physically ill....

This is what scares me about confiding in my doctor. He may be just like me or he may be the holier-than-thou type. I don't really know. I don't trust him. I don't trust any of them.

I used to trust doctors. My stepdaughter went to rehab last year and was honest about EVERYTHING. CSB showed up at my house investigating us. I realize that if there is real child abuse going on, then that should happen and they do have an obligation to report it. But, c'mon. She went to rehab a second time and lied about alot because she didn't want to wreak havoc for anybody in her family.

So, does honesty pay off? Especially when alot of these counselors in rehab are recovering addicts themselves? There are kids getting beaten and killed by their parents every day. I truly understand that. But there is a line that needs to be drawn. No parent is perfect.

I don't know what I'm trying to say. It's kinda like the ex-smoker who is more against smoking than the person who never smoked.

I just hope that my doctor is kind and understanding.

I can only hope.

I'm scared I'm going to cross a line and say something that I can't undo once it's done.

I hope I'm doing the right thing.
Jodi, I have no intention of being mean. I am going to tell you the truth.

You (and maybe your husband) are an addict and alcoholic. Why wouldn't they investigate your household, if this was told to whichever agency, that you are drunk around your children and there is fighting and abuse going on? It seems like a reasonable response to me.



Oh and another thing, if you don't get honest with yourself and someone in the position to help you, well all is lost.

Okay y'all, now go ahead and crucify me for being honest.
Well, I guess I am going to be mean too because, Jodi, that is your addicted mind trying to find excuses for not getting help. If you are an addict like me, you will come up with every excuse in the book not to get clean until you finally get tired of it. Don't look for loopholes to get out of going. Just go. If you don't trust your doctor or other addicts that have been where you are and gotten out of the hell you are stuck in, who are you going to trust? You can't trust your own judgement, it's clouded by alcohol. Believe that there is help out there and reach for it. You will get the same support face to face that you get here. All you have to do is ask for it. We care about you but there is not much we can do. You have to stop making excuses or you will die or worse, continue to live like you are.
smooch
I get that Janet. I really do.

What I'm saying is that this is from past allegations from my stepdaughter's dad and her birth mother, they chose to investigate me.

I'm not near mother of the year. I need alot of help. That wasn't the way to motivate me to get help. I could, right now, pass a drug test. According to the law, I'm not doing anything illegal. I'm above drinking age. I have no illegal (or even legal) drugs in my system. Yet I read in the paper everyday of mother's boyfriends who beat a 2-year-old. ANd they find out after it's too late.

Or someone like my stepdaughter who abandoned her 6 year old daughter in a motel room while she went out to buy crack. I'm not saying I'm any better.

I'm just saying I don't trust these "professionals" who I am supposed to confide in. Call it addict paranoia.

I'm just scared.
So........let me get this right?

Everyone of you either was either mother of the year or deserved to have your kids taken away?

Sorry if I'm being defensive. That's just my frame of my mind.

I'm sick and I'm tired. And I read all of those old rehab letters last night where my mother and my sisters told me I don't have to be a doormat anymore.

I'm not a f***ing doormat. I will assert myself.

I believe in myself.

ANd I will continue to repeat that until I really believe it.

I'm f***ing tired.
No Jodi, I'm not claiming to be mother of the year. Nowhere close. I'm on my third kid and still learning. I wasn't any better than you, I used around my son...I used alot. Not in front of him, but I was flipping flying on coke alot of the time. I made some big mistakes when I was using. I wasn't thinking clearly, thought I had all the answers, hell I did have all the answers, but they were wrong. I condoned my behavior because I "deserved" to party. After all, I worked hard, I worked 2 jobs and yeah, if I had energy to go out drinking and dancing, I "deserved" to. It was a given, non negotiable, to hell with the little kid who is home with daddy and crying cause he's afraid mommy is going to get killed driving drunk. Oh and at least my husband was home and sober with him. So hey, mother of the year...no freaking way. But a better more loving compassionate mom, one who's there for my son...yup, that's me now and I will take that over mother of the year any day..
I appreciate your raw honesty, Janet. That's what I'm talking about. Everyone here was once where I am now. Or atleast close, right? I mean...I'm no worse than anyone else...no better either.

I know that if I feel like someone is judging me, then they are doing it to help me. To knock some f***ing common sense into me. THat's why I said I get what you had to say and I could never be angry at you for that.

I do get it. I've been through this whole f***ing routine. That's what pisses me off.

I've f***ing been through it and I KNOW WHAT I HAVE TO DO TO STOP THE f***ING INSANITY!!!!!!!!!

It just pisses me off that I dont' have the love for my kids or the f***ing balls or whatever the f*** it takes to do it. I'm pissed at me. Not you. Not Kat. I know the f***ing drill. THat makes it worse. Beccause I do know the drill. And I will continue to fight it until I'm sober or I die. Becuase that's what an addict does best, right?

I'm so f***ing torn on what I want to do,. What I need to do. Why???? That's my only question.......WHY????? Why didn't god just give me a normal f***ing existence? f*** God. I'm sorry God. I' just don't understand why me.

Okay, pity party over,.
All I'm trying to say is don't i deserve a chance to be a goo d mom like you all have had? I can do it.

I know I can..

I just need a chance. I'm so f***ing depressed sometgimes.

I've got to go to weork in like hours. I am tired. I can't sleep. I 'm f***ing tired of being the bread-f***ing-winner in this family.

WHEN IS SOMEONE GOING TO TAKE CARRE OF ME???????

Never, Jodi. Just rely on yourself. Because you can do it. I know you can.

I'm tired of being out at 3 in the mornign, trudging through the snow and ice when it's 15 degrees....365 days a year. I've ben doing this since m y seco9nd was born. Almotst 13 years now. The tips at xmas are awesome. They pay for my kids' xmas and them some.

I hate the winter and the cold and being tired. I'm f***ing tired and I want some g0od rest.

Noone here can give me that. I know that. I'm just sayin'.....

Well, I will try to go to sleep. I don't see it happening. I feel tired and done drinking. I feel "saturated". That's the only way I can describe it. I go aboutg 2 days a year not drinking. I call those my "drying out" days. I just talked to tim last weekend on one of those days. Tey're not pretty.

I'm sorry. I've been coming here for so long., I am diseased, ain't I?

I hate the way I am.

Tomorrow it changes. It has to. Or I'm dead.

Of course you deserve the chance to be a good Mother. Perhaps better Mother would be a more suitable way of saying it. All of us were lacking. Sometimes it's really hard to admit that. I think for the most part we did the very best we could while in active addiction.
Even the most dysfunctional parents do a lot for their children.
Try to be positive and imagine yourself functioning at the level you're capable of. Look at tomorrow as the beginning of a new and better life. This is probably the most couragous thing you've ever done. You deserve to feel good about this.
I'm getting hyped for you here, Jodi. ((smile))
xxxooo
Jodi, let me tell you something I've learned. When I start to "judge" others it more often than not means that I see this behavior and don't like it, but the reason I am so critical is because I am like them.

Life isn't rosy for anyone.

Right now I am beginning to explore my life situations. This is stuff that most of the time I just roll over and take. I'm thinking about leaving my husband, this happens from time to time, I've been married 20 years. I started back yesterday into some more intensive therapy. I actually felt like I could breathe after, I vented out so many things. I talked about my parents marriage and was almost shocked at the revelation that I am reliving that.

Honey you can love your kids till the cows come home. It won't make a difference in your search for recovery. What you really need to do is love Jodi. Jodi is the one thing in the world that matters the most in your recovery. Loving yourself doesn't come easy, it doesn't come without a price. You can do this Jodi.

I look at you and yes, I can remember being where you are now. Maybe that's why I decided to get honest with you. I see myself in you. Let me give you an analogy: You are trapped in the bottom of a well, you are treading water, but tiring so fast. All you need to do is reach out for the rope that someone is offering you, but hell, why should you depend on someone else to help, after all you are treading water, able to keep your head above water...for now. Please allow yourself to reach out for help.

No offense to Jodi or anyone else who posted to her on this thread regarding her situation but that wasn't the issue that came to my mind when I decided to post this thread.

My thoughts were more along the hypocrisy of the medical community regarding the issue of addiction. The leniency and benefits the doctors were afforded even after butchering one woman's body and to have the support of the AMA behind them all the way in these cases is unbelievable. No matter how many times they relapse and how many people they harm we should continue to let them practice lest they "go underground" and practice. The wholesale support of these doctor/addicts by rehab centers and the AMA is totally out of line and in more than a double standard. These guys should do time in rehab and then spend some time in jail...I just don't understand why there isn't more of an outcry of the injustice of this situation. Because they like us are addicts that makes it ok? I just don't get it.

Jan
I agree with you Jan, you know how threads have a habit of going south. Oh well.

I posted on another thread about my experience with the hospital after my car wreck, I confided that I was an addict and after that it was a supposed given that I was just looking for drugs.

Any profession will look out after their own, unfortunate but true. I've seen it happen before, sure I will see it again. I was in aftercare and 90% of the ladies there were nurses who had gotten hooked on alcohol or prescription drugs. They had to report to a certain agency about their recovery. They were held accountable. I'm sure it only happens to those who are caught abusing. Too bad.
Jan,

I've been thinking about your initial post and I find that personal outrage, as well as lack of knowledge about the extent of the problem make me unable to suggest any reasoned solution. It is a problem though and likely a huge one. The stigma and consequences to a doctor in active addiction are huge. Don't have any idea what to do about it. I'll just stick with outrage for the moment.

Gina
During my using, there were times where I deserved to have my children taken from me. But not thier father. Get what I'm saying? I drove while using, with my kids in the car. I put thier lives in danger. My point is Jodi, I was not Mother of Year either. I was PTA president, soccer coach, etc all while using, so on the outside, I looked like the perfect mom and housewife. I was so far from that. You can talk yourself out of telling your dr the truth, but then you'll run out of chances of getting help. Come on girlfriend, take the plunge. Do the right thing for a change. xxxooo
Ditto what Gina said.

I really didn't know how to respond. I have a few friends who are physicians. I tried to think about how I would feel about them as physicians if they had addiction problems...and I would still feel they were good Drs. I think about my privacy through my own physician, and how I wouldn't want anyone to know if I went to rehab...unless I wanted to share it. What if I were a school teacher? A bus driver?

Does any of this make sense??? I think if a physician botches a treatment for ANY reason, they should be held accountable.

I do know a nurse who went into rehab. She needed to use her insurance to help pay for her to get help. Because of this, she had to report to 4 AA meetings weekly for 3 years to keep her nursing license in tact. She says it saved her life! She continued to nurse, even handle narcotics in the hospital, and was able to do so because of the meetings. Now, she is an organic farmer in another state! Ah...what sobriety can do!

I have had nurses in the hospital who could not administer drugs...and I knew that was why. Their license (DEA license) had been revoked.

I think Drs. are a pretty autonomous group. I just don't know that I need to know about their addiction problems unless I am about to undergo surgery by one of them...then, I think anyone can find out about a Drs. past through the AMA, can't they? I know, I can access whether or not my physician has been sued for malpractice. I guess that would be enough for me.

Why not just make Doctors take frequent drug tests? If their addicion is discovered and making it public knowledge violates their rights for privacy, then hospital administration could do these tests confidentially but very often. They should be done withoug warning and before any Doctor performs any medical procedure.
Perhaps after an extended period of time passing all tests they could be done less frequently but still without warning.
It's the only solution I could think of keeping both patient and Doctor in mind.
xxxxxooooo
I don't know why anybody should be shocked.Doctors and nurses are around all kinds of drugs 24/7.They have a high incidence of drug abuse.One of my good friends is a registered nurse who got popped 2 years ago.He has to have random drug test for 2 years.One positive and he's out.

I snuck into a Doctors only NA meeting with him.They are no different than we are.There is a high incidence of alcoholism too.From what I heard in the meeting a lot of them couldn't practice medicine anymore.All those years and money for med school........down the drain.One of them was doing construction work.Maybe California is different but Texas gets real nasty when an M.D. gets popped.

I don't hold any doctor in high esteem and never did.They are simply men and women who have a skill.I have a skill too.I think too many people give their power away when they walk into a doctors office.I trust my own power.
I ask questions too and research things on my own.I don't and have never taken a doctors holy word for anything.........that's insane.LOL
Great answer Tim,

But believe me I for one am not shocked that doctors get addicted any more than any one of us, if not more because of their access. It's the cover-up and support for the ones who damage other peoples lives that got to me. A patient has a right to know. And if this so called professional fails rehab 6times uh I think he needs his license suspended at the very least or taken away. I think Sarah mentioned she could look up and see if a doctor has been sued for malpractice. Yeah, I tried that with the doctor who caused my disability and a large fee was charged to find out.

I wish that we other addicts got the same kind of support that the doctors do from the AMA and other addiction specialists. For some reason they are considered special and deserve more understanding and consideration that us "regular addicts". In the meantime a lot of us regular addicts develop "white-coat syndrome and are afraid to even ask a doctor for something for pain even if we really truly need it. The whole deal is a bunch of bull and believe me I take care of myself and respect myself and stand up for myself whenever I have to go see a whitecoat. They are no better or different that me. Just the treatment they get for their addiction is different.

jmo

Jan
It's all about money and power.Even when it comes down to treatment it's about your insurance policy and how much money you make.They see these doctors and their earning power and get all giddy.Do they get special treatment?.....oh hell yes.

I had to roll up in a ball in my bedroom cramping and sweating with a 357 magnum parked close by in case I couldn't take it anymore.I was treated like a lepor in the ER.

It's not fair but I can't dwell on that sh*t.I'm already copping a resentment this morning at my mechanic.I don't think I can handle the AMA....maybe tomorrow.LOL