In the interest of the health, safety and welfare of the people of Oregon, the Oregon Medical Board, “OMB” or “Board,” is charged with protecting the public from the practice of medicine by unqualified, incompetent or impaired physicians and other licensees. With this principle foremost in mind, the Board has adopted a policy of rehabilitating impaired physicians and other licensees whenever possible.
The Board participates in the Health Professionals’ Services Program. The HPSP was established in July 2010 as a statewide confidential referral resource for rehabilitation and monitoring. Prior to the development of HPSP, the Board maintained its own successful Health Professionals Program “HPP,” for the past 20 years.
Licensees experiencing substance abuse or mental health problems who entered HPP’s treatment and monitoring program experienced significant success in being able to return to practice and overcome their addiction. The typical participant spent five years in the program. Experience, in Oregon and nationally, indicates that anything short of this standard of comprehensive monitoring leads to a markedly increased failure rate.
Within health care delivery systems, there is acute awareness of the need to identify substance abuse and mental health issues. Nearly all hospitals and other delivery systems require physicians and other licensees to answer personal history questions, which include questions regarding substance use and mental health questions. In addition to system practices, state law requires that all impaired licensees be reported to the Board (ORS 676.150).
Licensees with substance abuse and/or mental health issues are encouraged by the Board to seek comprehensive treatment before becoming impaired. The Board has adopted the following policy for addressing physicians and other licensees with substance abuse and/or mental health issues:
Self-referral: Licensees will be considered “true volunteers” when they have sought affiliation with HPSP on their own or through an intervention of others without prior Board knowledge. The responsibility of individuals and organizations required by law to report impaired physicians and other licensees may be discharged if the impaired licensee voluntarily enters HPSP. Voluntary HPSP participants require no further action relative to licensure, and they will not be reported to the Board so long as they successfully participate in the program.
The Board will not be notified of the identity of voluntary participants in HPSP but will be kept informed of program information and statistics on an on-going basis. HPSP participants will not be reported to the National Practitioners Data Bank as disciplinary cases. There will be, however, a formal agreement between HPSP and the licensee.
Board referral: At the discretion of the Chief Investigator or the Board’s Medical Director, in consultation with the Executive Director, licensees reported to the OMB for investigation and believed to have a substance or mental health related disorder may be offered an opportunity to participate in HPSP. Disciplinary action may be utilized for licensees determined as inappropriate for HPSP or requiring discipline in addition to HPSP monitoring.
Not all licensees with a chemical dependency or mental health problem will avail themselves of HPSP; those who choose not to participate or do not comply with the terms of the agreement with HPSP are subject to denial of license or discipline pursuant to ORS 677.190.
Chemical dependency or a mental health diagnosis does not have to be a condition that destroys a professional’s career, personal life and professional standing. When in remission, chemical dependency does not adversely affect a licensee’s ability to practice medicine. With proper treatment and follow-up, chemically dependent licensees or a licensee with a significant mental health disorder can continue their practice, often virtually uninterrupted.
In situations where a disciplinary action is necessary, it is often appropriate to reinstate a licensee as soon as their condition warrants it. The OMB has found that with proper in-patient treatment and good monitoring, a rehabilitation rate of approximately 90 percent is possible.
As the above policy indicates, self-referral is vastly superior to disciplinary action. By whatever method necessary, the Board strives to assure licensees with chemical dependency and/or mental health issues receive appropriate treatment. In its effort to both protect the public and rehabilitate physicians and other licensees, the Board encourages all licensees and their organizations to promote early intervention.
-Revised October 2010