The state of California recently overturned a mid nineties decision that allowed doctors with substance abuse problems to receive treatment without their patient’s knowledge and while retaining their medical licenses.
Sounds reasonable – but is it?
Under the new policy, doctors with substance abuse problems will be required to forfeit their license to practice medicine until they can conclusively demonstrate that their substance abuse no longer presents a danger to patients in their care.
Obviously, this is a contentious and difficult issue, and patient’s advocacy groups have been celebrating the policy reversal as a major victory for the citizens of California, and their right to receive care under both a sober and qualified doctor. I disagree with their reasoning and in fact feel that by reducing the treatment options available to doctors with substance abuse problems, patients are now under greater threat than they were previously.
Doctors are an at risk group for addiction
The stress of the job combined with very easy access to potent pharmaceuticals can prove far too tempting and too often lead to abuse. No one wants intoxicated doctors practicing medicine and endangering the lives of their patients, but this new legislation will decrease the ability of doctors to receive the help they need for their own benefit, and also decrease their motivation to admit to substance abuse.
As a matter of public safety, addicts practicing medicine is generally a bad idea, and instead of increasing the barriers to recovery and rehabilitation, we should be lowering them. When admitting to a substance abuse problem means forfeiting a career based upon many years of study and expense, the price of recovery is raised exponentially. Doctor’s are human like the rest of us, and when the personal cost of treatment becomes too high, they will react in the interest of self preservation, and continue their self destructive behaviors, as they also endanger the community.
As a matter of personal compassion, doctors also deserve our help and care. Anyone suffering through the pains of addiction deserves good access to life saving treatment, and this treatment should be equally available to all. By increasing the personal costs of rehab, you decrease the perceived availability of the treatment, and decrease the percentage of doctors that will get the help they need. This new policy endangers doctors, and endangers the public. Addicts are very good at hiding their use when they need to, and although the use of some will be detected, the use of many will not, and the continuation of medical treatment by intoxicated doctors will increase.
At a glance, it seems very logical that doctors should not be allowed to practice medicine while abusing drugs, but since the alternative harms both the doctor, and the patient; allowing "secret" treatment is both the most compassionate policy, as well as the policy that best protects public health.