I have recently represented a string of physicians and physician assistants who had issues involving some type of substance abuse. These ran from alcohol, to narcotics, to steroids to anti-depression drugs and all made the person involved a danger to patient care. From the professional point of view, however, these cases had different outcomes and I want anyone reading this article with a substance abuse issue to wake up and understand that the very first thing you have to do is admit that you have the problem. If you do admit the issue, then you can take steps to save your medical career on your own. If you continue to ignore the problem, the New York State Department of Health through its enforcement arm, The Office of Professional Medical Conduct (OPMC), will eventually step in and solve the problem for you. The “solution” by OPMC will result in the loss of your ability to practice medicine and will put you on a very difficult path when you attempt to get your license back.
All of these cases have some behavioral traits in common. The doctor or physician assistant will slowly start to be late for work. Then he/she will forget meetings and other appointments and will have to dream up excuses to explain the fact that this no-show event occurred. As the problem gets worse and continues on through time, there is a fear, every day, that someone at the office or the hospital will notice a change in personality and someone in authority will demand a urine and/or blood sample be taken. If that occurs, the problem will be out in the open and the ability to practice medicine will be cut short right then and there. There will be a report to OPMC and no doubt a suspension from the ability to practice at the hospital or at any other medical facility. When this happens, a cascade of permanent problems occurs. That suspension will have to be reported by you in several areas for the rest of your medical life. The documents I am talking about are as follows: your renewal of your license, your application for liability insurance, your application to be involved with an HMO, your renewal of hospital privileges and other similar documents. What I mean is that almost all these forms that a medical provider has to fill out contain a question that goes rather like this, “Have you ever been suspended from practice by any organization for any period of time? If so, write a complete explanation concerning this event.” Of course, you could answer “no”, but that would be an outright lie, and that will be determined to be an act of unprofessional conduct all by itself. Lying will not help your cause or your career. So, you have to answer “yes”, and that answer makes you and your career appear to be suspect, in other words, you will have a shadow of being untrustworthy hanging over you for the rest of your life. This is not a good thing.
So, what to do? The answer is that you absolutely must be honest with yourself and if you have a substance problem get yourself in therapy before you lose your source of employment and OPMC orders you into treatment if you ever want to see a medical license again. Here is a good way to determine if you have a substance abuse problem: if you had your urine and blood tested five minutes after arriving at work today, what would the result be? If the result would be positive, you have a substance problem and eventually it is going to cost you your job, perhaps your entire career, your marriage and might lead you into bankruptcy. Unfortunately, I have seen people go right down this path.
If are a medical professional and you come to the conclusion that you have a substance problem, go see someone who has a wealth of experience dealing with the issue. If you do things correctly, it is possible to get cured and avoid OPMC altogether. If OPMC does become aware of your substance issue, it is possible that you can keep working without being disciplined and without having your situation posted on the Department of Health website, for the general public to see. To do this, however, you need to understand the steps and measures you have to take to make OPMC feel confident that you are not a danger to your patients.
The first step toward keeping your career is by recognizing the problem and then having the courage to correct the problem.