Physicians and others who work in the medical field often experience tremendous stress in both their professional and personal lives, which can sometimes lead to substance abuse or other mental health issues.

For this reason, the Arkansas Medical Foundation was set up in 1983 to provide confidential treatment and follow-up monitoring that will allow these healthcare workers to practice safely.

 

Brad Diner, MD, is a psychiatrist who has served as the foundation's medical director for two and a half years. He said most clients are referred to the foundation as a disciplinary action, but he'd like to see more come in on their own.

"What we want to do is prevent that by getting people to self-refer to us," Diner said.
"That's the main reason we want to get the word out. There are so many doctors who don't even know we exist, or they think we're identified with some kind of disciplinary action, but we want them to continue to practice, and practice safely."

Currently the foundation serves about 90 clients. These include not only medical doctors, but also dentists, licensed respiratory care professionals, registered dental hygienists, optometrists and occupational therapists. The foundation also works with residents and medical students to try to head off any problems that may develop later in their careers.

"It's not atypical for a doctor to be stressed and overworked, and easily develop a relationship outside his practice as a way to get his needs met, and that's a vulnerability we try to prevent," Diner said.

The Little Rock-based foundation is a nonprofit agency that oversees a committee of doctors statewide who provide the aftercare monitoring and insure program compliance.

Clients aren't allowed to practice while undergoing treatment, but once they complete that and enter the monitoring stage, they can return to practice as long as they comply with all the requirements.

 

When clients come in voluntarily, Diner said, "They say, 'I know I have a drinking problem and I'm ready to do something about it.' There are hospitals – none in Arkansas – that specialize in treating physicians. We'll send them to one of those, they'll do testing and put together a report with recommendations. Those can be anything from therapy or drug screening to 90-day inpatient treatment.

"They'll go through that treatment, and come back with the stamp that this physician is ready to return to practice. But they must first enter into a contract with us for monitoring, and that monitoring entails AA meetings, random drug screens and medication such as antidepressants.

 

"A typical program is five years. They can go back to practice, and we know that they're safe; that's the point of doing the monitoring. We have about a 95 percent success rate."
When clients are sent by their board, Diner said, "all those same things will happen, but we have to go to the board every two months and report to the board how they are doing. But if a client is not compliant, we have to report that to the board and the board will take appropriate action.

 

"It's purely looking out for the safety of the people of Arkansas."
Vickie Walters, the foundation's program coordinator since 1996, gets to know each client personally. She works closely with them throughout the treatment and subsequent monitoring process.

 

Diner called Walters the program's "hands-on" person, because she essentially runs it. Walters' duties include setting up lab collection sites, getting the contracts together for monitoring, and acting as liaison with the various professional boards.
Walters said the program initially served clients struggling with substance abuse and dependence, but later branched out to include mental health and behavior/boundary issues.

"When you call us, it's confidential," Walters said. "We don't tell who told. We want people to know that what we want to do is save lives."

 

Many clients stay in touch even after completing the five-year program, she said.
"We're just there for the family all the way around," Walters said.

The foundation is funded in part by a portion of every doctor's annual fee to the Arkansas State Medical Board. It also gets annual donations from the Arkansas Medical Society and the State Volunteer Mutual Insurance Co., a provider of malpractice insurance. In addition, clients must pay an annual fee.

Most states have a similar program, Diner said. The Federation of State Physician Health Programs serves as a resource for these services by helping to establish monitoring standards, promoting annual meetings and state membership, and facilitating regional educational meetings.

In addition, "The joint commission that certifies and accredits hospitals requires that all hospitals have a program in place that identifies impaired physicians and have a program in place to treat them," he said.

 

The Arkansas Medical Foundation’s Web site is www.arkmedfoundation.org. The staff can be reached at (501) 224-9911, or by e-mail at arkphc@aristotle.net.