Why does a hospital or large medical group need physician consultants to assist their physician well-being committees and other professional and mid-level provider management entities?

Physician well-being programs devised for physicians with chemical dependency and, or mental health crises, deserve solid physician consultants who are well experienced in the safe balancing of public safety, occupational, and clinical requirements.  Addiction medicine physicians performing “diversion like” duties must be familiar with the basics of “investigating” a case, as well as being able to make the correct decisions regarding the possible need for formal evaluations, urgent medical or mental health requirements, choice of treatment programs, post treatment monitoring, and decisions regarding work cessation or work restrictions. In this role, the well being physician consultant will also serve to review various medical or regulatory records and may at times report to the hospital well being committee, hospital risk management, chief of staff, or MEC as appropriate.

After a physician has successfully completed treatment, he or she should be interviewed by a consulting physician who has the experience to devise a comprehensive aftercare and monitoring program.  This specialist must integrate mental health, medical, addiction, family issues, group therapy, biological testing, pharmacological, and legal/regulatory matters, as well as general occupational health, and patient safety requirements.  Please note that Greenberg and Sucher P.C. utilizes the most comprehensive urine screening panels,  performed by SAMSHA certified laboratories, we also utilize comprehensive hair testing panels. In Arizona, Greenberg and Sucher, P.C. pioneered the use of quantitative testing in order to detect for the presence or absence of critical therapeutic drugs such as antidepressants. The introduction of this pharmaceutical compliance tool has been invaluable, and has resulted in bringing physician monitoring to higher levels of clinical effectiveness, along with significantly improved outcome in public safety assurance.

The above leadership physicians should also have a firm grasp of the essential principles and duties of regulatory boards, relevant law enforcement agencies, local statutes governing prescribing and dispensing of controlled substances, and the state’s medical practice act, to include reportable medical conditions. Additionally, these key physicians need to understand the roles and practical functioning of physician well being committees, hospital risk management, medical executive committees, peer review processes and hospital by law issues.

The California Physicians Health Program’s co-founders are both well qualified to provide consulting services to physician well being committees for the State of California.  They have functioned as such statewide medical directors for the Arizona Medical Board’s confidential and disciplinary tracks for the past 15 years.  Additionally they successfully provided emergency Diversion “look-alike” capacity during the California shortage period of 2004-05. 

How are Physicians referred to the program?

Physicians can be referred by self, spouse or significant other, or other family members, employer, DEA/Law Enforcement/regulatory board, well being committee, department chair, supervisor etc.

Has your program worked with the Medical Board of California in the past?

We did work with the Medical Board of California Diversion Program at their request to provide monitoring for overflow that the program couldn’t handle in 2004-05 as well as physicians that did not qualify for the Diversion Program.  We believe we may be the only private physician provider to ever have delivered such services for the Medical Board of California.

What are the geographic locations of the services available to the physicians including any affiliated groups?

We have an office in Orange County and an office in San Francisco.  We work with a large group of facilitators and case managers for the Diversion Program.  They have facilities and groups in the San Francisco area, the Oakland area, Sacramento, Los Angeles, San Bernadino/Riverside County, Orange County and San Diego. Additionally, random drug testing is performed at a SAMHSA certified laboratory with a statewide network of collection sites.

Do you use case managers and/or group facilitators to maintain consistency and oversight in the program?

Yes .  They have common policy and procedures and operate under our direct medical supervision.

Briefly explain your confidentiality procedures.

All patients are held in confidence.  However, if the referent is an employer, contractor or facility where the physician holds privileges, we require a chemically dependent or otherwise impaired participant to allow us to assure the referent that the physician is compliant with program requirements and safe to practice.  If they require ongoing treatment and monitoring releases are signed to allow us to communicate with all members of their medical treatment team and the monitoring team.  Further they must sign releases to allow us to contact the referring party(ies) if they are significantly and recurrently non compliant, in relapse, unsafe to practice or if they drop out of the program without successful completion discharge.  No information is ever released in any public venue.

Do you offer drug and alcohol testing?

Greenberg & Sucher, P.C. has partnered with two laboratories, Southwest Laboratories located in Phoenix Arizona and United States Drug Testing Laboratories located in Chicago, Illniois. Both laboratories provide custom drug testing panels for hair, urine, nails and blood testing. We offer comprehensive panels appropriate for professionals including Ethyl Glucuronide, fentanyl and naltrexone in the panels.  We also provide therapeutic drug testing to verify that physicians with co-occurring psychiatric and/or medical conditions are in fact, compliant with their medication regimens.

What are the costs to the participants of the program?

PricingĀ of services provided upon request.

How does your program monitor the success or failure of the participant and when the participant may be eligible to leave the program?

Data is collected on an ongoing basis and outcomes and compliance are measured on a continuous basis.  Monitoring post chemical dependency treatment is generally for five years, although there is some variability based on the progress, individual severity, relapse history and factors, etc. program length for a physician with an abuse diagnosis (not dependence), is generally for two years with compliance.

What is your success rate of the participants of your program?

The last review study of our program for the Arizona State Board of Dental Examiners conducted by the Arizona Dental Association found a 10 year success rate of 79% and the most recent five year period of 92%.  It was during the more recent five year period that a) inpatient treatment was required, b) facilitated groups were added to the program and c) compliance standards were enforced and measured.

Have you worked with other Health Care systems? 

Scottsdale Healthcare in Scottsdale, Arizona; Banner Health throughout Arizona, Mayo Clinic Scottsdale and on a consulting/educational basis to most other healthcare systems in Arizona.  We have also provided educational services to Pomona Valley Regional Medical Center.

What experience do you have working within the realms of hospital professional staff management and interfacing with medical and other healthcare regulatory boards?

Dr. Greenberg served as the Chief Medical Investigator for three years, and the Assistant Executive Director for two years with the Arizona Medical Board.  He has also served as the Medical Director for CIGNA Healthplus of Arizona’s EAP, serving approximately 300 physicians, along with many other healthcare related professional and midlevel staff.  He routinely assists in covering medical board, dental board and osteopathic board emergencies as well as urgent self report and community referred cases.  Dr. Greenberg has served on physician health committees of medical groups and hospitals. 

How long have you been doing physician (and other professional) monitoring?

Dr. Greenberg used to do physician monitoring for the Arizona Medical Board when he served there as a state employee in 1987-88.  Thereafter, for three years the state medical association ran the monitoring program and Dr. Sucher assisted with this.  In 1992 Dr. Greenberg and Dr. Sucher won the state monitoring contract during which time Dr.’s Greenberg and Sucher have served as the program’s medical directors.  Dr. Greenberg and Dr. Sucher have won every open bid contract competition for the Arizona contract. 

References can be provided upon request.

Rev. 4/01/2011