PROGRAMS GIVE AID TO DOCTORS, BOASTS OF HIGH RECOVERY RATE

While research shows one in 10 people will misuse drugs at some point in
their lifetime, when the abuser is a doctor, nurse or pharmacist responsible
for the well-being of others, the problem becomes a matter of public health.
"It's certainly a concern," said Judy Eads, assistant commissioner of the
Tennessee Department of Health's Bureau of Licensing and Regulation. "It may
be only a small portion of overall licensees in a profession, but the
concern is for citizens at risk by exposure to an unsafe practitioner."

To put things in perspective, Eads noted that fewer than 1 percent of the
state's health care professionals are ever brought before the licensing
boards for any type of complaint. Of those who do, more than half - 65
percent of nurses and 56 percent of doctors last year - are there because of
alleged drug-related violations.

To address the risks, the state's 28 health-related boards apply sanctions
ranging from license revocations to temporary suspensions with practice
restrictions that can be lifted as licensees work through probationary
periods of treatment and counseling. To keep the public informed, the health
department regularly announces disciplinary actions taken by the boards and
also posts the information on the license verification section of its Web
site at www.state.tn.us/health.

Along with that, Eads said, the state also recognizes "the need to keep good
workers in the system," and to that end contracts with independent peer
assistance programs across Tennessee to help health care professionals
maintain their licenses and return to practice.

Dr. Jack Woodside, assistant medical director for the Tennessee Medical
Foundation's Physicians Health Plan for doctors with addictions and other
problems that may impair their practices, said while watchdog groups often
call for stiffer sanctions and more public notification of drug violations,
the TMF believes the therapeutic approach taken by programs like the PHP is
more effective.

As with any disease, Woodside said, the goal is to identify and treat
addiction as early as possible. The voluntary and confidential nature of
recovery programs like the PHP is intended to encourage practitioners to
seek help, he said, rather than driving them underground in fear of
sanctions and public disclosure.

"If there is a risk of sanctions, they are more reluctant to come in for
help and more likely to stay impaired," he said. "Addictions may go on
longer and to greater levels."

It is important for physicians to know that the PHP is not obligated to
notify the state, employers or insurance carriers of a doctor's request for
help and that the program instead serves as an advocate for the physician in
mediations with those organizations, he said.

Woodside attributes higher rates of success found among physicians in
recovery than in the general population - 85 percent to 90 percent for
doctors compared to 40 percent to 50 percent overall - to a combination of
the support provided by programs like the PHP and strong professional
contingencies. "Most doctors are highly motivated to keep their careers," he
said. "And there are very few professions with this type of program to
identify addictions early and to assist with treatment and follow up."

"Doctors have the advantage of programs like this with mandates for
treatment. In the Tri-Cities today, most end up in intensive counseling for
a few hours a day most days of the week and most (undergo treatment) at
facilities where the lengths of stay are three months or longer."

Part of a network of independent recovery programs working with health care
professionals across the state, the PHP is joined locally by the Tennessee
Professional Assistance Program for nurses and the Tennessee Pharmacists
Recovery Network for druggists. Together, the three programs facilitate more
than an half dozen support groups in the Tri-Cities area.

Typically, the programs begin with an evaluation of an individual's level of
dependency and need of treatment and the formulation of a recovery plan that
may range in duration from three to eight years. Often, the plans include an
intense period of intense treatment followed by years of weekly group
therapy sessions with other health care providers recovering from
addictions.

Most often, Bill Hamil an evaluator for the TPAP program said, nurses who
come to the program are those who have tested positive on a drug screen and
want to keep their jobs.

Their problems are accumulative, he said, a combination of high-pressure
jobs in which staff shortages "have everyone working in higher gear" and
ordinary "people problems" like divorce, finances and illness.

And while there is "no cookbook approach" to recovery, Hamil said, the
advantages of joining a group like TPAP are the group's "solid connection to
the treatment community" and the counsel of others in like situations. "Its
always helpful to meet people who have succeeded in what you are trying to
do," he said.

Jerry Naylor, a group facilitator for TPAP, said while "everyone's story is
a little different," some of the key common denominators are accepting
addiction as an illness, recognizing a lifestyle that has to be broken and
addressing the ongoing challenges of routine access to drugs in the
workplace.

Relapses happen and some nurses change the path of their careers to avoid
the risks of dispensing drugs to others, he said. "The important thing is,
if you're on that downward escalator of addiction, you don't have to go all
the way to the bottom. You can step off any time."