Question

Should a physician who has/had a substance abuse addiction be permitted to retain their license to practice medicine? What are the laws or ethics in California on this subject

Answer 1

Yes , licence of a physician with substance abuse should be blocked for a short period of time if he is proved to be an addict.. His licence should be blocked during the acute intoxication period and rehabilitation period. Care of the physician who abuses drugs now involves taking him or her to a facility that has the means to evaluate for addiction and after he returns to normal condition and is withdrawn from substance abuse his licence can be renewed

Ethical aspects in California

State laws vary tremendously in this area, too. Some States limit protection to cover only information a patient communicates to a professional in private in the course of the medical consultation. Information disclosed to a clinician in the presence of a third party -- like a spouse -- is not protected. California, protect all information the patient tells the clinician or the clinician gains during examination. California also protects other information acquired by the clinician in his professional capacity about the patient's mental or physical condition, as well as the advice the clinician gives the patient. When California courts are called upon to decide whether a particular communication of medical information is privileged, State law requires them to presume that it is.

California affords even greater protection to communications between patients and psychotherapists, a term that covers a wide range of professions. Communications by and to the patient as well as information communicated by a patient's intimate family members to therapists and psychiatric personnel 8 are protected. California also protects information the patient discloses in the presence of a third party or in a group setting.

Understanding what medical information is protected requires primary care clinicians to know whether State law recognizes the confidentiality of medical information in the many contexts in which the clinician acquires it.

Finally after getting treatment state medical licensing boards typically require physicians to self-report and to report on other physicians who are unable to practice medicine safely because of drug or alcohol use. Most states have a bypass mechanism that allows foregoing of a report to the state licensing board and instead allows a report to the state's PHP to satisfy this requirement.However, these bypass programs may have eligibility requirements that exclude certain physicians from participating and require a report to the medical board. Typical exclusions are for physicians who are already under licensing board discipline, those who previously have been terminated from a professional rehabilitation program, those who have diverted controlled substances for other than self-administration, or those whose continued practice of medicine would create a serious risk of harm to the public. As long as the reported physician complies with the practice limitations and continuing care requirements of the rehabilitation program and abides by the requirements of the PHP, the physician engaged in a bypass program typically can avoid formal, public reprimand or disciplinary action by the licensing board. However, in California, such a bypass rehabilitation program has come under public attack for permitting impaired physicians to continue to practice and for not being effective in adequately protecting patients from substandard care.

Federal laws, such as the Americans with Disabilities Act,and state civil rights laws generally protect physicians actively engaged in chemical dependency treatment programs as well as recovering addicts. These laws generally require “reasonable accommodation” for the recovering alcoholic and drug addict, such as a modified work schedule. (However, the Americans with Disabilities Act specifically excludes as a covered disability “psychoactive substance abuse disorders resulting from current illegal use of drugs.” ) Furthermore, federal and state laws mandate job protection, typically up to 12 weeks, during a medical leave for addiction treatment.