Physicians Practice - February 2008 - (Page 68)

HUMAN RESOURCES through with the prescribed treatment plans. The programs can be a vital source of support to smaller medical practices that may not be able to afford employee assistance programs or don’t have standing physician health committees. Every practice, however small, should have a written zero-tolerance substance abuse policy in place, says Bergitta Smith, chief operating ofﬁcer of the National Patient Safety Foundation. Clear language in the practice’s policy manual and in physician’s behavior. “Patients might not complain — they tend to just leave quietly when they don’t like something about a physician but the staff always knows,” she says. “Your staff ﬁgure out very quickly who the problem provider is.” Smith advises checking with the practice’s attorney when dealing with a physician suspected of having a substance abuse problem. Don’t depend on your regular attorney who provides business and tax advice to know the ins and outs of • Random blood and urine testing for drug screening by an outside ﬁrm; • Individual therapy, including seeing a psychiatrist for any comorbid conditions, such as depression or bipolar disorder; • Regular contact with a primary-care physician to deal with health issues; • Commitment to a self-care program that includes exercise, stress management, sleep management, and other life strategies; • Participation in support groups; and • Participation in Caduceus Groups for physicians. Krall says the physician returning to practice should be assigned work at ﬁrst that can be easily supervised and does not present ample opportunities for patient endangerment. For example, assign the returning emergency physician to an urgent care center or clinic instead of to a hospital emergency department’s night shift. Even if the returning physician is not permitted to practice medicine immediately, the recovery phase can still be productive. Smith recommends putting the physician to work developing new quality reporting rules, dealing with payer issues, or other critical tasks that need a physician’s input. Williams adds that substance abuse is a chronic disease and recovery requires lifelong monitoring and care, not a quick ﬁx. “Think of every person in your practice as a resource and ask how you can work together to help that resource achieve and keep achieving its maximum potential,” she says. Bob Redling has written on practice “Patients might not complain — they tend to just leave quietly when they don’t like something about a physician but the staff always knows. Your staff figure out very quickly who the problem provider is.” HONING IN Bergitta Smith, National Patient Safety Foundation physicians’ employment agreements will help draw a clear line between what the practice considers acceptable and what it does not. “Decision-making and critical thinking may not be optimal for someone who’s impaired and you don’t want to be in a position of having to tell that person they should have just known where the line was that you now say they shouldn’t have crossed,” Smith says. Smith says keeping the lines of communication open between the administrator and the physician leadership can help uncover potential substance abuse, behavioral, and mental health problems early on. Administrators are quick to hear what staff members say about a 68 | PHYSICIANS PRACTICE | FEBRUARY 2008 handling these situations, Roediger says. Instead, ask your regular counsel to refer you to an attorney who has experience dealing with physician impairment issues. FOLLOW-UP THAT WORKS For some physicians, outpatient treatment for several weeks may be in order. Others may require a stay in a residential facility for a few weeks. For all, the return to the practice can be the make-orbreak test. Follow-up should include informal support from colleagues but also a structured program that includes: • A written contract with the practice partners or employer that states clear expectations; management topics for 10 years. He has been practice management editor for Physicians Practice, Web content editor and senior writer for the Medical Group Management Association, and a speechwriter for the American Academy of Family Physicians. He can be reached at editor@physicianspractice.com. WWW.PHYSICIANSPRACTICE.COM http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - February 2008

Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

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