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Colorado Physician Health Program (CPHP) and Physician Health Issues Presentation to UCHSC Residency Directors December 10, 2008 Michael H. Gendel MD –

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Presentation on theme: "Colorado Physician Health Program (CPHP) and Physician Health Issues Presentation to UCHSC Residency Directors December 10, 2008 Michael H. Gendel MD –"— Presentation transcript:

1 Colorado Physician Health Program (CPHP) and Physician Health Issues Presentation to UCHSC Residency Directors December 10, 2008 Michael H. Gendel MD – Medical Director Sarah R. Early PsyD – Executive Director © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

2 Program Services  Client Services: Assessment Treatment referral Monitoring and support Family support Documentation  Workplace and Referral Source Services: Consultation on identifying physicians who need assistance Consultation on making effective referrals Workplace consultations Educational presentations © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

3 Program Services Cont.  Medical Community Services: Promote physician health awareness Educational presentations Partnership with organizations to meet special needs Develop meaningful research on physician health  Presentation Topics: Colorado Physician Health Program services Work stress Substance abuse, addiction Women in medicine Physicians in relationships and families Professional boundaries Self-care and physician health issues Disruptive behavior management © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

4 CPHP Services CPHP’s direct services are free to Colorado licensed physicians and physician assistants. CPHP has contracts to serve Colorado residents, medical students and physician assistant students. Participants are responsible for costs of any additional evaluations and treatment if those services are necessary. © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

5 Relationship To The Colorado Board of Medical Examiners (BME) BME Makes Referrals to CPHP Applications for licensure Renewal applications Complaints CPHP Provides “Treatment Monitoring” for individuals with license stipulations “Safe Haven” on applications and re-applications 22% of CPHP cases are known to the BME © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

6 Confidentiality State and Federal Laws CPHP Policies and Procedures Consent Forms © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

7 Clinical Assessment Assessment Review of documentation Self-reported history (health, lifestyle, family and work) Face-to-face interview Collateral interviews Laboratory tests and/or urine drug screen Review by clinical team External evaluation (i.e., psychological testing, neurological exam) © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

8 Annual Number of New Referrals Program History 1986 - Present * = BME License Renewal Years © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

9 Loss of Function Hierarchy for Ill Physicians  Community  Spiritual life  Recreation and avocation  Friends  Peers  Family  Work © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

10 Warning Signs Decline in job performance Absenteeism Attitude and/or mood Troubled professional/interpersonal relationships Professional boundary issues Physical symptoms or illness Decline in physician appearance Other problem areas © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

11 What You Can Expect From CPHP Following a Referral With signed consent: You will be notified that the referred individual came for evaluation and what the plan is CPHP will discuss with you arrangements regarding work if necessary CPHP will furnish status reports as necessary Without signed consent: You will not receive any information If you want information about a mandatory referral, require a signed consent in the referral documentation © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

12 Residents’ Problems Accessing CPHP and Treatment Services  Perception that department would not be supportive in terms of time away from work  Guilt about having other’s provide coverage or not doing their share  Perceived dissonance between supportiveness of residency director/chair and attendings/chief resident © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

13 Residents’ Problems Accessing CPHP and Treatment Services  Belief that having an illness/diagnosis, requiring treatment, or being a CPHP client will affect negatively impact their career  Denial (including age-related factors) that they could be seriously ill  Stigma about psychiatric or substance related conditions © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

14 Residents’ Problems Accessing CPHP and Treatment Services  Tradition of excessive work demands of residency (which entails ignoring important aspects of self- care and relationships) cannot be challenged or modified even to prevent or ameliorate illness  Problem may be enhanced for women of childbearing age (increased role conflict)  Reality: Lack of reasonable balance in residency years predicts lack of balance in subsequent professional activity © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

15 Referral is not enough  If a resident has a problem that needs ongoing assistance, the referring party needs to problem-solve with the resident how he or she will address the above concerns – time away, managing others (attendings, chief residents), coverage, guilt, balance, stigma, denial, career fears, etc. © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

16 UCHSC Residents USCHS Residents: A total of 37 UCHSC resident new referral were served during Fiscal Year 2007-08. Presentations/Exhibits Provided: Date Department Topic 07/02/07UCHSC Resident OrientationCPHP/Physician Health 07/16/07UCHSC Graduate Medical EducationCollaboration 08/02/07UCHSC Graduate Medical EducationCollaboration 08/18/07UCHSC Residency DirectorsCPHP/Physician Health 08/20/07Anesthesiology ResidentsCPHP/Physician Health 08/23/07Board of Medical Examiners/GMECollaboration 10/02/07Pediatrics ResidentsStress Management 10/16/07UCHSC Graduate Medical Education Collaboration 10/16/07Family Medicine Residents CPHP/Physician Health 11/05/07Internal Medicine Residents CPHP/Physician Health 11/13/07UCHSC Graduate Medical Education Training Program Collaboration 12/14/07Surgery ResidentsCPHP/Physician Health 02/13/08UCHSC Residency Directors Professional Boundaries 03/25/08Pediatrics ResidentsCPHP/Physician Health 06/20/08UCHSC Resident OrientationCPHP/Physician Health © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

17 CPHP Resident New Referrals Referral Source July 2007 – June 2008 N=50 Voluntary (58%) Mandatory (42%) © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

18 CPHP Fiscal Year 2007- 2008 Client Primary Presenting Problems N=190 Other= Credentialing Matter © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

19 CPHP Residents New Referrals Primary Presenting Problem July 2007 – June 2008 N=39 © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

20 CPHP Resident New Referrals Specialty July 2007 – June 2008 N=39 © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

21 Contacting CPHP CPHP may be reached at: 303-860-0122 or 800-927-0122 Office Hours: 8:30 a.m.- 4:30 p.m. Monday – Friday After Hours Clinical Emergencies: Pager: 303-437-2138 For additional information visit the CPHP website: www.CPHP.org © Colorado Physician Health Program 2008 All Rights Reserved Please do not reproduce or use without written permission of CPHP

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