Medical board ends therapy for doctors with abuse problems

The Arizona Medical Board is cutting costs by terminating required drug and alcohol therapy for 17 doctors with substance abuse problems.

The board will save about $37,000 this fiscal year by dropping the group therapy requirement for those 17 doctors in the Monitored Aftercare Program, a five-year treatment program where they are legally bound to also follow strict rules and submit to random drug tests.

The board decided that those doctors, whose names aren't being released, were at a low risk to relapse because their addiction was self-reported rather than brought to the board's attention by some other means such as an arrest or complaint, said Roger Downey, board spokesman.

The doctors had been in the program a minimum of two years and some were near completion, Downey said.

"Because of the budget situation, we were looking for ways to cut money," Downey said. "This was considered a fairly safe, minimal risk situation."

The decision to cut them loose didn't come without some opposition.

Dr. James Burke, whose job is to decide who practices at the three Scottsdale Healthcare hospitals, said he is concerned about the precedent the board is setting.

"Most of the scientific studies that have been done have shown that terminating these programs early can put patients at risk because there is still a chance of relapse and there is no good way to predict which physicians might relapse," Burke said Thursday in an interview.

Downey said the doctors still will be subject to random urinalysis.

Burke said he doesn't believe the random testing will be adequate because without any therapy or monitoring, the doctors who relapse won't be caught until later in their relapse.

The two doctors who have the contract to administer the program, Michel Sucher and David Greenberg, told the board it was a bad idea to terminate the 17 doctors from the program, according to minutes of a Feb. 4 board meeting.

Greenberg said the program provides participants with structure and support necessary for successful recovery.

He said the program is one of the strictest in the country and produced good results, but without the structure and support for the recovering doctors, the public will be at risk.

Greenberg wanted the board to at least keep the doctors legally bound to the program while amending their agreements so they would pay.

The 17 doctors were released from the program because they were the last ones whose treatment was subsidized by the board.

Before Jan. 1, 2007, the board subsidized the $425 per month for each doctor.

Doctors have had to pay their own way after that date.

But all of the doctors in the program were legally bound to follow strict rules of the program; otherwise, they could lose their license to practice, and in effect their livelihoods.

There are about 100 doctors in the program at any time and they must attend weekly group therapy, participate in a self-help or a 12-step program, and inform their employers and medical facilities where they have privileges that they are in the program.

They must also keep a medicine log, get a primary care physician - who is the only one who can prescribe them medicine - and abstain from alcohol and poppy seeds, the latter of which contain small amounts of codeine and morphine.

They must also be available 24 hours a day to provide random urine and hair samples.