Scott Humphreys, MD

Medical Director, Colorado Physician Health Program

Last month, Physician Health Programs (PHPs) from the United States and Canada met in Baltimore for our annual educational conference. Every year when I attend this meeting, I come away with the same thought: we are fortunate in Colorado to have such a robust PHP.

What continues to surprise me is just how different PHPs can be from one state to another. Sometimes the differences are so significant that programs almost struggle to relate to each other’s challenges. Each state has its own approach to funding, confidentiality, staffing, range of services, and relationship with its medical board. Those differences matter more than most physicians probably realize.

One of the biggest differences is confidentiality

In Colorado, physicians can voluntarily seek support for health-related concerns in a confidential manner. In many states, that is not the case. A physician seeking help may automatically become known to the medical board simply for entering the program. Not surprisingly, physicians are often much more reluctant to seek support when confidentiality is limited.

And like most things in medicine, earlier intervention usually leads to better outcomes.

Another major difference between PHPs is physician involvement. At CPHP, we have five physicians who are directly evaluating and monitoring. Other states may only have a fraction of a physician position serving as medical director. Every client at CPHP has a one-on-one relationship not only with a master’s-level clinician, but also with a physician medical director.

I have always believed doctors do better being cared for by doctors

There is something important about talking with someone who understands the realities of medical practice firsthand — the pressures, the culture, the responsibility, and sometimes the isolation. Physicians often spend years being the helper before ever considering asking for help themselves. Having physician peers involved can make those first conversations easier and more productive.

The scope of what PHPs address also varies considerably

Historically, many PHPs focused primarily on substance use disorders and standardized long-term monitoring agreements. While substance use disorders can be an important part of physician health work, they account for less than 20 percent of the conditions we serve.

Our most common referral today is voluntary referrals related to burnout and stress. We also evaluate and monitor psychiatric conditions, behavioral concerns, cognitive issues, and medical conditions.

The national PHP meeting is also an important educational and research conference. CPHP has a long history of contributing to physician health research, and I am proud of the work our team continues to do in this area. Over the past year, we published research showing that presentations to PHPs are becoming significantly more complex than they were even five years ago. We have also published and presented research that disruptive behavior is frequently associated with treatable psychiatric conditions or situational stressors rather than simply personality or character flaws. (Read our research at cphp.org/research.)

I left Baltimore feeling grateful – grateful for the Colorado medical community, for the colleagues doing this work around the country, and for a system in Colorado that recognizes physician health and patient safety are closely connected.

Not every physician in this country has access to a confidential, physician-centered pathway for support. After this conference, I was reminded again not to take that for granted.