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Ethical and Managerial Considerations Regarding State Physician Health Programs

Boyd, J. Wesley MD, PhD; Knight, John R. MD

doi: 10.1097/ADM.0b013e318262ab09

Many physicians are referred to state physician health programs (PHPs) for evaluation, monitoring, and treatment of mental health and substance use disorders. Most PHPs are “diversion” or “safe haven” programs, meaning that physicians who suffer from alcohol or drug problems can have their case diverted to the PHP in lieu of being reported to the state licensing board. If the physician agrees to cooperate with the PHP and adhere to any recommendations it might make, the physician can avoid disciplinary action and remain in practice. These programs are therefore quite powerful and yet, to our knowledge, there has not been any systematic scrutiny of the ethical and management issues that arise in standard PHP practice. Given our 20 years of service as associate directors of one state PHP we analyze and evaluate the standard operating procedure of many PHPs and offer ethical critique as well as suggestions for improvement.

From the Department of Psychiatry, Harvard Medical School and Cambridge Health Alliance, and Boston Children's Hospital (JWB), Cambridge, MA; and Department of Pediatrics, Harvard Medical School, Boston Children's Hospital (JRK), Boston, MA.

Send correspondence and reprint requests to J. Wesley Boyd, MD, PhD, 1493 Cambridge Street, Cambridge, MA 02139. E-mail:

The authors declare no conflict of interest.

Received July 07, 2011

Accepted June 03, 2012

© 2012 American Society of Addiction Medicine