The Oregon Physician Advocacy Group (ORPAG) is a member of the Federation of State Physician Advocacy Groups (FSPAG), which was founded in late 2007 as an independent physician-run alternative to Federation of State Physician Health Programs, Inc. (FSPHP). The FSPHP is an independent nonprofit corporation which controls the vast majority of standard "Physician Health Programs" (PHP's) operated by medical licensing boards in all 50 states. Also known as "diversion programs", PHP's were originally designed to provide a therapeutic avenue for physicians with "chemical dependency" (alcoholism and drug addictions) to access confidential treatment with protection from professional investigation and/or disciplinary action. Many PHP's have gradually expanded their missions to include monitoring and treatment management for physicians with mental illness, and some are now expanding even further to encompass monitoring and treatment management for all physicians with possible "diseases of impairment" (defined as alcohol and drug use disorders, psychiatric disorders, disruptive disorders, psychosexual disorders, metabolic disorders, and physical disorders -- including diabetes, hypertension, and asthma). These increasingly broad missions have not changed the fact that the majority of state PHP's are still run by medical directors who are qualified only in "addiction medicine" and have supervisory committees largely staffed by addiction specialists and members of the general public who are "in recovery" from various addictions and who need not be physicians at all.
Until 2010, Oregon's official PHP was called the Oregon Health Professionals Program (HPP), which was administered by both the Oregon Medical Board (OMB) and the FSPHP. The HPP was established by Oregon statute (ORS 677.615 to 677.677) in 1989 as a typical diversion program for physicians "who are chemically dependent". In 2009 the HPP was legally expanded to include physicians "who are chemically dependent or have a mental disorder." Nonetheless, the Oregon HPP's most recent former medical director, Susan V. McCall, MD, MPH, had ABMS board certification only in the specialty of Preventive Medicine and had clinical expertise only in "addiction medicine", which she had practiced in various settings since 1987, and with the HPP beginning in December 1995. In July of 2009, after the governor signed HB 2345 into law (which discontinued the HPP on July 1, 2010), Dr. McCall was finally replaced as HPP medical director -- by psychiatrist Denise Dion, MD, who was not board certified in any ABMS specialty.
On July 1, 2010, a new statewide "monitoring entity" called the Health Professionals' Service Program (HPSP) was established in order to reduce the OMB's legal liability for the bad medical decisions and haphazard administrative practices inherent in attempting to allow bureaucrats, entrepeneurs, consultants, secretaries, and former law enforcement officials to manage the personal health of physicians deemed to have (or suspected of having) "diseases of impairment". All covered professional licencees in the state of Oregon (physicians, nurses, dentists, and pharmacists) now fund the new HPSP through their mandatory licensing fees, which are diverted to pay private contractor Reliant Behavioral Health (RBH) to administer the HPSP. According to the official State of Oregon HPSP brochure, "Individual licensees are [then] responsible for treatment and monitoring costs." In a recent article published in the Bend Bulletin and written by award-winning investigative journalist Markian Hawryluk, entitled "Doctors Under the Influence", several Oregon physicians and treatment professionals have expressed concern that the new "monitoring entity" legislated by HB 2345 has completely lost the original therapeutic intent of PHP creation: to help sick doctors become well enough to safely practice medicine.
ORPAG has become very concerned that the dysfunctional culture and bureaucratic structure of many FSPHP member organizations (such as the now-defunct Oregon HPP and its immediate successor the Oregon HPSP) are increasingly harming the very physicians that they were originally designed to help. Both voluntary and involuntary enrollment in these PHP's can ultimately injure, disable and even kill allegedly impaired physicians -- in part through misdiagnosis, mistreatment, and mismanagement of their various medical problems by unqualified professionals, uncaring bureaucrats, and uninformed committees -- in part by reporting allegedly "noncompliant" physicians to their state licensing boards for professional investigation and/or disciplinary action (often resulting in public orders for license suspension or revokation, without meaningful due process protections and without any real opportunity for appeal) -- and in part by driving them into isolation and despair through systematic humiliation, defamation, loss of privacy, and loss of autonomy. As individual ORPAG physicians, we know these abuses are happening because each of our lives and our careers have been irreversibly damaged by this Kafkaesque system.
According to the Oregon Medical Association's 2009 Legislative Update published 5/26/2009:
"One of the key components to the successful HPP program is the ability of physicians to self refer to the program without the danger of being disciplined by the board. However, in a recent disciplinary proceeding before the OMB involving a physician who had self referred to the HPP due to chemical dependency, an Administrative Law Judge ruled that the licensee must both voluntarily refer herself or himself to the HPP Program and successfully complete the Program for the immunity provided in ORS 677.655(3) to apply. Because treatment programs often extend over a period of two to five years, the practical effect of the ruling is that a participant in the HPP program cannot be certain that he or she will not be disciplined even if the physician has, in good faith, self referred into the Program. This essentially strips away the immunity provision of the Program that is a major contributor to HPP success. Thus, the fate of HPP is compromised whether HB 2345 [bill dismantling the HPP in 2010, signed into law June 2009] passes or not. Comments received from the Oregon Medical Board indicate that OMA and OMB interpret this matter differently."
We believe that the health and safety of the Oregon public depends in part on maintaining the health and safety of its caregivers. ORPAG is striving to promote individual Oregon physician health and well-being by providing a completely anonymous forum for confidential networking, community-building, discussion and exchange of ideas for self-protection and self-advocacy on behalf of Oregon physicians who may potentially become impaired by substance abuse, physical or mental illness, or disability. The primary goal of ORPAG is to help Oregon physicians learn to heal ourselves and each other. We understand that physicians sometimes get sick too, and that just like other patients they need safe, supportive, and private access to quality healthcare resources of their own choosing, without risk of punishment or public disclosure just for seeking professional help. We know that many physicians with serious personal health problems actually avoid getting the help they need because of their tragically realistic fears of prejudice, humiliation, bullying, coercion, and other outright abuses by their medical licensing boards and state physician health programs. These abuses (and avoiding care due to fear of being subjected to these abuses) definitely contribute to many physicians' reluctance to seek care and likely contribute to some physician suicides. Avoiding care can also result in physicians continuing to practice medicine while impaired by treatable personal health problems.
Medical resources for improving the personal health and legal resources for protecting the civil rights of potentially impaired and disabled Oregon physicians (including the rights to privacy and due process) will also be shared and discussed in this forum. When the website is completed, the confidentiality of all participants will be strictly enforced.
ORPAG is not affiliated in any way with the HPP, HPSP, FSPHP, ABMS, RBH or the OMB.
This group (and this website) are still under construction.
Website last updated 12/14/2013.
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