Physician Health and Rehabilitation Committee

Basic Process

Any physician called to the attention of the Bexar County Medical Society (BCMS) Physician Health and Rehabilitation Committee (PH&R) may be contacted in an attempt to meet with that physician and discuss the alleged problem. At that time, immediate hospitalization at a treatment center may be insisted upon, or an invitation extended to attend the next meeting of the Committee for further discussion.

Under usual circumstances, the chair of the Committee will contact the BCMS PH&R Staff Liaison and let them know of a physician who may be needing help from the Committee. Occasionally a physician who needs help will contact the Staff Liaison directly and ask to be put on the agenda to speak at the next meeting as a guest.

When the physician comes before the Committee, he or she is asked to speak about the circumstances in their life that the Committee may be able to help with. This can sometimes be a very delicate situation. The physician may have some denial, their defenses may be up, and they are more than likely feeling very vulnerable. For these reasons, it is very important that all business in dealing with the physician be conducted with a great deal of empathy, patience and always confidentiality.

After the doctor has spoken about their situation, the Committee members will take a moment to explain the purpose and role the Committee plays in advocating for impaired physicians if the doctor signs a monitoring contract. Each contract can be individualized to accommodate the physicians’ needs, but there are certain basic rules. The contract could include any number of special stipulations such as weekly random toxicology tests and a number of AA/NA meetings to attend as specified by the Committee. The Committee will also monitor physicians who come to it on their own and sign a contract, prior to entering or following treatment.

Not all physicians who appear before the Committee agree to sign a contract. These cases are individually considered by the Committee and a decision is made as to what action the Committee should take at that time.

The Committee has established an AA/NA support group, the Caduceus Club, and each contracted physician is urged to make one of these weekly meetings. There are only medical professionals in this group and it is more comfortable for the physician than a mixed group. Other groups around town are informally monitored for attendance by several of the Committee members. At the monthly Committee meetings, the attendance is noted in the reports on the physicians. Attendance logs for these meetings must also be turned into the Staff Liaison on a monthly basis. Usually this is done by email, or records of attendance may be left in an envelope after the weekly Caduceus meeting for the Staff Liaison to pick up on Friday mornings.

The Analytical Toxicology Corp lab in north central San Antonio is the lab of choice for the Committee regarding calls. Analytical Toxicology Corp lab keeps a record of each physician and will send us copies of the lab reports for their observed random urines, where it is then placed in the doctor’s file. The Committee predetermines the number of urine samples per week or month, the period of time these tests must be done, and notifies the Staff Liaison, who calls the participants randomly throughout each month to test. It is very important to note that a release must be signed by the physician (usually at the same time that the contract is signed) that will allow Analytical Toxicology Corp lab (or other lab) to communicate these results to the Committee and Staff Liaison ONLY.

Letters of advocacy are not automatically sent to the Texas Medical Board or any other entity. The request has to be made by either the physician himself, or the entity that needs the letter. It is imperative that a release is signed by the physician, and kept on file, that allows the Committee to send these letters and other information. Usually this can be signed at the same time that the physician signs the contract.

Most contracts have a 5 year duration and one is considered to have successfully completed their contract of sobriety with the BCMS PH&R program, when their urine tests have been negative and their meeting logs are completed and in file. The physician may have the Staff Liaison write letters of compliance to anyone that requires one (the State, employers, hospitals, etc.), even after completion of the contract.

We believe this process has great reward, and usually enables the physicians to keep practicing medicine, since we are advocating for them