Research about PHPs and Health Professionals

FSPHP strongly advocates for the use of empirical data to understand physician health program outcomes and continually works with our PHP member programs and subject matter experts to move this effort forward.

Barriers to recovery for medical professionals: Assessing financial support through a survey of Physician Health Programs 
by Amy E. Vinson, MD (Boston Children’s Hospital/MMS Benevolent Society), Michael Fitzsimons, MD (Massachusetts General Hospital), Samuel Weinhouse, BA (Brigham and Women’s Hospital), Lisa Merlo, PhD, MPE, Chris Bundy, MD, MPH, FASAM, Steven Staffa, MS (Boston Children’s Hospital), Mark Rockoff, MD (Boston Children’s Hospital), Linda Bresnahan, MS
American Journal of Addiction, 2023
“This is the first publication that attempts to measure the extent to which the costs of qualified evaluation and treatment are barriers to help-seeking for physicians with impairing or potentially impairing health conditions. The findings suggest that the cost burden to physicians, especially earlier in their careers when intervention would be most helpful, may be a major impediment to health and well-being. Rather than seeing this as a problem with the PHP model, which has consistently delivered exemplary results, the authors conclude that costs should be shifted away from individuals and onto the system that benefits from their work without compromising the quality or qualifications of those who have the experience and expertise to effectively evaluate and treat this unique population.” Chris Bundy, MD, MPH, FSPHP Past-President, Executive Medical Director, Washington Physicians Health Program. “Physicians arrive in treatment at different times during their career. About 30% of these admissions are medical students or early career physicians, who are burdened by academic debt. Third-party payers provide limited support for career and life-saving care, decreasing the effectiveness of the long-term disease management process provided by PHPs across the U.S. and Canada. This article serves as a wake-up call for all. Effective treatment followed by disease monitoring works and is cost-effective. Why are we not able to use it in this vulnerable population?” Paul H. Earley, MD, DFASAM, FSPHP Past President, and GA Professionals Health Program, Inc. Medical Director.

Essential components of physician health program monitoring for substance use disorder: A survey of participants 5 years post successful program completion
by Lisa J. Merlo PhD, MPE, Michael D. Campbell PhD, Corinne Shea MA, William White MA, Gregory E. Skipper MD, Jill A. Sutton PhD, Robert L. DuPont MD
American Journal on Addictions, 2022
A January 2022 article authored by FSPHP Research Committee Co-Chair Dr. Lisa Merlo and published in The American Journal on Addictions describes elements of successful professional health monitoring programs (PHPs) from the perspective of former participants 5+ years after completion of their monitoring agreement for substance use disorder (SUD)--i.e., after 10+ years of recovery. The results provide preliminary evidence of the long-term sustainability of treatment success among PHP participants and document the particular importance of engaging with the PHP, formal SUD treatment, participation in 12-step programs, and random drug testing to achieve these outcomes. 
Thank you to the PHP staff from Idaho, Indiana, Florida, Mississippi, Missouri, Montana, New Hampshire, and Washington who assisted with contacting potential participants for this study, as well as to the physicians who participated by completing the survey.

Barriers and Facilitators to Seek Help for Substance Use Disorder among Dutch Physicians: A Qualitative Study
by Pauline M. Geuijen; Esther Pars; Joanneke M. Kuppens; Aart H. Schene; Hein A. de Haan; Cornelis A.J. de Jong; Femke Atsma; Arnt F.A. Schellekens
European Addiction Research, 2022

Do Medical Licensing Questions on Health Conditions Pose a Barrier to Physicians Seeking Treatment? A Literature Review
by Fisayo Aruleba, BSc Hons; Jeremy Beach, MBBS, MD, FRCP(C); Gordon Giddings, MD, MBA, FCFP, CCPE
Journal of Medical Regulation, 2022

Changes in Burnout and Satisfaction with Work-Life Integration in Physicians During the First 2 Years of the COVID-19 Pandemic
by Tait D. Shanafelt, MD; Colin P. West, MD, PhD; Lotte N. Dyrbye, MD, MHPE; Mickey Trockel, MD, PhD; Michael Tutty, PhD; Hanhan Wang, MPS; Lindsey E. Carlasare, MBA; Christine Sinsky, MD
Mayo Clinic Proceedings, 2022

Is It Burnout or Depression? Expanding Efforts to Improve Physician Well-Being
by Srijan Sen, M.D., PhD
The New England Journal of Medicine, 2022

Impact of the COVID-19 pandemic upon self-reported physician burnout in Ontario, Canada: Evidence from a repeated cross-sectional survey
by Jainita Gajjar, Naomi Pullen, Yin Li, Sharada Weir, James G Wright
BMJ Open, 2022

Physicians and Cognitive Decline: A Challenge for State Medical Boards
by Sharona Hoffman, JD, LLM, SJD
Journal of Medical Regulation, 2022

Suicide and Self-Harm Among Physicians in Ontario, Canada
by Manish M. Sood, MD MSc; Emily Rhodes, MSc; Robert Talarico, MSc; Caroline Gérin-Lajoie, MD; Christopher Simon, PhD; Edward Spilg, MBChB, MSc; Taylor McFadden, PhD; Kwadwo Kyeeremanteng, MD; Daniel T. Myran, MD MPH; Nicholas Grubic, MSc; Peter Tanuseputro, MD MHSc
The Canadian Journal of Psychiatry, 2022

Violence Against Physicians in the Workplace: Trends, Causes, Consequences, and Strategies for Intervention
by Rosangela Caruso, Tommaso Toffanin, Federica Folesani, Bruno Biancosino, Francesca Romagnolo, Michelle B. Riba, Daniel McFarland, Laura Palagini, Martino Belvederi Murri, Luigi Zerbinati & Luigi Grass
Current Psychiatry Reports, 2022

Physician Health Care Visits for Mental Health and Substance Use During the COVID-19 Pandemic in Ontario, Canada

by Daniel T Myran, Nathan Cantor, Emily Rhodes 1, Michael Pugliese, Jennifer Hensel, Monica Taljaard, Robert Talarico, Amit X Garg, Eric McArthur, Cheng-Wei Liu, Nivethika Jeyakumar, Christopher Simon, Taylor McFadden, Caroline Gerin-Lajoie, Manish M Sood, Peter Tanuseputro 
JAMA Network Open, 2021

Success Rates of Monitoring for Healthcare Professionals with a Substance Use Disorder: A Meta-Analysis - January 2021
This investigation highlights the limitations of prior studies demonstrating effectiveness of HCP monitoring programs and serves as an important guide for future research to update and improve upon the evidence-base.  FSPHP is pursuing such research and welcomes funding and collaborative partnerships with investigators interested in physician health. Click here for the FSPHP Research Guidelines.  The article emphasis that the results look consistent (and consistently good). The limitations about the lack of randomized or quasi-experimental studies described exists because there are ethical issues that prevent those studies from being done.

Alcoholics Anonymous and Other 12‐Step Programs for Alcohol Use Disorder
by John F Kelly, PhD, Keith Humphreys, PhD, Marica Ferri, PhD
March 2020, Cochrane Library

A Retrospective Cross-Sectional Review of Resident Care-Seeking at a Physician Health Program
by Amanda L. Parry, Elizabeth Brooks, PhD, Sarah R. Early, PsyD
October 2018

Helping the Healer: Population-Informed Workplace Wellness Recommendations for Physician Well-being
by Brooks E, Early SE, Gendel, MD, Miller L, Gundersen DC. 
March 2018 

When Doctors Struggle: Current Stressors and Evaluation Recommendations for Physicians Contemplating Suicide
by Elizabeth Brooks, PhD, Michael H. Gendel, MD, Sarah R. Early & Doris C. Gundersen, MD
January 2018

Investing in Physicians Is Investing in Patients: Enhancing Patient Safety through Physician Health and Well-being Research
by Elizabeth Brooks, PhD, Doris C. Gundersen, MD, Michael H. Gendel, MD
July 2017

Challenging Cognitive Cases among Physician Populations: Case Vignettes and Recommendations
by E. Brooks, M. H. Gendel, A. L. Parry, S. Humphreys, S. R. Early 
September 2016

Physician Health Programmes and Malpractice Claims: Reducing Risk through Monitoring
by E. Brooks, M. H. Gendel, D. C. Gundersen, S. R. Early, R. Schirrmacher, A. Lembitz, J. H. Shore
April 2013

Self-Prescribed and Other Informal Care Provided by Physicians: Scope, Correlations and Implications
by Gendel MH, Brooks E, Early SR, Gundersen DC, Dubovsky SL, Dilts SL, Shore JH
May 2012

Comparing Substance Use Monitoring and Treatment Variations among Physician Health Programs
by Brooks E, Early SR, Gundersen DC, Shore JH, Gendel MH
Jul-Aug 2012

Physician Boundary Violations in a Physician’s Health Program: A 19-Year Review
by Brooks E, Gendel MH, Early SR, Gundersen DC, Shore JH

Prognosis for the Recovery of Surgeons from Chemical Dependency: A 5-Year Outcome Study
by Amanda Buhl, MPH; Michael R. Oreskovich, MD; Charles W. Meredith, MD; Michael D. Campbell, PhD; Robert L. DuPont, MD
November 2011

Anesthesiologists with Substance Use Disorders: A 5-Year Outcome Study from 16 State Physician Health Programs
by Gregory E. Skipper, MD, Michael D. Campbell, PhD, Robert L. DuPont, MD
September 2009

How are Addicted Physicians Treated? A National Survey of Physician Health Programs 
by Robert L. DuPont M.D., A. Thomas McLellan Ph.D., Gary Carr M.D., Michael Gendel M.D., Gregory E.Skipper M.D.
July 2009 
A review of the national system of Physician Health Programs (PHPs) that manage the care of addicted physicians, from of a survey of all 49 state PHP medical directors (86% responded) to characterize their treatment, support, and monitoring regimen.

Tobacco Use by Physicians in a Physician Health Program, Implications for Treatment and Monitoring
by Stuyt EB, Gundersen DC, Shore JH, Brooks E, Gendel MH
Mar-Apr 2009

Setting the Standard for Recovery: Physicians' Health Programs
bRobert L.DuPont, MD, A. Thomas McLellan, PhD, William L. White MA, Lisa J. Merlo, PhD, Mark S. Gold, MD
March 2009

Five Year Outcomes in a Cohort Study of Physicians Treated for Substance Use Disorders in the United States
by AT McLellan, GS Skipper, M Campbell, RL DuPont
August 2008

Outcomes of a Monitoring Program for Physicians with Mental and Behavioral Health Problems
by John R. Knight, MD, Luis T. Sanchez, MD, Lon Sherritt, MPH, Linda R. Bresnahan, MS, John A. Fromson, MD
January 2007

Risk Factors for Relapse in Health Care Professionals with Substance Use Disorders
by Karen B. Domino, MD, MPHThomas F. Hornbein, MDNayak L. Polissar, PhDGinger RennerJilda JohnsonScott AlbertiLynn Hankes, MD
March 2005

Monitoring Physician Drug Problems:  Attitudes of Participants
by John R. Knight MD, Luis T. Sanchez MD, Lon Sherritt MPH, Linda R. Bresnahan MS, Jennifer M. Silveria BA & John A. Fromson MD
January 2002