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The Kentucky Physicians Health Foundation


 

 

[Under Construction]
KPHF Mission Outline

The following mission outline is currently used by the Kentucky Physicians Health Foundation in dealing with impaired physicians. This process is used only as a guideline as each separate case dictates individual variations and each participant is considered separately. Nor will this process cover all contingencies that may arise.

The Kentucky Physicians Health Foundation provides total oversight to this process on a routine basis. Within the dictates of timeliness, the Medical Director is required to implement these steps autonomously or with input from members of the Foundation's' Committee, as individual circumstances dictate.

Staff acts as a central information-receiving and coordinating source under the direction of the Medical Director.

MAJOR STEPS OF THE PROCESS
  Information receipt/reporting
 Confirmation/documentation
 Intervention
 Assessment/evaluation
 Acute treatment
 Aftercare
 Advocacy
 Relapse

Information/Reporting
Information is received from various sources on suspected impaired individuals. Common recurring sources are the Board of Medical License, colleagues/peers, hospital staff/administrators, coworkers, spouses, and other family members. Routinely, the information is received by the Medical Director, individual Committee members or staff. Reasonable efforts are made to acquire as much objective information as possible regarding the nature of the impairment, how it is manifest, substances in question and duration of abuse.

Confirmation/Documentation
The Medical Director, Committee member or staff acquires confirmation or documentation of the issue from the reporting source, local contacts and other credible sources. Confidentialty is respected at all times. Instances may arise where adequate confirmation may not be obtained and the process may be postponed or terminated at this point.

Intervention
If the situation dictates, intervention may be arranged by the Medical Director in cooperation with colleagues, family members, Licensure investigators and other principals. Some instances will not require intervention. Where intervention is appropriate, the Medical Director coordinates and/or directs that process.

Assessment/Evaluation
Depending on the situation, the Medical Director will arrange for assessment of the individual participant by a psychiatrist, counselor, therapist or neuropsychologist. Circumstances may require that assessment be conducted in an off-site facility on an inpatient basis, or assessments may be made by the Medical Director or intervenor on the spot.

Acute Treatment
If acute treatment is indicated, the Medical Director either makes or is involved in determining arrangements for acute care in an appropriate facility or on an outpatient basis. In the acute treatment phase, the nature and duration of treatment is determined by the facility principals, and the Medical Director shall seek continuing information during the treatment phase. Choice of facility will be determined, in part, by coordination with the Committee on family involvement and aftercare referral.

Aftercare
Following acute treatment, the Committee is the primary determining body for continuing care. Facets of aftercare include liaison with and routine reporting to the Licensure Board, when appropriate; development of a viable aftercare contract; involvement with a physician therapy group and/or an individual therapist; arrangement for random biological fluid testing; attendance in self-help group meetings; selection of a sponsor; and assignment of a Committee member as a regular contact. Routine contact with the Committee member is the responsibility of the individual participant. Aftercare efforts are coordinated between the Committee and affected hospital medical staff or other local groups for information exchange.

Advocacy
So long as the individual is compliant with the terms of the aftercare agreement and its intent, the Foundation will serve as an advocate with the Licensure Board, liability insurers, health insurance carriers, hospital medical staffs, colleagues and others in a responsible manner. This responsibility may require routine written or verbal reports on an individual's progress, as well as meetings with specific agencies.

Relapse
In the event that a relapse occurs, the Committee, through the Medical Director, or a member, will seek confirmation. As soon as is reasonable, a critical assessment of the individual's recovery program and nature of the relapse is made and additional treatment or recovery modification is determined. Agencies to which the Committee is an advocate will be advised of the relapse.

Record Maintenance
Records are maintained by the Foundation on each individual participant. These records will contain clinical, as well as anecdotal information, and are considered the sole property of the Foundation. Under KRS 311.619 and Federal regulations, these records are not considered to be discoverable, and their use will remain at the discretion of the Foundation and its Director within the boundaries of any legal reporting requirements. These records may also include contracts for assessment, treatment and aftercare.

Information Release
Information is not released to any party without the express-signed consent of the individual involved, excluding legal or prior contractual demands. A general signed information release is considered adequate consent except for individuals or agencies seeking only specific items of data. Anecdotal information will be released only at the discretion of the Medical Director or the Committee. Any information acquired without written consent of the individual shall be considered formally to be anecdotal.

Compliance
While overall recovery may be apparent, individual facets may not be quantifiable. A total recovery program, ideally, is attitudinal and cannot be objectively measured. It is the responsibility of the Chairman, Medical Director and the Committee, using practical and personal experience, to define individual recovery facets and determine compliance. Compliance can be supported through random biological fluid testing, which is at the individual's expense, and through formal reports from designated therapists. Overall compliance, however, remains a subjective determination.

 

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Copyright © 2008 The Kentucky Physicians Health Foundation
Last modified: 05/19/09