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KPHF
Process and Structure
The
process and structure of the Kentucky Physicians Health Foundation is
as follows:
 The
Kentucky Physicians Health Foundation Committee consists of members
chosen for their geographic location and/or special interest and contribution.
These members shall be chosen by nomination by any member of the Committee
subject to approval by the Committee. Each member shall serve a four-year
tenure with renewal upon personal request.
The
membership includes four psychiatrists, a representative from the state
medical schools, a resident in psychiatry from those schools and a permanent
member of the women's alliance.
We
meet every other month. The duties of these members includes the assigned
monitoring of individuals in their area. This monitoring process involves
recovery meeting attendance, random drug screens, various other forms
of accountability and therapy activities.
We
strive to have on our committee an approximate mix of 2/3 members in
recovery from alcohol/drug dependency and 1/3 non-recovering members.
It is mandatory that recovering members have at least 5 years in recovery.
We
derive much assistance from the psychiatric members of the Committee
regarding problems other than chemical dependency and substance abuse.
We
have outpatient evaluating teams in Lexington and Louisville. These
teams consist of a Board certified psychiatrist and a certified chemical
dependency counselor. Independent evaluations are done by each member
of this team when chemical dependency is suspected.
For
issues involving psychiatric problems such as disruptive behavior and/or
admitted inappropriate sexual behavior, we use psychiatric consultation,
in addition to obtaining neuropsychological profiles and psychosexual
testing where appropriate.
We
have the option of using residential evaluation mechanisms in facilities
with much experience in physician assessment.
After
the evaluations are completed, the evaluators send us written reports
containing their diagnosis and recommendations. The diagnosis and recommendations
will determine what treatment, if any, is necessary.
If
chemical dependency is the problem, treatment may constitute inpatient
or outpatient treatment. Outpatient treatment is generally done within
the community if an experienced program is available and appropriate.
If inpatient is indicated, it may result in a short-term 21 to 28 day
program including detoxification. It may result in a long-term residential
program that varies from three months to whatever length of time is
needed.
We
have extensive experience in working with both of these areas and have
productive referral patterns that are therapeutically and cost effective.
If
psychiatric problems are involved, we work with the individual to facilitate
a relationship with an appropriate psychiatrist and/or mental health
system.
If
physical problems exist, measures are taken to advise the physicians
as to what plan of action is appropriate.
Following
the completion of treatment for chemical dependency and/or alcoholism,
the individual is entered into an aftercare, reentry and monitoring
program.
The
program is as follows:
Therapy is
started with participation in a weekly co-facilitated physicians therapy
group. This is not a monitoring or support group per se. Participation
in this group generally lasts for one to two years. At all times when
it can be facilitated, we involve the family and/or significant other
in the recovery process.
A support
group for chemical dependency problems is initiated by placing the
individual in a twelve-step program. The attendance frequency is determined
by the Kentucky Physicians Health Foundation -Impaired Physicians
Program's treatment team. These meetings are documented and sent to
our office the first week of the month for the previous month.
Drug screens
are instituted and are done randomly. The frequency of these occur
anywhere from weekly to monthly, depending on the length of time in
recovery and other considerations. These results are kept in the files
at our office.
If individual
therapy is indicated, it is determined by the treatment team involved
with the physicians groups. The information is conveyed to us and
appropriate arrangements are made.
A
monthly treatment team meeting is facilitated regarding each of the
individuals in each of the therapy groups. Progress is noted and alterations
are made as indicated by the physician's progress.
The
standard contract is five years in duration. As increasing levels of
recovery occur, modifications are made in frequency of drug screens
and in attendance in physicians therapy groups. At no time do we allow
discontinuation of a twelve-step and/or other appropriate spiritual
participation.
For impairments other than chemical dependency, a wide latitude of directions
may occur but they are monitored at all times by appropriate reports
at prudent intervals.
If an individual is completely compliant with the outlined program,
we stand as his/her committed advocate in any area where advocacy is
requested. These areas frequently are with third party reimbursement
systems. KBML, hospital staffs and medical malpractice carriers.
This
advocacy usually constitutes prudent interval reports to those who request
them. Arrangements are made to satisfy the need to establish the credibility
which our participants have earned through their participation and compliance
with our program.
Our participants are assessed a nominal fee to participate in our program.
Evaluations, treatment, therapeutic activities, biological
testing, and other incurred expenses are all on a separate fee-for-service basis
paid to the provider of those services.
Recovery statistics
for mental, physical and emotional problems will vary depending on the
specific diagnosis.
Our recovery statistics for chemical dependency and alcohol problems
approximate 90-94%. Other states with similar programs have replicated
these figures.
The
seminal message here to our medical colleagues and significant concerned
others is simple: We have an effective and appropriate way to treat
our doctors and their families.
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