"It's the idea of a carrot and a stick," said Dr. Scott Teitelbaum, director of the UF-run Florida Recovery Center, which treats addicted physicians referred from around the country. "There's always a level of resistance -- people never feel they need the level of care that's recommended. Someone might not agree with you, but if they want to practice medicine they have to comply."
Often, with the support of peers and growing realization that treatment is working, physician-patients' motivations change from simply wanting to obey the rules to wanting to change their lives, Teitelbaum said.
One-fifth of doctors were reported to their board during treatment and monitoring -- some more than once with multiple disciplinary actions taken.
But 78 percent of doctors in the programs had no positive drug tests during five years of intensive monitoring. And five to seven years after starting treatment, 72 percent were actively practicing medicine, without drug abuse or malpractice.
Eighteen percent left medical practice, while others relapsed into drug use. Three percent of those who didn't complete their programs had substance-related deaths or committed suicide.
Although the programs employed a variety of approaches, the researchers found that success was not related to specific therapists or modes of therapy, but rather to the long-term nature of the treatment.
Still, there are some "essential ingredients" that successful programs have in common, Gold said. Those include treatment extended over years -- not weeks or months -- and unambiguous success markers such as urine testing and return to work and normal family activities.
|Contact: Czerne M. Reid|
University of Florida