I first came to know the North Carolina Physicians Health Program while I was a lawyer for the North Carolina Medical Board.  It always pained me to become involved in a Medical Board case involving alcohol or other substances abuse or dependence or mental illness.  The Board’s only tool in such a case was to take away the person’s license.  This protects the public from an impaired practitioner but does little or nothing to help that person.  It pained me to be a part of this because it deprives society of the otherwise much needed services of this person and because there is a program that might have helped this person avoid this fate – NCPHP.

            NCPHP’s basic promise is simple:  Physicians and physician assistants can be reported to the program or can report themselves and remain anonymous while getting help for substance abuse or mental illness.  The idea is to provide an avenue to seek help, hopefully early in an illness, because persons can join the program without risking the loss of the license.  Physicians and physician assistants who join the program in this way and who cooperate with the program are known to the Board only as statistics.  About half of NCPHP’s participants began and remain as “anonymous” participants.  I was grateful for this as a Board prosecutor both for the work it saved me and for the help these persons received.

            NCPHP must “break the anonymity” of (report to the Board) those who “constitute an imminent danger to the public or to himself; [those who] refuse[ ] to cooperate with the program, refuse[ ] to submit to treatment, or [are] still impaired after treatment and exhibit[ ] professional incompetence, or [where] it reasonably appears that there are other grounds for disciplinary action.”  The Board then takes its action.  The Board is correspondingly required to report to NCPHP “all physicians whose health and effectiveness have been significantly impaired by alcohol, drug addiction or mental illness.”  Physicians and physician assistants with licensing problems are eligible for all NCPHP’s services, too.  The Board and NCPHP do good work together here, but the Board’s role is prohibit the physician or physician assistant from practicing until they can do so safely – something no physician or physician assistant would want to endure.

            Over the years I have heard considerable criticism of NCPHP.  I have heard from malpractice plaintiff’s lawyers that NCPHP is nothing more than a formal mechanism for sweeping problems under the rug.  I have heard from practitioners under the Board’s scrutiny that NCPHP is set up to find a problem whether one exists or not.  Neither of these criticisms matches my experience.  My perception is that NCPHP applies current medical knowledge to address the complaints by or against the physicians and physician assistants it sees, giving its best objective diagnosis and treatment recommendation.  When NCPHP believes there is a problem, it says so; when it thinks not, it says not.  And it remains ever ready to help in whatever way it might. 

                                                                                                            James A. Wilson

                                                                                                            Attorney at Law

                                                                                                            Durham, NC