IMPAIRED PHYSICIANS, TREATMENT OF

The State Medical Board may limit, revoke or suspend a physician's license to practice medicine due to impairment of the physician's ability to practice according to acceptable and prevailing standards of care. The impairment may be caused by: habitual or excessive use or abuse of drugs, alcohol, or other substances that impair the ability to practice; or mental or physical illness, including, but not limited to, physical deterioration that adversely affects cognitive, motor, or perceptive skills. ORC § 4731.22 (B) (19), (26)

Any physician licensed by the State Medical Board accepts the privilege of practicing in Ohio subject to supervision by the Board. By filing an application for licensure or by holding a license to practice medicine, a physician shall be deemed to have given his or her consent to submit to a mental or physical examination when ordered to do so by the Board and to have waived all objections to the admissibility of testimony or examination reports that constitute privileged communications. ORC § 4731.22 (B) (26)

SUBSTANCE ABUSE TREATMENT UNDER MEDICAL BOARD SUPERVISION

If the State Medical Board has probable cause to believe that any physician licensed in Ohio or any applicant for a license suffers such impairment, the Board may compel the individual to submit to a mental or physical examination, or both. The examination shall be at the expense of the Board. Any mental or physical examination for assessment of a potentially impaired practitioner shall be undertaken by a treatment provider or physician qualified to conduct such examination and chosen by the Board.

Failure of the individual to submit to a mental or physical examination ordered by the Board constitutes an admission of the allegations against him or her unless the failure is due to circumstances beyond the individual's control, and a final order may be entered without the taking of testimony or presentation of evidence. If the Board determines that the individual's ability to practice is impaired, the Board shall suspend his or her certificate or deny his or her application and shall require the individual, as a condition for initial, continued, reinstated, or renewed licensure to practice, to submit to treatment.

Before being eligible to apply for reinstatement of a license suspended under this division, the physician must demonstrate to the Board that he or she can resume practice in compliance with acceptable and prevailing standards of care under the provisions of his or her certificate. Such demonstration shall include but shall not be limited to the following:

1. Certification from an approved treatment provider that the practitioner has successfully completed any required inpatient treatment;
2. Evidence of continuing full compliance with an aftercare contract or consent agreement;
3. Two written reports indicating that the individual's ability to practice has been assessed and that he or she has been found capable of practicing according to acceptable and prevailing standards of care. The reports shall be made by individuals or providers approved by the Board for making such assessments and shall describe the basis for this determination.

The Board may reinstate a license suspended under this division after such demonstration and after the individual has entered into a written consent agreement.

When the impaired practitioner resumes practice after reinstatement of his or her license, the Board shall require continued monitoring of the practitioner, which shall include but not be limited to compliance with the written consent agreement entered into before reinstatement or with conditions imposed by Board order after a hearing, and, upon termination of the consent agreement, submission to the Board for at least two years of annual written progress reports made under penalty of perjury stating whether the license holder has maintained sobriety. ORC § 4731.22 (B) (26)

PRIVATE SUBSTANCE ABUSE TREATMENT

A person or organization that is a treatment provider approved by the Board, an impaired practitioner committee of a hospital or a peer assistance program of a medical society is not required to report a physician with substance abuse problems to the State Medical Board if the physician has consented to go into treatment in an approved treatment program. If there is reason to believe that the physician has ceased treatment or that the physician has violated other provisions of the Medical Practice Act, the State Medical 
Board must be notified. ORC § 4731.224 (B)

An approved treatment program shall be required to report to the State Medical Board the identity of any impaired or potentially impaired physician who:

• fails to be examined within one week of a referral for examination
  (i.e., referral by a peer assistance program of a medical society or an impaired practitioner committee of a hospital);
• fails to enter treatment within forty-eight hours following the determination by the treatment program that the physician needs treatment;
• fails to enter into a treatment contract establishing the terms of treatment and aftercare, including supervision or restrictions on practice;
• refuses to suspend practice upon entry into any required inpatient
  treatment;
• fails to abide by the terms of the treatment contract;
• resumes practice prior to a clear determination by the treatment program that the physician is capable of practicing according to acceptable and prevailing standards of care; or
• suffers a relapse at any time during or following aftercare.

For purposes of this section, any physician who enters into treatment at an approved treatment program shall be deemed to have waived any confidentiality requirements which would otherwise prevent the treatment program from reporting to the State Medical Board. ORC § 4731.25

Approved treatment programs will be required to report the identity of an impaired physician returning to practice to hospital administrators, medical chiefs of staff and chairpersons of impaired practitioner committees at any hospitals where the physician holds clinical privileges. If the physician does not have clinical privileges at any institution, the treatment program shall contact the impaired physicians committee of the county medical society in every county where the physician practices. ORC § 4731.25 (H)

(See also: DISCIPLINARY ACTIONS BY THE STATE MEDICAL BOARD;  MANDATORY REPORTING TO THE STATE MEDICAL BOARD )

IMPAIRED PHYSICIANS, TREATMENT OF