Will my doctor friend lost his medical licence if he checks into an inpatient mental facility?
October 14, 2011 10:39 AM   Subscribe

My best friend is a doctor in Miami (with a board-certified specialism) and he's having a nervous breakdown. He's afraid that if he checks himself into a mental hospital he'll lose his licence to practice medicine. I have couple of questions.

1. Is it true that his medical licence is at risk? His mental health issues are coupled with alcoholism issues - I believe he's using alcohol to self-treat an underlying mental illness. Does being a mentally ill alcoholic mean he'll lose his licence even if he would never put a patient at risk by working when he's suffering a breakdown, would never drive while intoxicated, etc (he's called in sick for the past few weeks)?

2. Can anyone recommend some sources of help located in Miami? Either in-patient treatment facilities or a psychiatrist who would make housecalls and provide some sort of intensive treatment.

My friend does have health insurance. I live out of the country so am not able to drive him anywhere.
posted by anonymous to Human Relations (12 answers total)
It's hard to answer this without knowing what you mean by "breakdown." I know nothing about medical licensing so I'll skip that bit, but if your friend is suicidal he needs to go to the hospital emergency room.
posted by sweetkid at 10:48 AM on October 14, 2011

This paper from the Journal of Medical Licensure (PDF) suggests that a diagnosis of mental illness *can* lead to sanctions, but they are not mandatory or automatic (maybe in one state?), and they are unlikely to be permanent. So, is his license at risk if he seeks treatment? Maybe a little bit. But I'm not convinced that his license (or at minimum his professional reputation) isn't *already* at risk; medicine is a small world, and there is no way your friend is keeping this a secret from his colleagues if he's calling in sick for weeks at a time.

I wish I had specific recommendations but if your friend is as sick as he sounds, the risks of getting help are vastly outweighed by the risks of not getting help.
posted by mskyle at 10:51 AM on October 14, 2011 [1 favorite]

IANAL nor am I a license expert, but I do know a doctor who went through something that sounds similar to your friend, and she checked into a mental health recovery and rehab center in the Caribbean. She chose to do so because she did not have the time nor the inclination to determine the answer to the exact question you're seeking an answer to. She paid out of pocket even though she was insured.

She has not had any negative repercussions professionally, as in losing her license to practice, though she did quit her job in advance so she would not have to explain her absence. If your friend can take a leave of absence from his job, he'd be lucky indeed.

My friend is now medicated for her anxiety, sees a local therapist regularly (which was set up in advance while she was in treatment), and is back to practicing at a new job and living more or less normally.
posted by juniperesque at 10:56 AM on October 14, 2011 [5 favorites]

There are addiction treatment/rehab centers designed specifically for physicians. Many doctors go through them without losing their license. Here's an example of a program. These centers focus on the specific needs of doctors, and they are highly confidential. You might google for some programs, and call them with questions.
posted by cushie at 11:05 AM on October 14, 2011 [2 favorites]

Most of the major medical associations (either the AMA or by specialty) have resources for doctors who are struggling with addiction and/or mental health issues, and specifically have plans for doctors to get treatment while not putting their practices and licenses at risk. You might start with the University of Florida's Impaired Physicians program and see who they recommend in Miami.
posted by judith at 11:06 AM on October 14, 2011 [2 favorites]

Call these people. I know physicians who've been through addiction treatment who now practice independently, but as their FAQ points out the exact path he can take depends on specifics, and often they're temporarily prohibited from practicing.
posted by a robot made out of meat at 11:19 AM on October 14, 2011

He needs to look at his disability insurance policy. Doctors are usually insured to the gills, both through their employer and privately, against the risk that they can't practice medicine anymore. Like, their income doesn't even go down at lot of the time.

If he does run into problems because of a psychological condition, that may well be a covered loss, which should take a lot of the fear out of the process.

Have him start with HR or whoever takes care of his benefits.
posted by valkyryn at 11:44 AM on October 14, 2011

I'm in a different allied health profession in a different state, so grain of salt for this an all that. The purpose of licensing boards is to protect the well being of patients. From the conversations I've had with board members here, and from material presented in ethics workshops, the message I've taken away is that the board really wants you to get help if you need it. They do not want you to continue to practice when you are impaired, potentially harming your patients.

The Impaired Physicians Program Judith linked to above provides for confidential care as long as there is no pending investigation of malpractice: (from this website)
"Confidentiality of medical records and participation in impaired physician programs is essential to the successful protection of the public. Confidentiality permits open and honest communication and early treatment prior to public harm. The Florida Medical Practice Act permits the confidential treatment of physicians with impairments. "

So many health practitioners face something like this at some point in their career. Physicians are human and are in incredibly stressful careers. It is wise and brave to ask for help when you need it. Please, tell your friend to get help before he harms himself or someone else.
posted by goggie at 12:24 PM on October 14, 2011 [3 favorites]

And the bigger risk is that he waits too long to get treatment, and manages to seriously hurt somebody while he isn't at his best.

He's not alone, he's not unusual, and he needs help NOW, not later. He may feel like a special snowflake only because he doesn't know how common this is.
posted by ivan ivanych samovar at 9:28 PM on October 14, 2011 [1 favorite]

I've also had a colleague who struggled with depression and alcoholism, and he did the right thing and sought help through the official channels at a point where he was really living on the edge (went through the administration in our department and the medical board folks), and went through one of the residential treatment programs, I think he was there at least 8 weeks, and as far as I can tell now, several years later, he's practicing pretty much exactly as he would have been otherwise, independent practice and seems to be doing great (although honestly, I hadn't had a clue he had a problem up until one episode right before he sought treatment, so obviously he was a very functional alcoholic - but he never drinks at social events anymore).

I hope your friend gets the help he needs. Soon.
posted by treehorn+bunny at 12:41 AM on October 15, 2011

He'll get in worse trouble if he gets caught not treating this than if he goes to treatment. This is the bottle speaking- "I can't get better, I'll be in trouble!"

The consequences of say, wigging out in front of a patient or being caught doing a medical procedure while drunk are nowhere near as bad as being able to say "I was in therapy for X months and I don't drink at social functions at the hospital anymore."
posted by Phalene at 11:35 AM on October 15, 2011

I am not an addiction specialist but I work in a field where addiction is enough of a concern that we get a fair amount of education on it, and am also on the credentials committee at my hospital where we have to deal with impaired physicians from time to time, so I have a little more experience with this than some people. The advice here is good; your friend's license is much more at risk if he comes to the attention of the medical board because of illegal or unethical behavior than if he seeks treatment on his own. These things are generally decided on a case-by-case basis, so it is impossible to know exactly how it will play out, but he will in all likelihood be dealing with people experienced with impaired physicians who will be able to address his concerns. In some cases people go back to practicing much as they did before, in some cases changing specialties is appropriate, and sometimes (but not often) leaving medicine altogether is the best option. The Florida Medical Association's Impaired Physician program linked above would be my suggestion of the best place to start.
posted by TedW at 6:58 AM on October 18, 2011 [1 favorite]

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