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intervention should be experienced and appropriately trained for the specific type of intervention, particularly in the areas of addictive and psychiatric illness. Historically, this technique has been utilized with chemically dependent licensees who are in denial. However, it is effective with other illnesses such as process addictions and psychiatric illnesses. Intervention is typically carried out in person by PHP staff. Any combination of family members, colleagues, or office staff may be included depending on the specifics and needs of each case. The goal of intervention is to effect formal evaluation and treatment if needed. 5. Evaluation/Assessment – PHPs should have authority to conduct an initial screening assessment and coordinate a referral for professional evaluation in order to determine the nature and extent of functional impairment and underlying illness. Whenever possible, the evaluation of the physician should be conducted by a PHP-approved independent clinician or by an independent multidisciplinary evaluator(s) to avoid the appearance of conflict of interest. Ideally, the PHP should have a panel of expert evaluators that have been vetted and found to be acceptable for referrals. Whenever possible, the physician should be offered more than one name or facility from which to select an evaluator(s). The PHP should use the criteria set forth in ―Criteria for Referral‖, Section V, and FSPHP Guidelines, Appendix III, to determine if a physician should be referred for an evaluation. 6. Treatment – Treatment, or secondary prevention, strategies attempt to diagnose and treat an illness, especially in its early stages with the goal of preventing worsening of the illness. For example, typical treatments for addictive illness include inpatient hospitalization for detoxification, residential treatment, or outpatient treatment. Treatment modalities may include medications, twelve step-mutual self help meetings, professionally led group therapy, individual counseling, as well as other types of treatment. The PHP should insist the criteria set forth in Treatment program criteria, Section VII and FSPHP Guidelines, Appendix III, are followed, particularly to determine if a facility or practitioner is acceptable for referrals. 7. Discharge & Continuing Care – PHPs must possess the ability to develop and implement discharge, continuing care and monitoring plan(s). Continuing Care contracts should be designed to ensure that the physician participant can practice with reasonable skill and safety based on recovery or remission of underlying illness. The PHP should also have the authority to ensure compliance with continuing care contracts and have authority to remove physician participants from practice who pose a risk to patient safety. Federation of State Medical Boards 14 8. Relapse Management – Methods should be designed for the early recognition of relapse and the PHP should have the ability to respond in a timely and effective fashion. This response will include a report to the board when consistent with agreed upon reporting requirements. For addictive illness, the PHP should meet the criteria set forth in Relapse management and monitoring, Section XI, and FSPHP Guidelines for Addressing Relapse, Appendix III. PHPs should develop a track record that supports board confidence in their judgment to manage relapse issues. 9. Confidentiality – A voluntary track allows an option for the physician to maintain confidentiality. It is, however, critical that the PHP medical director communicate with the state medical board the identification of previously anonymous participants in the event of either substantive non-compliance or level III relapse. In order to facilitate voluntary track referrals, boards should develop a mechanism to protect the confidentiality of PHP voluntary participants. 10. Reporting of PHP Data to Medical Boards – Aggregate PHP data (statistics) should be disclosed to the board and should be considered public information. Such data are useful for quality control purposes. Program data can suggest areas of strength in the PHP, areas of needed improvement, and need for adequate program funding. 11. Recovery Monitoring – Recovery monitoring should provide documented evidence as to
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