Doctors Bristle at Proposed Physician Wellness Program

Fantozzi knows most medical schools already expose students to a variety of such wellness education programs. "What's not being done at all is anything consistent for the practicing physician, something that reminds them that the career they've chosen is stressful, and maybe not now, but in 10 or 20 years, they may find the rigors affecting their decisions as a practitioner," he says.

One program he uses as a model is that of Kaiser Permanente Northern California, where 6,800 physicians have a mentoring system, social activities, and educational classes focusing on watching out for and preventing the stresses that can destroy a practice.

"Every one of our 19 sites has a budget and a committee that oversees wellness, in addition to committees that are required by law," says David Schearn, MD, director of physician education and development. "They have various social activities, scheduled retreats, with family or without, to deal with burnout, or address financial issues that can be an enormous cause of stress."

Fantozzi says physician committees that grant physician staff privileges would be a good place to launch such programs. "But when you survey those committees, you see their understanding of what they do is to deal with bad behavior, a doctor who made a bad choice. They don't see themselves providing education. They see themselves as a prosecutor," he says.

But Jerrold Glassman, MD, head of credentials for Scripps Mercy Hospital in San Diego, disagrees that such committees should serve such a purpose, saying it's "another unfunded mandate. You can't pile these requirements on for the general physician population when the problem only affects a few," he says.

Fantozzi's idea is "naïve," says James Hay, MD, the CMA liaison to the Medical Board, who doesn't think such programs would reduce physician addictions that lead to misconduct. "There's no evidence that mandating a course in anything increases quality in anything," he says.  

Already, the medical board requires 50 hours of continuing medical education coursework every two years, and requires a one-time 12-hour course in pain management. They don't have time to take more, he says.

Hay and the CMA are still bristling over the Medical Board's vote to end the diversion program, which they felt could have been fixed. "Under the old program, there were 250 doctors in diversion. Now there are 30 on probation. It's clear to us the public is less safe than they were two years ago."

And he thinks it's silly to believe educating doctors about those behaviors will prompt those with problems to come forward. "You never meet an alcoholic who tells you how much they drink," Hay says.

 Luis Sanchez, MD, director of physician health services for the state of Massachusetts, also adamantly disagrees with Fantozzi's idea. Instead, he thinks the medical board is using wellness education as a way to side-step the fact that it's no longer overseeing physicians with problems.

"What he wants is so off base," Sanchez says. "He's saying, ‘Let's ram this down their throats, and then we're no longer responsible because we've done what we have to do," says Sanchez, a member of the board of the Federation of State Physician Health Programs. "There's a huge gap between required to take a course and seeking help."

President Barack Obama earlier today applauded businesses that have lowered their own health costs by paying for health and wellness programs for their employees.  That concept is the same as his own, Fantozzi says.  While California physicians are not in the strict sense of the word "employees" of the medical board, the board has a commitment to promote wellness in its physicians in the spirit of its mission to protect the public.

Fantozzi knows the idea is going to be politically hard to mandate, and already he is getting what he calls "pushback." But he thinks reason will ultimately prevail.  

"We shouldn't be thinking about what we can do for one doc, or the next doc. We should be thinking how to help all docs," says Fantozzi.