Medical Matters: 30 years of CPSA’s Physician Health Monitoring Program (PHMP)

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By: Dr. Jeremy Beach, Assistant Registrar, Physician Health Monitoring

Part of my role at CPSA is to meet with physicians who have health concerns, including those who may be having problems with alcohol use. Alcohol has long been associated with the culture of medicine in a number of countries, and certainly was in the United Kingdom where I worked as a junior doctor. The other day, I came across an article from The Guardian: “Alcoholism and me: ‘I was an addicted doctor, the worst kind of patient.’” The article shares an insightful, and I thought moving, personal story of a psychiatrist who became a patient due to his alcohol and substance use disorder. Unfortunately, he dismissed some unhealthy behaviours in the early stages, which resulted in more severe health conditions that impacted his ability to practise. This honest, personal account reinforces that physicians are human, and our profession doesn’t make us immune to having health issues.

2022 marks the 30^th anniversary of CPSA’s Physician Health Monitoring Program (PHMP). During this time, PHMP has evolved from a program that was created largely to monitor the health of physicians with substance use disorders to a much more diverse program that covers a wide range of areas, including physical and mental health disorders; boundary issues, disruptive behaviour and professionalism concerns; and more. PHMP also facilitates CPSA’s Practice Conditions Monitoring Program that monitors compliance with practice conditions that may be imposed on a physician by various areas of CPSA, such as Professional Conduct or by a Hearing Tribunal.

PHMP exists to help maintain physicians’ health so, for the most part, they can stay in practice and provide safe, high-quality care to patients. PHMP is often contacted when a concern is raised about a physician’s health, typically by the physician themselves, a colleague or a patient. The intent of PHMP is always to work collaboratively with a physician. There is sometimes confusion about the differences and respective roles of CPSA’s PHMP and the Alberta Medical Association’s Physician and Family Support Program (PFSP). While the programs often work with the same physicians, and are both interested in returning physicians to good health, they are separate programs. Importantly, PHMP doesn’t aim to provide or facilitate treatment—that is best left to the physician’s own providers. Rather, the PHMP team works closely with a physician and their own healthcare providers to come up with a plan to, where necessary, monitor their health. In a typical year, PHMP may work with some 400 physicians, and approximately 80 per cent continue to practise with minimal or no change to their day-to-day work. However, on the rare occasion that a physician’s own health or patient care is at risk, we may ask them to limit their practice or, in extreme cases, withdraw until the issue is resolved. If you’d like more information about PHMP, please feel free to contact me.

Finally, I’d be remiss not to mention that as we enter the third year of navigating COVID-19, I’ve seen how much effort physicians have invested in maintaining their own health while continuing to prioritize the health and safety of Albertans. These have been challenging times and just as you’ve navigated health issues and concerns with your patients, PHMP is here to help answer any confidential questions you may have or offer support as needed.

Dr. Jeremy Beach obtained his medical degree in the U.K. in 1983 and subsequently specialized in occupational medicine. Prior to his arrival in Canada, he worked in the U.K. and Australia, with a short spell in Malaysia. Dr. Beach moved to Canada in 2002 to work as the residency program director in occupational medicine at the University of Alberta. He joined the CPSA as Assistant Registrar in the Physician Health Monitoring Program in 2016. His interest in physician health stretches back to when he prepared a report for the British Medical Association that was published in 1993 on the Morbidity and Mortality of the Medical Profession. He sat on the steering committee of the Physician and Family Support Program for a number of years prior to joining CPSA.