Substance use is the leading cause of doctor’s licensing actions: study

According to a recent report, actions taken against a doctor’s license for substance use are more common than those for psychological impairment or actions related to physical health. Despite a sharp increase in 2011, the frequency of substance use-specific legal actions taken against physicians decreased between 2004 and 2020.

According to a recent study published in JAMA. Psychological impairment was the reason associated with more than 1 in 10 (11.5%) actions against physician licensing, while physical impairment was the reason for about 12% of those actions, according to the study.

The researchers analyzed 5,032 actions taken against the licensing of American physicians. The actions were reported to the National Practitioner Data Bank and were related to substance use, psychological impairment and physical impairment. The National Practitioner Data Bank is a web-based repository of reports containing information on medical malpractice payments and certain adverse actions related to healthcare professionals, providers and suppliers. It is provided by the US Department of Health and Human Services,


Dr. Lisa Rotenstein

“Although there has been increased attention [on] mental health of physicians, we wanted to understand the extent to which changes in attitudes and practices were reflected in actions taken by hospitals or licensing boards, which are reported in the National Practitioner Data Bank,” Lisa Rotenstein, MD, a primary care physician at Brigham and Women’s Hospital in Boston and senior study author, said medical landscape Drug News.

Rotenstein, who is an assistant professor at Harvard Medical School, studies mental health issues in doctors and interns. Rotenstein was the lead author of a 2016 study that found more than a quarter (27.2%) of medical students had depressive symptoms. She was also the lead author of a 2018 study published in JAMA on the prevalence of burnout among treating physicians.

Lawsuits against doctors trend down

2011 marked the peak of actions taken against physician licensing for substance use, according to the study, but actions related to substance use have otherwise maintained a steady decline over the past 17 years. Researchers found that doctors with legal actions stemming from substance use or psychological impairment were more likely to receive indefinite sanctions, while also having emergency action taken against their doctor’s license. ‘exercise.

Additionally, according to the study, physicians who faced license lawsuits due to substance use or psychological impairment were more likely to rack up a higher number of lawsuits. during their career.

Forty-seven percent of physicians reported experiencing burnout according to Medscape’s 2022 Burnout and Depression Report: Stress, Anxiety, and Anger. Emergency physician burnout rose from 43% in 2020 to 60% in 2021, according to the report.

More than a quarter (26%) of physicians reported using alcohol to cope with burnout in 2020, according to Medscape’s 2021 Report on Physician Burnout and Suicide. According to the 2021 report, 48% of physicians chose exercise to deal with burnout, while 35% indulged in junk food.

Peter Grinspoon, MD, a Boston-based primary care physician, wrote in The Los Angeles Times in 2016 that the drug addiction rate among doctors starts at 10% and can go up to 15%; by comparison, rates of substance use in the general population are 8% to 10%. “What seems to explain the difference is the distress of the doctors and, in the case of drug addiction, an abundant access,” he added.

Grinspoon wrote a book in 2016 titled Free refills: a doctor facing his addiction, which chronicles his experience of recovery and relapse as a physician dependent on opioid painkillers.

The findings of the recent study by JAMA “suggest that we have made progress in addressing substance use issues in a way that does not result in licensing measures or even addressing the need for physician support related to substance use,” said Rotenstein.

Still, she insists there is “substantial opportunity to improve mental health and support offerings for physicians and reduce the stigma of seeking and receiving mental health support, ideally avoiding the need for licensing actions”.

According to Rotenstein, the cases listed in the National Practitioner Data Bank represent the most serious cases; these reports have reached a high level of attention or concern and are the result of adverse reaction reports submitted by healthcare facilities and state licensing boards.

“There are many, many more physicians whose cases aren’t represented here but who struggle with depression, anxiety, addiction, etc.,” Rotenstein said.

Aine Cryts is a veteran IT and healthcare writer based in Boston.

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Milton S. Rodgers