By Neal Gray, MD and Danielle Moody

Update on the Bexar County Medical Society’s Physician Health and Rehabilitation Program

By Neal Gray, MD and Danielle Moody

The Physician Health and Rehabilitation Program (PH&R) started in the 1970s. In the beginning, the program would occasionally interview a physician accused of being intoxicated, but there were few resolutions. In 1982, Dr. Neal Gray recognized the need and went to a number of courses at the American Medical Association, partnering with other doctors around the country to create a program for physicians. The goal was to return physicians to the safe practice of medicine and to the active privileges at their respective hospitals.

In 1983, Dr. Gray volunteered himself to join the Impaired Physicians Committee and shortly after became Chairman. He worked with staff from across the country to devise a contract for the program. It was found that another physician could intervene in the disease progression, and treatment could be offered to physicians for assistance.

The program was a new concept for the state board. The team was seeing an average of five to ten patients a month. Dr. Gray explained that one out of eight physicians struggle with alcoholism. Doctors in the program struggle with the misuse of alcohol, drugs and opiates. The physicians who get started on opiates get sick very fast and, in some cases, have died.

The program continued and changed very little since the early days. It gained enough success that the cities of Austin, Dallas and Houston started creating similar programs. The state of Texas eventually took the program and made it into their Texas Physician Health Program. Dr. Gray mentioned that most of the PH&R program’s patients have come from Bexar County, but they have also taken patients from all over South Texas, including Austin. The program has never turned anyone away, nor has it ever charged a fee.

The process begins with a referral from a family member or hospital staff to stage an intervention for the physician. Two or three members from the committee meet with the physician and explain the program to them in order to help them get sober. The PH&R program has been very successful in doing this, now hundreds of times. The Bexar County Medical Society (BCMS) hosts PH&R meetings every month, with members from a wide variety of specialties. The BCMS patient’s coordinator often receives a phone call from somebody that needs help and then they are referred to the program. The BCMS provides the meeting space for the committee and a meeting space for Caduceus which is an organization composed of recovering physicians.

Relapse is common among physicians, but can be prevented by following the actions outlined in the program’s contract. The five-year contract was derived to focus on relapse prevention with the objective of making sick doctors well, not bad doctors good. It was also created to make sure doctors could have access to rehab and be able to get back to work. It gives a progress report on the physician, discussing whether or not they are in compliance with the contract. Many cases need letters of compliance to hospitals written regularly, which BCMS staff assists with. Each physician signs the contract along with the PH&R committee under these guidelines: 1. No usage of alcohol or drugs of issue, 2. Have a primary physician who understands their situation, 3. Attend AA meetings, 4. Have urine, blood or drug testing frequently, 5. Work with hospitals and clinics to satisfy working mandates, 6. Align with the Texas Physician Health Program.

The PH&R program has been successful in providing assistance to the physicians in need, and the future of the program is bright. Dr. Gray explained that the program will continue to do the same thing they have been doing for several decades. Physicians can come to the PH&R Committee; they will respect their confidentiality and will do their very best to return the physicians to their families and to the active and safe practice of medicine.

Neal Gray, MD is a retired board-certified Anesthesiologist and Addictionologist. Dr. Gray was the 1992 President of the Bexar County Medical Society and received the Golden Aesculapius Award in 2018. He is a life member of the Bexar County Medical Society.

Danielle Moody is the Editor of San Antonio Medicine.