AUGUSTA, Maine — New legislation seeks to update Maine law governing the reporting and discipline of medical professionals suspected of having substance abuse problems.
The bill would require state medical licensing boards to investigate any report of alcohol or drug use by a physician that could indicate a substance abuse disorder. Under existing law, reports of “habitual drunkenness” and drug addiction prompt investigation by state licensing officials.
Rep. Jane Pringle, a Windham Democrat serving her first term in the Maine House, said she sponsored the bill at the request of the Maine Medical Association, which represents about 3,800 physicians, medical residents and students in the state. Pringle, a retired primary care physician, said the legislation’s updated terminology, replacing the term “habitual drunkenness” with “use of alcohol or drugs that may indicate a substance abuse disorder,” appropriately reflects that substance abuse is a disease.
“This dated language in the statute is stigmatizing and offensive to many in the medical community, particularly if they suffer from one of these conditions,” said Andrew MacLean, deputy executive vice president for the Maine Medical Association.
Medical licensing boards naturally cite the existing statute when corresponding with physicians who are being investigated, he said. The language not only offends many individuals, but also may wind up in public documents concerning disciplinary actions that are posted online, MacLean said.
“This language to some extent follows these people for the rest of their lives and careers,” he said.
The legislation, LD 411, also would give licensing boards the authority to take action if a medical professional’s alcohol or drug use “may” endanger a patient, a change from current law, which gives licensing boards grounds for discipline when it’s “foreseeably likely” that patients could be harmed.
In a news release, the House Democratic Office described the bill as legislation “aimed at protecting patients by ensuring that health care providers who may have drug or alcohol problems are reported to the proper state authorities.”
“This change will allow the board to investigate any significant report, clear those who may be wrongly accused and deal with the rare case in which there may be a problem,” Rep. Victoria Kornfield, a Bangor Democrat who co-sponsored the bill, said in the release. “It is about providing the public transparency and giving our licensing board the flexibility they need to ensure public safety.”
The bill also has the support of two Republicans, Skowhegan Sen. Rodney Whittemore and Rep. Tom Tyler of Windham. It has been referred to the Labor, Commerce, Research and Economic Development Committee. A public hearing on the bill is scheduled for Feb. 28.
In general, rates of substance abuse among physicians are comparable to the general public. But a 2008 review in the Harvard Review of Psychiatry found that prescription drug abuse is five times higher among physicians than in the rest of the population.
In addition to often working in high-stress environments, health practitioners also have easier access to medications, said Lani Graham, medical director of the Medical Professionals Health Program, a Maine Medical Association program that provides support and advocacy to health practitioners struggling with addiction and mental health issues.
“Medical professionals want to serve, so sometimes they make errors in judgment in order to help themselves serve better,” she said. “I’ve had physicians and nurses and others say to me, ‘When I started out with this I wasn’t trying to have fun, I was just trying to stay awake or calm myself down.’”
The program helps physicians, pharmacists, nurses and other medical professionals to find treatment resources and plan for returning to safe clinical practice.
Graham said the existing statute’s language, stating that a physician is “foreseeably likely” to harm patients as a result of a substance abuse problem, could scare off hospital and other potential employers, even years after a physician has received treatment for addiction.
“Why would they hire somebody under those circumstances?” she said. “It seems so harsh.”
Graham also finds the newly proposed language problematic, she said.
“I don’t see illness as a reason for discipline,” Graham said.
MacLean said there was no intention to change the disciplinary standard with the wording change.
Of the 30 adverse licensing actions imposed in 2012 by the Maine Board of Licensure in Medicine, eight involved substance abuse issues, according to the board’s website. So far in 2013, four of the seven adverse licensing actions have involved substance abuse by medical professionals.
“Properly treated, people can function in daily life and medical professionals can continue to hold a license and serve the public,” MacLean said.