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The Nevada Health Professionals
Assistance Foundation (NHPAF) was formed in the fall of 1996 to provide support
to health care professionals in the state of Nevada . For the past several
years, the Foundation has served as the diversion program for the Nevada State
Board of Medical Examiners . In doing this, the program provides physicians,
physician assistants and respiratory therapists an alternative to discipline
when they suffer from an illness which has the potential of leading to
impairment in their practice of medicine or respiratory therapy. The program
assists the clinician through evaluation and treatment and then provides
advocacy based on illness, recovery from illness and the clinician’s wellness.
Clinicians suffering from
psychiatric illnesses, especially drug addiction and alcoholism, may be referred
to the NHPAF by themselves (most often under pressure from others), their
colleagues, regulatory agencies, hospitals, families, pharmacies, a physician
who is treating them, hospitals and others. Initially, the illness is manifested
as difficulties in marital, financial, social and legal areas. The last area
affected by the illness is the practice setting.
The Top Twelve Indicators of
probable illness are:
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Change in Personality.
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Increasingly irritable and
moody at work or social events.
-
Difficulties or arguments (with
nurses and other hospital personal progressing to colleagues and patients).
-
Absences from work or canceling
office hours especially on Monday or the day after a major holiday weekend.
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Absences often attributed to
other illnesses as well as to financial or social crisis.
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Rounds at unusual hours, late
in the evening or very early in the morning.
-
Deficits in clinical record
keeping.
-
Difficulties reaching the
physician by page or phone.
-
Arrests for a drinking and
driving offense or for unacceptable behavior.
-
Intoxicated at social
functions including job-related functions.
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As the illness continues into
more severe stages there is obvious impairment at the worksite, including
the odor of alcohol on the clinician’s breath, signs of intoxication and
passing out after using intravenous medication on a bathroom break (seen in
anesthesiologists addicted to high potency anesthetic agents).
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Finally, withdrawal from social
activities and isolation from colleagues and social support systems.
The clinician frequently
explains that the financial, legal and family problems are causing all the
difficulties when in reality the illness or the addiction is the origin of most
of the difficulties.
If you notice the above changes
in clinicians, they may be suffering from an illness which can be treated so
that they can continue or return to the safe and effective practice of medicine.
Contact to refer or ask
questions:
Nevada Health Professionals Assistance Foundation (NHPAF)
9811 W. Charleston Blvd., Suite 2-382
Las Vegas , Nevada 89117
Phone: 702 521 1398
Fax: 702 341 7237
Email: NHPAF2@aol.com
The NHPAF can be helpful when an
intervention is needed. After physicians are identified or suspected to have an
illness they may need an intervention which may utilize confrontation or
techniques of persuasion and motivation (with stages of pre-contemplation,
contemplation, preparation, action, and maintenance). Most interventions today
use a combination of approaches personalized to the specific clinician, his or
her work setting and his or her support system. A major point to remember is to
never confront the physician or other health care professional who you think may
be suffering from an illness described above alone by yourself. He or she will
just tend to disqualify you and may avoid you in the future. Always approach
with at least one other person, and preferably under the guidance of the NHPAF.
Once referred clinicians are
interviewed and are guided through an independent medical evaluation by NHPAF-approved
clinicians and/or centers, guidance through treatment and recovery is based on a
review of the evaluation by NHPAF.
Among other things, NHPAF works
with hospitals, group practices and surgical centers in developing policies and
using techniques in approaching physicians who are disruptive. Although
disruptive behavior may take many forms, there are usually two categories of
observed behavior. The first is inappropriate response to patient needs or staff
requests, which includes late or unsuitable replies to pages or calls,
unprofessional demeanor or conduct, lack of or refusal to be cooperative with
others and approaching problems with rigid, inflexible responses to requests for
assistance or cooperation. The second is the progression from the lack of regard
for personal comfort and dignity of others to the use of inappropriate or
offensive words or actions directed toward another person, including sexual
comments or innuendoes, sexual harassment, behavior which is seductive or
aggressive, including verbal or physical assault, along with, racial, ethnic, or
socioeconomic slurs.
When clinicians are referred to
NHPAF, they are first sent for an independent medical evaluation, since the
behavior may be due to a variety of illnesses such as bipolar depression, major
depression, alcohol or drug dependence, other addiction, a neurological illness
or a metabolic disorder. One of the most tragic results of such an evaluation
was a physician who was diagnosed to suffer from Huntington's Disease. Where
there is no identifiable illness, NHPAF uses a wellness model to promote better
coping by aiding clinicians in the development of effective coping styles
related to their work or practice. Mentoring and coaching by a fellow clinician
is also helpful. Sometimes brief consoling identifies and addresses issues
contributing to the behavior. NHPAF may refer clinicians to courses which review
boundary issues and elements of professionalism inherent in their work
environment. Clinicians who participate in the NHPAF may appreciate the positive
changes they see in themselves as well as in their professional, social and
family lives.
The NHPAF is a member of the
Federation of State Physician Health Programs (FSPHP). Additional information
about the FSPHP can be found at the
http://www.fsphp.org internet site.
You may make a confidential
referral to NHPAF or may want to ask questions about the program.
If so, contact the NHPAF:
Nevada Health Professionals
Assistance Foundation (NHPAF)
9811 W. Charleston Blvd., Suite
2-382
Las Vegas , Nevada 89117
Phone: 702 521 1398
Fax: 702 341 7237
Email: NHPAF2@aol.com
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