The Journal of Addiction Medicine will include a review in the December 2012 issue of the publication that examines the potential ethical concerns and conflicts that can occur when physicians need treatment for addiction. Physician Health Plans, also called PHPs, have an important role to play in assisting doctors who need substance abuse treatment and are organized by state. According to the review the current system used by the PHP model is not consistent across the board and has a higher likelihood of conflicts of interest and ethical concerns. The review calls for an independent oversight of the practices that PHPs follow. According to the review findings PHPs may be coercive, and many treat the same addiction problems that they diagnose. This can be a conflict of interest because the PHP profits from determining that the physician needs help.
Physicians have little or no control over the PHP findings, and no legitimate way to voice concerns. According to the review authors “Once a PHP recommends monitoring, physicians have little choice but to cooperate with any and all recommendations if they wish to continue practicing medicine.” The review was performed by two doctors from Harvard Medical School, Dr. John R. Knight and Dr. J. Wesley Boyd, who both spent many years as associate directors for PHP organizations. According to both review authors “We recommend that the broader medical community begin to reassess PHPs as a whole in an objective and thoughtful manner.” Until physicians feel secure enough to speak out against any perceived conflicts or ethical concerns things will not change, but many physicians are worried about speaking out against a system that could penalize them.