The field of addiction medicine has matured greatly in the past 20 years and progressed from basic science and anecdote to large-scale clinical studies with meaningful outcomes.

A good example appeared recently in the British Medical Journal (BMJ 2008;337:a2038). A five-year outcomes study of a large cohort of U.S. physicians treated for substance abuse was presented. About 10-12 percent of physicians in our country develop a substance abuse disorder.

The purpose of this study was to determine the effectiveness of state physician health programs. These programs do not treat physicians. They provide assessment and triage into care systems, and then carry out post-treatment monitoring. The ISMA’s Physician Assistance Program functions in this way.

The BMJ study concluded that about three-fourths of U.S. physicians with substance use disorders managed in physician health programs had favorable outcomes at five years. The data suggest that these programs, including the ISMA’s program, operate not only in the interest of the individual physician, but also in the interest of public safety.

In fact, 95 percent of physicians who completed monitoring in the study were licensed and working as physicians five years later. This clinical data tell us why it is so important to extend a helping hand to our chemically dependent colleagues.

In the same BMJ issue, our colleagues to the north reported on a cohort of Canadian physicians in a similar study with optimistic outcomes. These data amplify and support the groundbreaking research done by Doug Talbott, M.D., and published in JAMA in 1987.

Not only is this research important for physicians to understand, it is essential for those of us on hospital credentialing committees or executive committees. We need to carry this message to non-medical committee members (administrators and attorneys) who may drift toward a “get tough” policy.

Ample evidence now supports intervention and medical treatment rather than the punitive pathway. Anecdotal experience suggests punishment without rehabilitation actually brings opposite results, driving the problem further “underground.” This not only serves the physician poorly, but also quite possibly decreases patient safety.

Addiction is another medical problem needing treatment. Treatment outcomes are excellent. The protocols exist. Let’s use them.