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ISMA's Physician Assistance Program
Offering assistance to an impaired or disruptive physician

By forming a working relationship with the ISMA PAP, your hospital or medical staff can effectively deal with an impaired or disruptive physician. The following process promotes effective rehabilitation.


Intervention offers a way to approach the impaired practitioner in a caring, nonjudgmental manner and request that the physician receive assistance for a problem. To set up an intervention:

  • A concerned colleague, hospital administrator or nurse contacts either the ISMA PAP or a hospital-based committee member with information regarding a potentially impaired physician.
  • The committee and ISMA PAP staff review the information and determine if it is adequate to reasonably conclude an impairment exists. If more information is needed, the referral source may be asked to identify other concerned parties to provide additional details.
  • A meeting is held with the impaired physician and an assessment is requested by a source approved by the ISMA PAP.

Assessment/Treatment Referral

Once an intervention has successfully occurred, the following usually represents the best interests of the physician and hospital:

  • Formal enrollment in the ISMA PAP
  • Agreement to immediately enter an approved assessment program and allow formal communication between the assessing agency and the ISMA PAP
  • Agreement to follow all treatment recommendations resulting from the assessment recommendations
  • Agreement that failure to comply with this plan violates the hospital agreement and may result in action on medical privileges and/or medical license

Monitoring/Advocacy Services

A key service offered by the ISMA PAP is the monitoring contract. A typical physician contract remains in effect for five years and may include monitoring the following:

  • Attendance at 12-step support groups, where appropriate
  • Random urine drug-screen testing, where appropriate
  • Individual, family and/or group counseling, where appropriate
  • Communication with all appropriate therapists and treating physicians
  • Attendance at Caduceus meetings, a support group for health care professionals, where appropriate
  • Regular meetings with the PAP-named physician monitor and/or staff
  • Any other requirements deemed necessary to aid recovery

As part of this contract, the physician allows regular communication with all necessary and appropriate hospital personnel. Additionally, regular progress compliance letters can be sent on behalf of the recovering physician, when consent is given.


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