When Candace Backer, LCSW, LCAC, applied for a job through the Indianapolis Star in 1990, almost all she knew was that it entailed working with physicians. That sounded interesting. So Backer, then the clinical director of an inpatient substance abuse hospital for adolescents, mailed her resume and cover letter to the anonymous post office box listed in the ad.

That led to interviews with ISMA’s general counsel and Commission on Physician Assistance, who had seen the need for a program to help physicians who were dealing with substance abuse. They hired Backer as the first full-time coordinator of the ISMA Physician Assistance Program (PAP).

“In 1990, there weren’t very many programs, so our doctors were forward-looking in establishing one,” said Backer, who will retire Jan. 4 after 30 years with ISMA.

“It has been a tremendous privilege and honor to work with so many gifted and talented physicians. I’m proud of the work ISMA has done to help develop the national model of best practices in assisting physicians and to see the extraordinary rates of recovery, especially with substance use disorders.”

ISMA Executive Vice President Julie Reed, JD, said ISMA is fortunate to have benefited from Backer’s expertise and commitment for the past 30 years. “Her work with the Physician Assistance Program has created a solid foundation for success in supporting Indiana physicians that will continue after her departure,” Reed said.

Backer spent her first five years as PAP coordinator building the program from the ground up. Working with the ISMA Commission on Physician Assistance, Commission Chair Randall Stevens, MD, and Medical Consultant Fred Frick, MD, she assessed physicians’ needs, consulted with staff of the handful of other state programs at the time, created policies and procedures and visited county medical society and ISMA Alliance meetings to generate referrals.

As more physicians became employed in the late 2000s, they faced new pressure to increase their caseloads and navigate the technicalities of electronic health records. Backer began working with a greater number of distressed physicians – those dealing with behavioral concerns or mental health issues. Now-Senior Case Manager Anne Naus Kelley joined the staff in 2013, and the program’s Doctor Your Spirit web resources on burnout, health and wellness, civility, depression and suicide were added in 2015.

Even as the number of physicians’ concerns grew, a national study in 2008 showed the program was making a difference. Of 904 doctors with substance use disorders admitted to physician assistance programs in 16 states, including Indiana, 80% had not relapsed after five years – a rate that continues today, Backer said.

Backer calls confidentiality the foundation of the PAP’s success in assisting hundreds of Indiana physicians and medical students. “Physicians always want to remember that, when they call our program, it is confidential and we cannot talk to anyone without their written consent,” she said.

She emphasizes the ongoing need for physicians to manage their own emotional and mental health and create a balance between their personal and professional lives, especially during the COVID-19 pandemic. Changing the culture of institutions to ensure physician wellness is equally important, she said. She hopes that more hospital systems and medical schools will hire chief wellness officers and that those leaders will maintain their involvement with clinical medicine and the concerns of physicians on the front lines.

In recognition of her work helping Indiana physicians overcome addiction, Backer was honored with the 2018 Hero in the Fight award from the Mental Health Association of Indiana. And, in September, ISMA honored her with a resolution at its virtual annual convention, expressing the “deepest respect and heartfelt appreciation” for her “unparalleled commitment to physicians in Indiana and for her service to ISMA and the medical profession.”

Senior Case Manager Anne Naus Kelley, LCSW, LCAC, will succeed Backer as coordinator of the ISMA Physician Assistance Program, and Susan M. Kelley, MSW, LCSW, LCAC recently joined the staff as case manager.