Board to Consider Standardizing Impairment Orders

At the TMB Board meeting on August 30th, there was discussion of standardizing the length, the terms and conditions of impairment orders. It may be with such cases in the future, the individual would not even go to a hearing unless the circumstance of that person’s impairment history was out of the norm. According to the discussion, the “standard” case seems to be someone who abused alcohol or drugs in medical school or residency. They recognized they had a problem and sought treatment. Under those type cases the TMB would formulate a standard agreement of maybe seven years to monitor those individuals. Typical monitoring would be with drug screening, mandated attendance at a 12 step program, required participation in a county medical society impairment committee and approved mental health care. TMB staff will have a proposal for the Board members to consider at the October meeting. Those cases that are “egregious” would be sent to a disciplinary hearing.

My Take: I think this is a reasonable idea that could be well used and certainly could speed up the process of having someone monitored by the Board. The three concerns that come to my mind are:

(1) What does “egregious” mean? Is it someone who harmed a patient while impaired, or is it a doctor who does not meet the “standard” view of how impairment cases make it to the Board? It is not clear to me at this time.

(2) What if someone wants a hearing? How is that process going to be resolved? Obviously, the TMB cannot waive someone’s due process rights, so how will that play out? It is a critical question that must be resolved and a plan is in place.

(3) The individuals who are offered such Orders need to be fully aware of the consequences of such Orders. There are a lot of pitfalls that people find once they are bound by an Order that they do not know about and, frankly, the TMB does not do an adequate job educating them on those issues until after the Order is in affect. In the staff’s defense, it is not their job to educate the licensee; it’s the licensee’s responsibility.