Deadline for ICU credentialing approaches

Medical Staff Survey (pdf)

Marsh survey - CEO conducts Gallup poll, dialogue with employees

Remembrance and aid offered to Tsunami victims

'State of the School' addressed

Health Events

Medstaff: by the numbers

PAWS isn't only for patients ...

Well-being beyond worry?

by: LAWRENCE M. SHUER

You detect the odor of alcohol on a colleague's breath while both of you are working with patients. . .

You watch an esteemed colleague take narcotic pain medications to relieve stress. . .

You feel saddened but also alarmed as a long-time mentor forgets key steps in a treatment process he or she learned decades earlier. . .

You see and hear another colleague verbally abuse a nurse or resident. . .

- - - - - - - - -

What can you do besides worry about these doctors and their patients? You can refer them to the Well Being Committee.

I am extremely proud of the Well-Being of Physicians and Physicians-In-Training Committee, and as I occasionally do, I'd like to use this column to highlight not only the role of this committee but to show how all of us can help advance the good work that this group performs.

Put simply, the Well-Being Committee is the venue charged with assisting impaired physicians or physicians-in-training at Stanford Hospital and Clinics, as well as at Lucile Packard Children's Hospital. Impairments addressed by the committee include difficulties arising from the aging process, a mental disorder, or the abuse of alcohol or other drugs by any physician or physician-in-training. The committee also has been asked to deal with medical staff members or house staff who demonstrate disruptive or inappropriate behavior.

The Well-Being Committee consists primarily of senior physicians and other professionals who have been chosen for their interests and expertise in the area of medical staff well-being. All members have demonstrated a genuine desire to become involved with the core of the committee's work - to assist in the physical, emotional and spiritual well-being of the medical staff and physicians-in-training. The committee's work is guided by three principles: caring, confidentiality and cooperation.

People come to the committee's attention in various ways, including self-referrals, colleague or supervisor referrals, or referrals from the Medical Board. The committee also automatically interviews physicians who have been convicted of a D.U.I. (drunk driving) charge.

But however an individual is brought to the attention of the committee, his or her confidentiality is protected. The process depends on cooperation between the individual being assisted and the committee. The goal of the committee is always to support the individual in his/her recovery. Only then will the committee accomplish its additional goals of improving patient care and enhancing Medical Staff effectiveness.

What is special about the committee is that this group is not at its core a court, but rather, a diagnostic body mandated to working with its clients. This philosophy is reflected clearly in the steps taken in each case: After referral, the committee meets with the individual to determine if a problem exists, and if so, to define it. Next the committee and the medical staff member will develop a plan to address the problem. Solutions could involve a variety of treatment options and will usually be formalized into a contract between the individual and the committee.

The committee maintains a resource list of organizations and experts who can provide professional assistance to the impaired person. As appropriate the committee works with the Medical Board of California's Diversion program, as well as with many other inpatient or outpatient rehabilitation programs. For example, the Help Center at Stanford University has been a resource for people with behavioral issues.

The committee monitors the treatment progress of the individual. If the individual refuses to follow the recommended plan or fails to comply with its terms, then the matter is referred to my office for further action as needed.

The multiple goals of helping the individual while also protecting patients and improving care are reflected in a team approach to working with referrals. Typically, one committee member will be chosen to serve as a liaison with the impaired individual. Another medical staff member will serve as site monitor to ensure that neither patient nor employee safety and well-being is compromised during the recovery process. For example, if drug or alcohol use are identified as the problem, the work site monitor will usually have the ability to request blood or urine tests as indicated to document compliance with institutional policies and the treatment plan.

The committee takes a holistic approach. Most notably, in recent years the committee has been called on to address issues of workplace behavior, such as stepping in when a physician exhibits a pattern of verbal abuse toward nursing or other support personnel. Here the challenge can be to help the physician understand how behavior jeopardizes his or her effectiveness in delivering good patient care.

I'm gratified that during the past nine years, I have had an opportunity to work closely with the committee and observe many of its successes. After a recent visit here, a physician who coordinates the Well-Being Committee for the Santa Clara County Medical Society described our committee as a role model for all of the other hospitals in our county.

We will soon have more details available on a Well-Being Committee website which will be accessible through the Medical Staff services page on the public SHC website: http:// www.stanfordhospital.com/forPhysiciansOthers/physicians/ medicalStaffServices/committees/medicalStaffServices Committees.html

Additionally, if you have need of the committee for yourself or a colleague - or are simply interested in further information - I urge you to contact the committee member or staff member of your choice for a confidential discussion.

Here are the members

-- Chair: William E. Berquist, M.D. (berquist@stanford.edu)
-- Ray Gaeta, M.D. (gaeta@stanford.edu)
-- Peter Gregory, M.D. (pgb@stanford.edu)
-- Joe Hopkins, M.D, (joeh@stanford.edu)
-- Lorrin Koran, M.D. (lkoran@stanford.edu)
-- Jaime Lopez, M.D. (lopezjr@stanford.edu)
-- Peter Moskowitz, M.D. (pmoskowitz@cppr.com)
-- Peter Nelson, M.D. (peternelson94025@yahoo.com)
-- Rebecca Powers, M.D. (whoakmed@aol.com)
-- Stephen Richmond, M.D. (shrichmond@pol.net)
-- Frank Sarnquist, M.D. (frank.sarnquist@stanford.edu)
-- Barbara Sommer, M.D. (Bsommer@stanford.edu)
-- Richard Whyte, M.D. (riwhyte@stanford.edu)

Staff or ex officio contacts include:
-- Harvey Cohen, M.D., chief of staff at Packard Hospital. (punko@stanford.edu)
-- Ann Dohn, director of the office of Graduate Medical Education (house staff), (adohn@stanfordmed.org)
-- Sandi Edgar, director of medical staff services, (sedgar@stanfordmed.org)

- - - - - - - -

Please feel free also to contact me. I've tried to convey that the success of this committee is not only a direct responsibility of my duties as chief of staff - but a deep personal commitment as well.

(lshuer@stanford.edu)