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Colorado Physician Health Program

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Title: Colorado Physician Health Program


1
Colorado Physician Health Program
Annual report July 1, 2008 through June 30,
2009 by Sarah R. Early, PsyD, Executive Director
Michael H. Gendel, MD, Medical Director Colorado
Physician Health Program
The mission of Colorado Physician Health Program
is to assist physicians, residents, medical
students, physician assistants and physician
assistant students who may have health problems
which if left untreated, could adversely affect
their ability to practice medicine safely.
2
Colorado Physician Health Program Program
Highlights July 1, 2008 through June 30, 2009
  • New CPHP Medical Director CPHP Board of
    Directors is pleased to announce Doris C.
    Gundersen, MD, as Medical Director effective July
    1, 2009. After a nationwide search, Dr.
    Gundersen was selected to succeed Michael H.
    Gendel, MD, who served in this role for ten
    years. Dr. Gundersen has served as CPHP
    Associate Medical Director since 2000. For a
    complete biography please visit www.cphp.org.
    Dr. Gendel will remain active in the physician
    health field and will assume the role of Medical
    Director Emeritus at CPHP. He plans to continue
    to work with CPHP for the next several years.
  • Patient Safety Committee Formation On February
    17, 2009, CPHP Board of Directors created a
    Patient Safety Advisory Committee. This
    committee consists of several members of the
    medical community active in patient safety
    initiatives. The committee members include Patty
    Skolnik, Director for the Colorado Citizens for
    Accountability, Judy Ham, CEO of Cerebral Palsy
    of Colorado and Edward Dauer, Esq. with the
    Colorado Patient Safety Coalition. CPHP utilizes
    this committee to address issues regarding public
    protection and to provide a forum of objective
    discussion on CPHPs policies and procedures in
    regard to patient safety. CPHP is very pleased
    of this addition to provide comprehensive,
    well-considered services to ensure safety to all
    of Colorado. On June 17, 2009, CPHP
    representative Doris C. Gundersen, MD, Associate
    Medical Director, and Ms. Skolnick, attended the
    Citizen Advocacy Center Annual Meeting in San
    Francisco, CA. Several members of the Federation
    of State Physician Health Programs also attended
    to impart the importance of physician health
    programs in enhancing patient safety as well as
    to learn the patient safety issues that are
    currently being addressed. CPHP is glad to be a
    part of these essential discussions.
  • Spirit of Medicine Campaign CPHP completed the
    annual Spirit of Medicine fundraising campaign
    with successful results!  CPHP utilizes
    fundraising to supplement expenses that exceed
    the Peer Assistance Budget.  The Fundraising
    Committee led by Board Director Tom Currigan, Jr,
    coordinates and directs the efforts of this
    campaign. We appreciate all of our generous
    contributors and especially want to recognize our
    donors who provided gifts of 5,000 or more
  • Centura Health
  • St. Marys Hospital and Medical Center
  • The Medical Center of Aurora
  • Colorado Permanente Medical Group (CPMG) We
    extend special appreciation to CPMG as a charter
    member of the LivingWell Giving Society
  • Valley View Hospital We would like to express
    our appreciation for their membership as the
    newest member of the LivingWell Giving Society
  • All donors are recognized on CPHP website,
    www.cphp.org, from 2007-2008 campaign.
  • CPHP Newsletter Distributed The Summer 2009
    edition of CPHP News was mailed to all active
    Colorado licensed physicians and physicians
    assistants and various other medical entities
    throughout the state.  CPHP Education and
    Outreach Committee chaired by Board Director Mike
    Calvin, PA, directed this publication effort.
    CPHP is proud of this initiative in an effort to
    provide the Colorado medical community with
    informative physician health articles and to
    promote CPHPs mission and services.  Given the
    importance of this educational and outreach
    venture, we are committed to publishing CPHP News
    annually.  CPHP News is also available for
    download from our website at www.cphp.org.

Board of Directors 2008 2009 Chair Stephen
Dilts, MD Vice-Chair James Borgstede,
MD Secretary Caroline M. Gellrick, MD
Treasurer Larry A. Schafer, MD
Director-At-Large Bruce H. Wilson, MD
Director- At- Large Maureen J. Garrity,
PhD Michael Van Buren Calvin, PA Thomas G.
Currigan, Jr. George D. Dikeou, Esq John H.
Genrich, MD Alfred D. Gilchrist Debbie
Lazarus Michael Michalek, MD Lawrence Varner,
DO
2
3
Colorado Physician Health Program National/interna
tional research and conferences July 1, 2008
through June 30, 2009
  • CPHP prioritizes physician health research and
    interaction among the national and international
    community of physician health practitioners to
    promote best treatment practices for physicians
    and enhance public protection. All research
    efforts and conferences attended out of state are
    compensated through CPHP fundraising efforts. No
    Peer Assistance Funds are utilized for these
    activities.
  • Kaiser Permanente Grant supported National
    Research Meeting CPHP hosted a National Research
    Meeting for Physician Health Researchers on April
    17, 2009 in Denver, thanks to the generous
    support from Kaiser Permanente. Researchers
    prominent in the field of physician health across
    North America attended. The purpose of the
    meeting was to develop coordinated national
    research projects to scientifically evaluate
    physician health matters. The efforts put forth
    by this conference will ultimately inform others
    through publication of best practices and to
    guide public policy. CPHP extends appreciation to
    Kaiser Permanente for supporting this research.
  • Publications
  • Elizabeth Stuyt, MD, Doris C. Gundersen, Jay H.
    Shore, Elizabeth Brooks, and Michael H. Gendel
    published Tobacco Use by Physicians in a
    Physician Health Program, Implications for
    Treatment and Monitoring in the March 2, 2009
    issue of American Journal of Addiction. Dr.
    Stuyts spearheaded this study and her interest
    in tobacco use by impaired physicians has been a
    driving campaign across the country to examine
    the link between tobacco and sustained recovery.
    In fact her research and advocacy efforts have
    prompted several national physician inpatient
    treatment center to go tobacco-free.
  • Dr. Gendel, along with four other physician
    health authors published How are Addicted
    Physicians Treated? A National Survey of
    Physician Health Programs in the July 2009
    edition of the Journal of Substance Abuse
    Treatment. This article educates as to the
    various treatment practices and success of
    addicted physicians monitored by physician health
    programs.
  • Physician Health Conferences
  • International Conference on Doctors Health CPHP
    Medical Director, Executive Director, and
    Associate Medical Directors attended the
    International Conference on Doctors Health in
    London, England November 17-19, 2008. CPHP
    provided the following research presentations
  • Tobacco Use by Physicians in a Physician Health
    Program, Implications for Treatment and
    Monitoring Authors Libby Stuyt, Doris
    Gundersen, Jay Shore, Elizabeth Brooks and
    Michael Gendel
  • Physician Boundary Issues in a Physician Health
    Program A 19-Year Review Authors Jay Shore,
    Elizabeth Brooks and Michael Gendel
  • Blueprint Project, Colorado Site A study of
    physicians with substance use disorders followed
    by the Colorado Physician Health Program -
    Authors Michael Gendel, Jay Shore and Elizabeth
    Brooks
  • Gender Differences and Predictors of
    Reactivation at a Physician Health Program,
    Implications for Outreach and Intervention
    Authors Nahid Hotchkiss and Sarah Early
  • Western Region of the Federation of State
    Physician Health Programs (FSPHP) Annual Meeting
    CPHP Medical Director and Associate Medical
    Directors attended the Western Region of the
    FSPHP Annual Meeting in Seattle, WA September
    4-6, 2008. Associate Medical Director, Elizabeth
    Stuyt, MD provided a presentation on the topic
    Tobacco Use by Physicians in a Physician Health
    Program, Implications for Treatment and
    Monitoring.
  • Federation of State Physician Health Programs
    (FSPHP) and CPHP Involvement CPHP Medical
    Director, Associate Medical Directors and
    Executive Director attended the FSPHP Annual
    Meeting in New Orleans, LA from April 27-30,
    2009. Doris C. Gundersen, MD, Associate Medical
    Director presented on Research Projects Future
    Directions.
  • We welcomed the opportunity to learn about
    physician health research and activities from
    around the world at these conferences.

Medical/Associate Directors Medical
Director Michael H. Gendel, MD Associate Medical
Directors Mary Ellen Caiati, MD Doris C.
Gundersen, MD Scott H. Humphreys, MD Jay H.
Shore, MD Michael S. Sturges, MD Elizabeth Stuyt,
MD Staff Executive Director Sarah R. Early,
Psy.D Director of Clinical Services Cae Allison,
LCSW Director of Finance Karen Chipley,
MBA Receptionist Megan Curry Clinicians Lynne
Klaus, LCSW, CACIII Christine Lewis, MA, EdS,
LPC Sally Moody, MSW, LCSW Compliance Coordinator
Joyce Muniz Executive Assistant Amanda
Parry Administrative Assistant Tracy Sue
Walters Developmental Specialist Todd Weiss
3
4
Colorado Physician Health Program New referral
Highlights July 1, 2008 through June 30, 2009
CPHP received 318 New Referrals in the Fiscal
Year 2008-2009! This is the largest number of
annual New Referrals in CPHP history! In Fiscal
Year 2007-2008, CPHP received 276 referrals.
This shows a 15 increase in New Referrals. The
average active caseload at any given period
during this quarter was 465 participants. This
represents a 2 increase from the Fiscal Year
2007-2008 which had 457 active participants at
any given time. Of the 318 New Referrals in the
Fiscal Year 2008-2009, 53 were voluntary and 47
were mandatory. 25 of the New Referrals
(N80) that came to CPHP are able to utilize the
Safe Haven Provision on medical licensure
application/reapplication.
Yearly Comparison of New Referrals to the CPHP
1986-Present
BME License Renewal Years
Licensure of New Referrals
Of the total New Referrals this year, 77 had
active Colorado Medical Licensure. The breakdown
of licensure is as follows Medical license 65,
PA license 3, Training License 14, Applicant
for Colorado licensure 7, Out of State 2 and
Medical or PA Students 9.
4
N318
5
Colorado Physician Health Program Referral
Specifications July 1, 2008 through June 30,
2009
Sources of New Referrals
The highest single source of New Referrals for
the Fiscal Year 2008-2009 were Self at 34. The
second highest source of New Referrals was the
BME at 26. CPHP continues to be proud of the
number of Self Referrals to the program
demonstrating trust and confidence in CPHP. 75
out of the 318 New Referrals were reactivated
thus, 24 of New Referrals were previously seen
at CPHP.
N318
Primary Presenting Problem New Referrals
A Primary Presenting Problem area which best
represents the participant is identified by the
clinical team following the completion of the
initial intake interview. In an effort to better
understand the relevancy of this data, CPHP has
removed cases that are in process or have not
yet been assigned a primary presenting problem.
Of the 318 New Referrals in the Fiscal Year
2008-2009, 94 were in process at the time of this
report, thus 224 were assigned a primary
presenting problem. The majority of New
Referrals presented with a psychiatric problem
(24), followed by a DUI/DWAI (16), and lastly a
behavioral problem (13).
N224
Specialty of New Referrals
In an effort to reflect the true representation
of specialties served, CPHP is reporting on cases
where specialty information has been collected at
the time of intake. Of the 318 New Referrals in
the Fiscal Year 2008-2009, 94 had not completed
an initial intake session at the time of this
report, thus for 224 New Referrals, specialty
information had been collected. For the Fiscal
Year 2008-2009, there was a wide variety of
specialties represented. The most frequently seen
specialty at CPHP was Family Practice and
Internal Medicine both at 16.
Gender of New Referrals
34 were Female and 66 were Male (N224).
N/A Student or PA Other Allergy/Immunology,
Hematology/Oncology, Neurology, Ophthalmology,
Orthopedics, Otolaryngology, Physical Medicine
and Rehabilitation, Podiatry, and Spinal Cord
Injury Other Surgery Plastic Surgery,
Neurological Surgery, and Thoracic Surgery.
N224
5
6
Colorado Physician Health Program Inactivations
and COUNTIES SERVED July 1, 2008 through June
30, 2009
Inactivations
  • Inactivation refers to when a case is closed at
    CPHP. During the Fiscal Year 2008-2009 there were
    312 cases inactivated. Of these 312
    inactivations, 27 referrals were declined, 2 did
    not complete an evaluations, 3 withdrew their BME
    application, 22 declined evaluations, 14
    completed consultation, 2 had their BME order
    rescinded, 12 relocated, 3 categorized as
    Other, and 2 unfortunately died therefore, 225
    were evaluated. Of the 225 evaluated, 197 (88)
    were inactivated with an outcome considered to be
    successful and/or satisfactory.

N312
Length of Active Status
  • Length of Active Status at CPHP is depicted to
    the right. The majority of participants (67)
    completed the necessary involvement with CPHP in
    one year or less. Last fiscal year 2007-2008,
    63 of participants completed the necessary
    involvement of CPHP in one year or less.

N312
Region Number Percent
Adams 15 7
Arapahoe 25 11
Boulder 23 10
Broomfield 4 2
Clear Creek 1 .5
Denver 66 30
Douglas 12 5
El Paso 19 9
Fremont 1 .5
Garfield 1 .5
Jefferson 15 7
La Plata 1 .5
Region Number Percent
Larimer 7 3
Logan 1 .5
Mesa 2 .5
Montezuma 1 .5
Morgan 1 .5
Otero 1 .5
Other 1 .5
Out of State 15 7
Pitkin 2 .5
Pueblo 4 3
Summit 1 .5
Fiscal Year 2008-2009 N 224 100
Counties Served
Of the 224 New Referrals seen for a full initial
evaluation, regional data has been collected.
During the Fiscal Year 2008-2009 New Referrals
resided in 23 Colorado counties. Counties
that contain less than 10 physicians, based on a
BME listing of Colorado licensed physicians
(obtained in September 2008) are grouped into one
category (Other) to protect the confidentiality
of clients residing in those counties. Counties
in this category include Archuleta, Baca,
Cheyenne, Conejos, Crowley, Custer, Dolores,
Hinsdale, Jackson, Kiowa, Mineral, Park,
Phillips, Rio Blanco, Saguache, San Juan and
Sedgwick.
6
7
Colorado Physician Health Program REACTIVATIONS
July 1, 2008 through June 30, 2009
Referrals versus Reactivations
Reactivation refers to when a participant
returns to CPHP after having been
inactivated. Of the 318 New Referrals in Fiscal
Year 2008-2009, 78 were Reactivations. This
represents 25 of the total New Referrals. This
is an increase in 4 when compared to Fiscal Year
2007-08.
Primary Presenting Problem Reactivations
A Primary Presenting Problem area which best
represents the participant is identified by the
clinical team following the completion of the
initial intake interview. In an effort to better
understand the relevancy of this data, CPHP has
removed cases that are in process or have not
yet been assigned a primary presenting problem.
Of the 78 Reactivations in the Fiscal Year
2008-2009, 24 were in process at the time of this
report, thus 54 were assigned a primary
presenting problem. The majority of
Reactivations presented with a behavioral problem
(17), followed by a DUI/DWAI or psychiatric
problems both at 15.
N54
Sources of Reactivations
The highest single source of Reactivations for
the Fiscal Year 2008-2009 were BME at 37. The
second highest source of Reactivations was the
Self at 27.5. CPHP continues to be proud of the
number of Self Referrals to the program
demonstrating trust and confidence in CPHP. Of
the Reactivations in Fiscal Year 2008-2009, 42
came back to CPHP voluntarily, and 58 were
mandated. The number of voluntary referrals
shows an 8 decrease for Reactivations when
compared to last Fiscal Year.
N78
7
8
Colorado Physician Health Program Report requests
and Financial Breakdown July 1, 2008 through June
30, 2009
Report Requests
CPHP processed 1530 requests for reports during
the Fiscal Year 2008-2009. In Fiscal Year
2007-2008 CPHP received 1331 report requests.
This shows an increase of 13 in report requests.
N1530
Financial Summary CPHP finished the Fourth
Quarter and Fiscal Year with a Year-to-Date Peer
Assistance Net Loss of 64,105.92 versus a
Year-to-Date Budgeted Loss of 87,251.00.
Year-to-Date Revenue is largely on target with
Year-to-Date Expenses approximately 22,800.00
less than budget primarily due to staff
shortages. The Net Loss was supplemented with
cash reserves from the annual Spirit of Medicine
campaign.
Revenue Sources
The majority of revenue that was generated at
CPHP during Fiscal Year 2008-09 was from the Peer
Assistance Contract (75). The next largest
source of revenue was from Donations (16) which
were contributions to the CPHP annual Spirit of
Medicine fundraising campaign.
8
9
Colorado Physician Health Program COMMUNITY
OUTREACH July 1, 2008 through June 30, 2009
  • Availability of Services In addition to CPHP
    providing services to Colorado licensed
    physicians and physician assistants, contracts
    exist to provide services for residents, medical
    students and physician assistant students. CPHP
    is proud to assist medical professionals early in
    their career to promote personal good health and
    wellbeing. CPHP currently serves the following
    programs
  • Residency Programs
  • University of Colorado Health Sciences Center
  • St. Joseph Hospital Residency Program
  • St. Anthony Family Medicine Residency
  • Southern Colorado Family Medicine Residency
  • St. Marys Family Practice Residency Program
  • Colorado Health Foundation Transitional
    Residency Program at Presbyterian/St. Lukes
    Hospital
  • Denver Health Emergency Medicine Residency
  • Fort Collins Family Practice Residency
  • Physician Assistant Training Programs
  • University of Colorado Health Sciences Center
  • Red Rocks Community College Physician Assistant
    Program
  • Medical School
  • University of Colorado Health Sciences Center
  • CPHP and COPIC Continue Educational
    Collaboration CPHP and COPIC have again
    partnered to continue the ninth series of
    educational presentations for Colorado
    physicians. Presentations are provided
    throughout Colorado on the subjects listed to the
    left.
  • COPIC Financial Assistance Fund COPIC Companies
    provide CPHP with the Financial Assistance Fund
    to directly assist CPHP physician clients that
    would otherwise be unable to afford our services.
    Their generous donation of 20,000 is greatly
    appreciated. Thank you!

CPHP SERVICES
  • Client Services
  • Assessment
  • Treatment referral
  • Monitoring and support
  • Family support
  • Documentation
  • Workplace and Referral Source Services
  • Consultation on identifying physicians who need
    assistance
  • Consultation on making referrals
  • Workplace consultations
  • Educational presentations
  • Medical Community Services
  • Promote physician health awareness
  • Educational presentations
  • Partnership with organizations to meet special
    needs
  • Develop meaningful research on physician health

Address 899 Logan St., Suite 410 Denver, CO
80203 Phone 303-860-0122 Fax      303-860-7426 w
ww.cphp.org Office Hours Monday Friday 830
a.m. 430 p.m.
9
10
Colorado Physician Health Program Community
outreach Continued July 1, 2008 through June 30,
2009
Audiences American Academy of Pediatrics Colorado
Chapter Aurora Medical Center Avista Adventist
Hospital Centura Health Administration Center for
Personalized Education for Physicians Center for
Creative Leadership Child Health
Associate/Physician Assistants Training
Program Childrens Hospital Department of
Psychiatry Childrens Hospital Medical Executive
Committee Colorado Academy for Physician
Assistants Colorado Association for Medical
Staff Services Colorado Association for Nonprofit
Organizations Colorado Acute Long Term
Hospital Colorado Board of Medical
Examiners Colorado Hospital Association Colorado
Health Foundation Transitional Year
Fellows Colorado Nurses Health Program Colorado
Medical Society COPIC Colorado Rural Health
Association Colorado Society of Osteopathic
Medicine Colorado Permanente Medical Group Delta
County Memorial Hospital Denver Health
Hospital Exempla Good Samaritan
Hospital Federation of State Physician Health
Programs Fort Collins Family Practice Residency
Grand River Hospital in Rifle McKee Medical
Center Memorial Health System North Suburban
Medical Center Longmont United Hospital Lutheran
Medical Center Memorial Health System McKee
Medical Center Parkview Medical Center Parker
Adventist Hospital Porter Adventist Hospital
Presbyterian/St. Lukes Hospital
N
Red Rocks Community College Rocky Mountain Vista
University Rocky Mountain Society of
Gastroenterology Nurses Spalding Rehabilitation
Center Southern Colorado Family Practice
Residency St. Anthony Summit Medical Center St.
Anthonys Residency Program St. Josephs
Residency Program St. Marys Hospital St.
Mary-Corwin Hospital Swedish Hospital UCHSC
Anesthesiology Department UCHSC Department of
Psychiatry UCHSC Graduate Medical
Education UCHSC Neurosurgery Department UCHSC
School of Medicine Veterans Affairs Hospital
Denver
10
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