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Medical Boards Let Physicians Practice Despite Drug Abuse

The Virginia medical board also allowed him to keep practicing, despite a law requiring that it suspend or revoke the license of anyone convicted of a felony.

After Gardiner sued Pholeric, the Virginia medical board concluded in 2002 that he had stolen cocaine solutions meant for his patients at Countryside Ambulatory Surgery Center and Loudoun Hospital Center. The state board put him on probation but let him keep practicing. He entered inpatient drug treatment again in 2001, and his license was fully reinstated in 2003. The medical board placed him on probation last year after his urine tested positive for marijuana, records show. Pholeric told the board he was "exposed to secondhand marijuana smoke" the night before his drug screen.


Kim Gardiner suffered a dislocated jaw after undergoing ear surgery performed by John F. Pholeric Jr., who has had a cocaine addiction. (Erik S. Lesser For The Washington Post)

SUNDAY: Doctors with substance abuse problems are allowed to keep practicing, often despite relapses, and medical boards rarely revoke licenses.
Physicians Practice Despite Abuse
Some Doctors Sent to Rehab
Graphic: Doctors Disciplined
Timeline: John F. Pholeric Jr.

MONDAY: A physician in Maryland or Virginia is twice as likely to be punished as a doctor in the District, where the medical board's record of serious disciplinary action has been among the lowest in the country.
D.C. Board Rarely Punishes Doctors
Despite Deaths, D.C. License Upheld
Graphic: Medical Discipline

TUESDAY: Doctors who are disciplined often restart their careers by moving to a another state, despite a federal system meant to prevent physicians from hiding troubled pasts.

_____Related Documents_____
John F. Pholeric Jr.
Kenneth D. Hansen
Joseph Shaw Jones
Lewis M. Satloff

_____Resources_____
Many state medical boards allow you to search for your doctors' standing and medical compliance history.


_____Q&A_____
Washington Post staff writer Cheryl Thompson discussed her "Special Treatment" series.
Audio: The Post's Thompson

_____Message Boards_____
Post Your Comments

Before his retirement last month, Pholeric said in several lengthy e-mails to The Post that drug addiction is an "occupational hazard" that should not end a physician's career.

"Do you throw these people away, or do you treat them, monitor them and assure public safety?" Pholeric wrote.

Pholeric said he was sober for 17 years, from 1983 through late 2000, but 1987 Virginia medical board records show he failed a drug screen, and 1999 records show the cocaine theft. He blamed a "long and difficult" schedule for his relapses but said he has been drug-free since September 2003.

"I am no longer trying to prove a thing," he said in an e-mail. "If patients don't think I am doing a good job, they should go somewhere else."

But Pholeric decided to retire March 7, in part because of the Post investigation, he said in a brief phone conversation.

"Your help in getting me to retire has been excellent, thank you," he said before hanging up.

Relapses

Paul H. Earley, medical director of the Impaired Professionals Program at the Ridgeview Institute in Smyrna, Ga., said it is common for doctors with substance abuse problems to relapse. One in 10 doctors do so within two years, he said. Others, he said, are in and out of rehab for years.

"There are people who can't stay sober . . . and they shouldn't practice medicine," he said.

From 1999 to 2004, nearly 1,400 physicians across the country were disciplined for substance abuse and reported to the National Practitioner Data Bank, a federal clearinghouse for disciplinary action and medical malpractice payments against doctors. Of those, many were repeat offenders: 259 physicians were reported twice; 58 had three reports; and two physicians had six reports, according to data bank records.

The controversy over whether medical boards should treat prolonged substance abuse as a career-ending offense is partially rooted in a much broader debate over whether addiction is an illness or a crime. The same question has come up in other arenas, from the judicial system to disability policy.

Arthur Caplan, chairman of the Department of Medical Ethics at the University of Pennsylvania School of Medicine, said it is common for the medical community to let doctors with a history of substance abuse continue to care for patients.

"Treating impaired doctors with kid gloves has been true since I was on the New York state licensing board in the '70s, and it hasn't changed," Caplan said. "I'm all for rehabilitation, but when you have multiple violations of drug abuse, you can't be near a prescription pad."

James T. Birch Jr., 50, a family practitioner who practiced for years in Norfolk, contends that a doctor with a drug or alcohol problem should be given as many chances as a doctor who is physically ill.

"Suppose you have a diabetic surgeon whose blood sugar drops and he's in the middle of a procedure," he said in an interview. "How many chances do you give him?"

From 1990 to 2001, Birch tested positive for alcohol, marijuana or cocaine seven times and went to four drug treatment centers, one financed by taxpayer dollars, according to Birch and state records. The Virginia medical board suspended his license four times but each time gave it back.

"I think the board was very fair to me," said Birch, who said he has been drug free for nearly four years. "I was given five chances. I think the board understands and recognizes addiction as a disease and not some type of moral turpitude."


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