Members of the Commission on Medical Discipline see their job as twofold: to protect the public and to rehabilitate doctors with problems.
Dr. Clarence Coombs is an example of how they like to see that philosophy work.
Coombs, a psychiatrist, was convicted in 1985 of drug distribution and Medicaid fraud in Baltimore and Montgomery County.
The commission placed him on probation last summer under an unusually detailed eight-page order intended to ensure that he overcomes his difficulties, including drug dependency.
Coombs, in his fifties, is now a staff psychiatrist at Springfield State mental hospital in Sykesville, where, under terms of the probation ordered by the commission, he is closely supervised.
He is required to submit to random drug tests, to take part in therapy, and to attend at least five meetings a week of self-help groups for people with psychological dependencies.
In contrast to the actions of the Maryland commission, the disciplinary board in Texas, where Coombs also held a medical license, revoked his right to practice after the convictions.
"Maryland was willing to give me another chance," Coombs said in a recent interview. For that, he said, he is deeply grateful.
"I think I have something I can contribute to the public."
Coombs, who has participated in intensive drug treatment programs, said that he was addicted to cocaine and heroin while he was prescribing narcotics to patients who were drug addicts.
"I was impaired myself and not really aware of how severe the problem was," said Coombs.
The commission and the state medical society are strong advocates of rehabilitating physicians.
Alcoholic or drug-addicted doctors who come to the medical society's attention are referred to the commission if they fail to complete the society's voluntary treatment program or refuse to take part in it.
Barbara Hull Foster, one of several assistant attorneys general who has worked for the commission part time during the past few years, was hired last fall as the commission's first full-time lawyer and was instrumental in drafting Coombs' probation order.
It was a major undertaking, said Foster, but it was worth the effort.
"I believe under the order the public safety is protected," she said.
Coombs' history with the commission goes back to July 1983, when he was placed on emergency suspension for writing excessive drug prescriptions for patients in his Silver Spring practice.
In November of that year, the commission found him incompetent but it restored his license on probationary terms that allowed him to accept a job as a staff psychiatrist at Austin State Hospital in Texas.
Coombs was convicted of criminal charges in
Maryland in 1985, while he was still practicing in Texas.
At a hearing last summer, the commission decided that Coombs' incompetence and his criminal convictions were in part a result of his drug dependency, which he had overcome after six months in a treatment program for impaired physicians. The commission placed him on probation and allowed him to accept a job in a structured setting at Springfield State hospital.
Springfield has hired another psychiatrist who was recently placed on probation by the commission, Dr. Francesco B. DiLeo.
Last summer the commission found that DiLeo had taken hallucinogenic drugs with his patients and had sex with one of them.
Springfield State Superintendent Bruce Hershfield said he was glad to be able to recruit DiLeo and Coombs and is satisfied with the performance of both. They are working side by side with supervising psychiatrists, said Hershfield. The extra monitoring and supervision required by the commission for the next few years will pay off in the long run, he hopes, if Coombs and DiLeo decide to make their careers at Springfield.