Colorado Physician Health Program

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Colorado Physician Health Program
Annual report July 1, 2008 through June 30,
2009 by Sarah R. Early, PsyD, Executive Director
Doris C. Gundersen, 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.
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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 Directors2008 2009 ChairStephen
Dilts, MD Vice-ChairJames Borgstede,
MD SecretaryCaroline M. Gellrick, MD
TreasurerLarry A. Schafer, MD
Director-At-LargeBruce H. Wilson, MD
Director- At- LargeMaureen 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
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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, 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
• Physicians Integral Care Programme (PAIMM) of
  Barcelona (Spain) Michael H. Gendel, MD, Medical
  Director Emeritus was the plenary speaker
  presented at the 10th Annual Physicians Integral
  Care Programme of Barcelona in November 12-14,
  2008. He presented on the history of Physician
  Health Programs in the United States.
• 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
• Doctors health State of the art. A plenary
  panel session reviewing the development and
  current status of doctors health programmes in
  the US, Canada, Panel Presenter Michael Gendel
• 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 Doris C. Gundersen, MD Medical Director
Emeritus Michael H. Gendel, MD Associate Medical
Directors Mary Ellen Caiati, 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
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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.
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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
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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.
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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.
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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
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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.
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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 at Denver
• 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 at Denver
• Red Rocks Community College Physician Assistant
  Program
• Medical School
• University of Colorado at Denver
• 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 410Denver, CO
80203Phone [phone]Fax      [phone] w
ww.cphp.org Office Hours Monday Friday830
a.m. 430 p.m.
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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
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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 UCD
Anesthesiology Department UCD Department of
Psychiatry UCD Graduate Medical Education UCD
Neurosurgery Department UCD School of
Medicine Veterans Affairs Hospital Denver
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