For instance, Lea knows from the diversion groups he works with that about 75 to 90 percent of the addicted physicians, nurses, dentists, pharmacists and other health professionals stay sober and return to work safely for up to five years following treatment. What is not known is how many of those former patients stick with their recovery programs after their mandatory five-year monitoring program expires.

Lea hopes Hazelden's sophisticated research department can do follow-up studies to help document long-term outcomes. "Do our patients have good recovery rates because they've complied for five years to save their jobs, or are they truly living a life of Twelve Step recovery?" asks Lea.

In addition to outcome studies, Springbrook hopes a strong research component can suggest ways to improve care for its health professional population. Also, as part of nonprofit Hazelden, Springbrook now has the opportunity to raise money and provide financial assistance to health care professionals who can't afford treatment. "A patient-aid program will help us treat more people," says Lea.

The health care track, which fills on average one-third of the primary treatment beds at Springbrook, also hopes to benefit from some "joint learning" as it shares its clinical strengths with Hazelden's Health Care Professionals Program in Center City.

Referent relations stand out
Springbrook has earned a solid reputation largely because of its outstanding referent relations, first-rate treatment, and the ability to let clinical needs drive the length of stay. That variable length of stay, usually 30 to 90 days, is needed because most diversion programs require longer, more intensive care for its clients, says Marvin Seppala, MD, vice president of Medical Affairs at Hazelden who oversees programs for health professionals. "The extended care, or Level II care, at Springbrook is a cross between the Jellinek [extended care] and Fellowship Club [halfway house] care offered in Minnesota," he says.

Almost all physicians and the majority of other health care professionals who come to Springbrook are mandated to treatment. That is, they come at the direction of diversion programs or medical licensing boards that require them to be assessed and/or treated as an alternative to disciplinary action. Most states have programs, such as the Oregon Health Professionals Program, which facilitate confidential care as long as the client successfully completes treatment and the terms of monitoring.

The diversion programs were created to protect the public from licensed professionals who are unable to practice safely because of impairment from chemical use or illness. A typical scenario: A colleague suspects a peer is abusing drugs, reports that person to the diversion board, the diversion program investigates, and, if evidence reveals reasonable cause of a problem, the peer will be intervened upon. The peer can either follow recommendations of the diversion group or be referred to the medical licensing board for investigation and possible disciplinary action.

Physicians and other health professional clients at Springbrook receive a thorough assessment and the same treatment services as the rest of the patient population. They also attend two special group therapy sessions each week for health professionals and have direct contact with Lea to address special issues. "It's really a balancing act to address their special needs and at the same time explain that their disease is no different from the next person," said Lea.

'They're not alone'
For instance, a physician may room with a plumber; this helps drive home the point that doctors are not unique. "Mainstreaming physicians is important, but walking into a room with other physicians helps them recognize they're not alone," said Seppala. "To be among peers makes a big difference in terms of accepting their problem."

The special issues of health professionals are many. To begin with, health professionals often deny their addiction or cover it up. "Many physicians simply don't seek help," said Seppala. "Unless it's an acute appendicitis, they will often ignore illness or they will diagnose it and try to treat it themselves."

Other special issues include dealing with access to drugs on the job. Overcoming the shame of their disease is a big obstacle as well. Doctors and others are ashamed for violating personal and professional ethics, said Lea. When they return to work, they need to decide how to address their patients and colleagues about their illness. "How do you explain being away for 90 days?" says Lea.

Before discharge, Lea meets with each patient and conducts a "practice assessment" to explore the multiple professional practice issues that might jeopardize recovery, such as the time demands of one's practice, relationships at work and home, and balancing work and home life.

The risks to sobriety are discussed with the diversion program referent, who consults with Lea and Claudette Wallace, coordinator of Continuing Care. The referent decides on "ways to change one's practice and specific return-to-work limitations." Before discharge, patients generally are required to sign a five-year contract with the diversion/monitoring program.

"The contracts include random drug testing, facilitated group therapy, attendance at Twelve Step groups, and no self-medicating," said Michel A. Sucher, MD, medical director of the Monitored Aftercare Programs for the Arizona State Board of Medical Examiners. Compliance with these contracts average from 80 to 90 percent for a range of licensed health professionals monitored, said Sucher.

The keys to success: "A highly educated patient population who receives very good treatment and strict monitoring," said Sucher.

"Health professionals are a particularly good group to work with," said Lea, a former family practice physician and an alumnus of the Springbrook Health Professionals Program, with 11 years of recovery. "I've been in their shoes, so I know what they're experiencing. They're motivated and resistant at the same time, so that's a challenge. They're scared to death--professionally, financially and personally. They are not feeling people for the most part. They're usually thinkers, and feelings are not encouraged in medicine. They need to feel in their hearts instead of their heads."

For more information on the Health Professionals Program, call (800) 257-7810.

Published in The Voice, Summer 2002