Using the “Impaired” Term Against You

After Pat Conrad, MD wrote his piece about PHP programs, I received the following (with permission to print):

I joined a physician as an employee in a practice many years ago. I was given his name by his brother. I visited and met with him. The time predated the internet. He and his staff were warm and friendly. I thought it was a good match.  I was to replace a doctor who left him a few months earlier over differences. I could not check this out.

We relocated. Some of the doctors on the hospital staff said I did not seem like someone he would hire. I did not know what he meant.

My wife became pregnant via IVF. There were complications and I would have to take her to the ER. The head doctor said this was disruptive and we needed to terminate the pregnancy. We did not. I was called in one day and told my contract was to be cancelled. I started to look for a new position. But this was not fast enough for him. 

He called me in a few weeks later and told me had cancelled my contract. My attorney reviewed the contract and showed where it could not be cancelled without cause (loss of license, drug abuse, and similar issues).   

I came in one day. The nurses and the residents said they were told not to take any of my orders as I was impaired.  An anonymous letter reached the Medical Society/Board that I presented to work under the influence of drugs and alcohol. I never used any illicit drugs or nontherapeutic medications. I do have a drink or two at weddings, etc. I never drink when working. In fact, he was upset that I did not drink at the happy hours he held as I needed to be home with my wife and our adopted children. 

In any event, he cancelled my contract and my health insurance on the spot. I was able to get COBRA and it was important. Our baby was born 10 weeks early and was in NICU for that time. 

I had to meet with the impaired physician program in the medical society. The conclusion was I did not use drugs. I was stressed in a hostile work situation. 

I was able to relocate. In fact, I went to work with a doctor that I had worked with for several years on a prn basis. He knew me and had been a resident with the other doctor. He would not comment with his experiences with him other than he was a smart man.

I sued for breach of contract. I cannot elaborate on this due to some clauses involved. We found in discovery that he had done similar actions (although not identical) to other physicians contracted to him.

The “impaired” tag that physicians are getting is scary. It makes physicians NEVER want to get help. This story is decades old but the same playbook is being used today. Be careful out there. Very careful.

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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “Using the “Impaired” Term Against You

  1. Aaron M. Levine
    March 9, 2019 at 5:16 pm

    Do you remember Robin Cook? He was an ophthalmologist turned mystery writer. Coma was made into a movie. One of his books, and I cannot recall the name involved an anesthesiologist. The doctor had diarrhea and was dehydrated. He gave himself an IV for hydration and I believe some paragoric. In any event, the bad guys, malpractice attorney, snuck into the spinal meds a contaminated injectable guaranteed to cause seizures, death and a big law suit. Of course the anesthesiologist’s patient died and they went after him for being a druggy. I do not want to give away more of the plot if you are interested.

  2. gasman
    March 6, 2019 at 11:38 am

    article is so true of how things are in south carolina. caught sleeping in my office one day (have only taken a nap every day since college) and someone smelled alcohol on my breath. never drug tested, sent to php and then sent to alabama for “evaluation” . obvoiusly needed extensive 13 week rehab to tune of $36000 and then 90 in 90 and sign in for random testing every day. relapsed (positive urine and peth test) four years later. this time sent to north carolina for 8 weeks for $22000. more 90/90 more random test. had another positive test 9 months later (peth cutoff 20, mine 21) . decided that didn’t need the bullshit anymore and retired. sure money exchanged hands somewhere along the way since i find it difficult to believe that south carolina board of medical examiners has no one within the state that can evaluate a physician. majority of people in the php program look at you with disdain that you would even consider looking at alcohol, much less drinking it. Wanted to tell them it was like sex and watermelon-sometimes you gotta have some. bit my tongue to keep my mouth shut

  3. Thomas David Guastavino
    March 3, 2019 at 9:43 am

    I learned early on that the only way to handle “dirt” being thrown at me was to find “dirt” on the throwers, in my case, a hospital CEO. I observed many instances of what I considered to be “patient safety issues and when a threat was made against me I threatened them right back. Worked like a charm and I was able to retire on my terms.

  4. Pat
    March 3, 2019 at 8:31 am

    “The X-Files” was the hottest TV show when I was in residency, and their motto was the most apt for this career: “Trust No One.”

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