Sacramento, CA – Consumer advocates will address the Medical Board of California at a public hearing today to persuade the Board to follow the law and ensure that doctors entering programs for substance abuse face appropriate monitoring by the Board and consequences if they relapse. The organization will comment that proposed regulations for the confidential program, called the Physician Health and Wellness Program (PHWP), must cite the Uniform Standards for Substance Abusing Healthcare professionals passed into law in 2008. The Uniform Standards give the Medical Board the consumer protection tools it needs to monitor substance abusing physicians.
Consumer Watchdog reviewed the proposed regulations for the PHWP program and found the regulations were vague on the requirement the Uniform Standards be followed by the physician, the PHWP vendor, and the Board. Consumer Watchdog sent the Medical Board of California a letter with recommended changes to the PHWP program regulations.
Some of the protections the Uniform Standards provide include requiring the Board to:
- Issue a cease practice order
- Require the doctor to undergo a clinical diagnostic evaluation
- Require a physician to undergo random drug testing for five years at 52-104 biological fluid tests for the first year and 36-104 drug tests for the second year up to five years
- Calls for a physician that fails to obtain drug testing, tests positive for substance abuse or treating patients while under the influence to face consequences including a cease practice order, additional drug testing, and disciplinary action.
“We believe that the Uniform Standards should be specifically cited in every regulation that the applicant, the program vendor, and the Board must comply with and the PHWP proposed regulations do not do this as currently drafted,” stated Michele Monserratt-Ramos, Consumer Watchdog’s Kathy Olsen Patient Safety Advocate. “The proposed regulations must be revised to include not only what the Uniform Standards require but also the consequences that all stakeholders face when out of compliance.”
The Physician Health and Wellness Program was created to replace the terminated confidential physician diversion program that was shut down for failing to protect patients after failing five audits. The PHWP was created by legislation for the Medical Board to refer doctors or doctors can self-refer for treatment. In either case, the Uniform Standards must be followed.
Amendments to the regulation are necessary to specify the Uniform Standards will be followed because evidence shows the Board does not always follow them now, despite the law. The case of Dr. Maryann Vreke, reported on in the Ventura County Star here, is an example. Had the Medical Board complied with the Uniform Standards, it would have issued an immediate cease practice order against Dr. Vreke’s license and she would have been evaluated and tested before returning to practice. Instead, the Board issued an Interim Order imposing license restrictions while still allowing her to practice as an anesthesiologist.
According to the Ventura County Star, Dr. Vreke has been in and out of recovery programs since 2013. Dr. Maryann Vreke has been accused of stealing fentanyl, morphine and other drugs from patients and practicing while under the influence as stated in Medical Board public documents. The issue surrounding Dr. Vreke’s substance abuse, stealing of anesthetic drugs, and practicing while impaired was brought to Consumer Watchdog’s attention by email from a concerned healthcare professional who was familiar with Dr. Vreke’s ongoing impairment and practicing while under the influence. The concerns listed in the email were verified by Medical Board public documents.
Dr. Vreke was a repeat offender. According to Medical Board documents, she was found guilty of stealing medications for herself while on duty, and also being frequently impaired while on duty in 2016. The Medical Board issued 7 years’ probation against her license and granted her early termination of that probation. Yet 3 months after termination of her probation, Medical Board documents state that Dr. Vreke was found unconscious while on duty in the hospital with an IV port and an empty syringe still in her arm. Although the hospital’s President of the Medical Staff reported in a letter to the Board that she was practicing again while under the influence, the Board still did not issue a cease practice order and instead issued an Interim Order still allowing her to practice medicine today.
“If we can’t depend on the Medical Board to follow the Uniform Standards as required, then how can we expect PHWP vendors to do the same. This is the reason why the proposed regulations need to specifically state the Uniform Standards in each regulation that applies,” said Michele Monserratt-Ramos, Kathy Olsen Patient Safety Advocate at Consumer Watchdog.
The Medical Board of California voted to unanimously terminate its confidential physician diversion program for substance abusing and mentally ill physicians in 2008. At the time, the Board President Dr. Richard Fantozzi stated that “abuse of the privilege of the program by some participants repeatedly put consumers at risk. The public now demands transparency.” The Uniform Standards may not provide the transparency that consumers were looking for, but it definitely provides accountability and gives the Medical Board the tools it needs with or without a physician health and wellness program to address major and minor violations of a confidential physician health and wellness program with consequences that will protect not only the patient but also the substance abusing physician who wants to change his/her life.
Information on the Uniform Standards for Substance Abusing Healthcare Professionals in California here.
The Medical Board’s draft regulations for the confidential Physician can be found here.