MPHP frequently uses multidisciplinary assessments to identify all the factors that may have contributed to a physician’s referral to our program. We are often asked by administrators what is involved and why we use multi-disciplinary assessments. The following will address these questions.
Often the referral source for a physician sees only one part of the problem, but may have no way of knowing the multidimensional factors underlying the problem that has become an issue.
Shortly after Robert Bondurant became the Program Coordinator for MPHP in 1994, a physician in the program and his wife contacted him. They were seeking his early release from the program . The wife spoke in glowing terms of her husband’s progress in recovery. They said their counselor was supportive of this special consideration. Mr. Bondurant requested a letter from the counselor reviewing the physician’s progress and recommendation of early release. A short while later, a letter from the counselor was received confirming what the physician and his wife said. However, the very next day, the local newspaper published a story about the arrest of this
physician. The arrest involved drugs, money, and extensive criminal behavior. This was an epiphany for Mr. Bondurant that a one-on-one evaluation without verification was not going to be sufficient. It was then that Mr. Bondurant learned about the multi-disciplinary concept through the Physician Health Program network. From that point forward, MPHP has often utilized this method to gain a better understanding of all the dynamics involved with a particular physician.
A few years ago, another physician was referred to MPHP with the presenting issue of depression. During a meeting with this individual, she was asked whether she had been medically evaluated. Her answer was “no”. After she was medically evaluated, cancer was diagnosed, which then led to cancer treatment and subsequent remission. Her depressive symptoms disappeared!
Multi-disciplinary assessments have revealed such things as underlying brain damage, dementia, PTSD, sleep apnea, diabetes, etc. Without the assessment, the causative factor(s) was unknown.
In the case of substance abuse, the situation may be relatively straight forward. However, with other problems, it may take additional efforts to uncover the full picture. Particularly when denial by the physician is involved, the assessment is useful in sorting out the facts and developing a treatment plan.
A comprehensive assessment may last between 3-5 days depending on the individual situation and may encompass a psychiatric evaluation, medical evaluation, psychological testing, laboratory tests, review of collateral information provided by others such as the referral source, etc., chemical use assessment, psychosocial history, client interviews, and review of patient history, etc. The assessment team may include clinical psychologists, boardcertified psychiatrists, physicians, social workers, nurses and substance abuse professionals.
In addition, small group participation may be utilized. This allows the staff to observe social interactive skills. Staff may derive clues to the physician through small group dynamics that may not be revealed through individual sessions alone.
Typically upon the conclusion of the assessment, feedback is provided to the client on their findings and conclusions. A treatment plan is also developed which addresses each identified problem. These findings are integral to the success of working with the individual physician to achieve return to normal functioning. At some point during the monitoring phase, the physician may be referred back to the organization that performed the multi-disciplinary assessment to review the physician’s progress in recovery and adherence to the treatment protocol they developed. While the MPHP does not diagnose or treat, we do utilize other organizations to provide this service. Then, we implement and facilitate their recommendations.