California Public Protection and Physician Health (CPPPH) – A Brief History

by Gail Jara, Executive Director CPPPH

In June of 2007, the Medical Board of California voted to end the 27-year-old California Diversion Program, making California one of only a few states in the US without any central physician health program.   The California Medical Association (CMA) quickly convened a “Workgroup on Public Protection and Physician Health” with a coalition of stakeholders, including California Society of Addiction Medicine (CSAM), California Psychiatric Association (CPA), the Permanente Medical Group (TPMG), California Hospital Association (CHA), the California Society of Anesthesiologists (CSA), and eventually many other organizations and individuals who would be affected by the dissolution of the Diversion Program including liability carriers, well-being committee members, and individual service providers.  That Workgroup met regularly to coordinate new strategies for addressing public protection and appropriate responses to physicians who experience medical, psychological, emotional, behavioral or substance use issues in the absence of a Medical Board-run program. 

The Medical Board’s Physician Diversion Program was formally closed in 2008 and some 300 physicians who had not yet completed the program were released.  Private organizations and programs emerged to provide some of the needed services, but workgroup members continued to report a serious loss of options and concerns. Some of the concerns were about the lack of a central entity that could provide physicians and other consumers (hospitals, well-being committees, treatment providers) with evaluation tools and service referrals, individual case consultation, or information about credible educational and treatment resources, monitoring programs and testing services.  Also cited was a lack of standardization or guidelines with which to measure the range and quality of services that did exist.

There was also significant concern that some physicians who needed ongoing support and monitoring continued to practice without aid and supervision.

In a survey of 1,891 practicing U.S. doctors that appeared in July 2010 in the Journal of the American Medical Association (JAMA), researchers found that 17% of the physicians surveyed reported direct, personal knowledge of a physician who may be experiencing mental health or substance use issues, but many said they did not report these physicians.  Lack of a trusted confidential resource was one of the reasons mentioned.

It is from this backdrop that California Public Protection and Physician Health, Inc. (CPPPH) was established in 2009 as an independent non-profit corporation dedicated to developing a statewide physician health program to respond to the needs articulated by the Workgroup members and others.   From its inception, CPPPH founders recognized that a full-scale program that promotes physician wellness and coordinates all the services needed to address the spectrum of physician health issues would take time, energy and funding to reach full potential. 

CPPPH has proceeded to address these needs while its parent organizations pursue legislation to establish and fund a state sanctioned program.  CPPPH seeks to respond to the American Medical Association (AMA) Resolution that all states should provide access to programs that address physician health so that colleagues will know how to intervene appropriately.  

CPPPH fosters dialogue, information sharing and coordination among physician health committees by convening half-day workshops every four months in three regions of the state, with these objectives:

  • Deliver practical information, education and training for committees and persons currently doing physician health work in California.  At workshops offered every four  months in each region, topics are covered in depth with ample opportunity for questions and information sharing
  • Provide the structure for ongoing communication and statewide information sharing
  • Identify and share information about the resources that the committees currently use
  • Identify needs that CPPPH will want to address as it develops plans for a statewide  program and that will allow CPPPH to serve as the voice for physician health in California

For information about
CPPPH, Its Regional Networks
and other details, see www.CPPPH.org.

October 2012