PRESIDENT’S MESSAGE: 
Michael Baron, MD, MPH, DFASAM, FAPA, Fall 2024

Michael Baron, MD, MPH, DFASAM, FAPA

Twenty-seven years ago, Dr. David Dodd saved my life. He was the first full-time medical director of today’s Tennessee Medical Foundation - Physician’s Health Program (TMF-PHP) and the third president of the FSPHP. If he were alive today, he would say that he confronted me and intervened. It matters less how it happened than that it happened.

Back then, the Tennessee Impaired Physician Program was a two-person show: Dr. Dodd, a surgeon, was the Medical Director, and his surgical nurse became everything else including the case manager. Together they put down the roots for the TMF-PHP that has functioned well for over 45 years. 

Just as it changed my life for the better, the Tennessee Impaired Physician Program changed for the better. The program name changed to the Physician’s Health Program (PHP). It moved from the medical director’s home office to an office building; staffing grew from one RN to seven full-time employees. Initially charged with helping physicians with alcoholism, today it helps physicians and many other healthcare licensees with substance use and other mental health disorders. The changes were incremental but substantial. 

What hasn’t changed is that we help healthcare providers through an individualized approach without regard to gender, race, or religion. Forty-five years later, the TMF-PHP has grown up and has provided some amazing and dramatic results. 

The TMF-PHP is the only program I know on an intimate basis. I was monitored and supported for three years but have remained connected to this program for my entire recovery. As I have become more involved in the Federation, I have realized that while some programs enjoy the budget and growth that TMF-PHP has enjoyed, some programs have challenges; they are not as well funded or do not have the strong relationships with their state medical board, state medical association, or medical professional liability carriers that other programs enjoy. Although there is considerable overlap from PHP to PHP, there are also differences. 

It is those differences that the FSPHP Performance Enhancement and Effectiveness Review (PEER™) program will help to address. PEER™ is a structured review process designed as a practical tool to identify opportunities to align PHPs with best practices, thereby reducing PHP practice variations; it may help less funded programs solicit better funding by pointing out specific needs to their funding sources. PEER™ was developed in conjunction with its sister program, the FSPHP Evaluation and Treatment Accreditation (ETA™) program. The ETA™ will provide guidance and recognize evaluation and treatment services that are qualified to specialize in the care of medical professionals.  

I have been involved with the development of the ETA™ program. Over this past summer in β test mode, the ETA™ program assessed two evaluation and treatment centers, while PEER™ reviewed three Professional Health Programs. This was an incredible achievement that culminated five years of work. Kudos to all those professionals who sacrificed their time and used their expertise in the treatment of safety-sensitive professionals and their effort and energy to develop these two programs. After some minor tweaking, we plan to launch both programs this fall of 2024. Both programs have been a monumental endeavor that started as the brainchild of Dr. Brad Hall from West Virginia when he was FSPHP president.

Both programs are under the oversight of the FSPHP Accreditation and Review Council (ARC). The House of Medicine is well represented in the ARC with committee members from the Federation of State Medical Boards (FSMB), American Medical Association (AMA), American Psychological Association (APA), Accreditation Council for Graduate Medical Education (ACGME), Medical Professional Liability Association (MPL), and American Osteopathic Association (AOA). PEER™ and ETA™ are exceedingly important to how PHPs function and where their participants are referred for evaluation and treatment. Congratulations to all of you who have worked so hard bringing these two programs to fruition—a job exceedingly well done. 

The FSPHP has been involved in other areas as well; for years we have been actively promoting safe haven for health fitness questions found on health licensure, insurance panel, hospital credentialing, and medical malpractice applications. The work of Drs. Gundersen and Hengerer promoting the safe haven questions has been key to abolishing the stigma associated with getting help for a mental health disorder. We have received help from some newcomers to this arena and together have begun to turn the tide, but this work is far from over. The confidential triad of regulatory protection, record protection, and application protection are the cornerstones to helping protect our programs and our participants.

The PHP outcome data coined the “Blueprint Studies” are often quoted but are old and need to be updated. (Learn more at Five Year Outcomes in a Cohort Study of Physicians Treated for Substance Use Disorders in the United States by AT McLellan, GS Skipper, M Campbell, RL DuPont, August 2008).We are in the middle of collecting and extracting new data—thank you to Drs. Karen Miotto and Lisa Merlo for championing this work. These, like other study results, will show that participants who successfully complete five years of monitoring have a lower risk for return to use than the risk for initial use by their physician peers. Also, the risk of a malpractice claim is less after successful completion of five years of PHP monitoring than that of their non-monitored physician cohorts. As a result, PHPs help to improve the quality of care their physician participants provide, thus adding a financial benefit to medical malpractice liability carriers.

Many professional liability carriers are now understanding the economic benefit that PHPs provide. Some of these carriers are already helping to fund their state PHPs. The Federation has financial pledges from five medical malpractice liability carriers and was awarded $5,000 by the Medical Practice Liability Association (MPLA). Using this momentum, we are soliciting donations from other carriers.

Soliciting contributions may require a few phone calls, some letters, and follow-up, which seems like a pretty reasonable workload. But combining that with administrative duties, membership maintenance, and oversight of projects, including the few mentioned above, can be overwhelming for our already overachieving Executive Director Linda Bresnahan and our volunteer committee members.

To combat our own burnout, we must realize the FSPHP is a relatively small professional organization with limited resources—smaller than most other national medical organizations. Although being lean and mean may have advantages, it can be unfavorable, too. FSPHP board members are often the same people serving on our committees and ad hoc workgroups, using the same brain trust on most of our projects. We cannot keep adding to the workload of these same individuals, and we cannot take on every challenge. As we often preach, “We need to know our limits.”

The volunteer members and the employed staff of the Federation have elegantly met those limits and challenges. A large thank you to our Board of Directors, Committee Chairs, and Committee members for all the work you do carrying this organization. I also want to acknowledge the amazing work and the dedication of time of our past presidents and the executive committee members. For the last two years as president-elect, I have attended those weekly meetings that include the current, past, and future presidents and the Executive Director. Dr. Bundy, a recent Past President, has graciously accepted the inaugural position as the FSPHP’s first Chief Medical Officer. His presence as CMO has and will make my job much easier.  Thank you, Dr. Bundy, for your work, help, intellect, and friendship. You “walk the walk.” Our Executive Committee and especially our Executive Director, Linda Bresnahan, put in enormous amounts of time and dedication to the success of this organization.

I also want to thank you, our members, for supporting the Federation. Without members, we would not have an organization. I stand in awe of the amount of passion that those mentioned above and our members have for this organization.

I could not fulfill the responsibilities and requirements of this office without the support of the Tennessee Medical Foundation’s staff and boards. Jennifer, Brenda, Tamiko, April, Dot, Barbara, and TMF board members—thank you for providing the extra resources I need to do this.

To conclude my first President’s Message, I also want to say I am grateful for the trust you placed in me to lead this organization over the next two years. A PHP saved my life, career, and family. Saving lives and saving careers is much more than a slogan; it is what we do, and it is the most rewarding work I have ever done. ■

Read more on this in the Fall 2024 issue.