Thousands of physicians practice while in rehab, according to Associated Press, covered in Wired . Should they be out on disability?

SAN FRANCISCO (AP) — Troubling cases in which doctors were accused of botching operations while undergoing treatment for drugs or alcohol have led to criticism of rehab programs that allow thousands of U.S. physicians to keep their addictions hidden from their patients.

Nearly all states have confidential rehab programs that let doctors continue practicing as long as they stick with the treatment regimen. Nationwide, as many as 8,000 doctors may be in such programs….

Now some high school math: According toPhysician Executive, July August, 2005, quoted on BNET Research,on average Primary Care physicians in the U. S. see 85 patients per week. If a doctor sees 85 patients per week, and sees patients 42 weeks per year, allowing time off to play golf, attend conferences, and take vacations, he or she sees 3,570 per year. For 8,000 doctors, that adds up to 28.56 million people per year. The story continues …

These arrangements largely escaped public scrutiny until … California’s medical board outraged physicians across the country by abolishing its … program. A review concluded that the system failed to protect patients or help addicted doctors get better .

Opponents of such programs say the medical establishment uses confidential treatment to protect dangerous physicians.

“Patients have no way to protect themselves from these doctors,” said Julie Fellmeth, who heads the University of San Diego’s Center for Public Interest Law and led the opposition to California’s so-called diversion program.

Most addiction specialists favor allowing doctors to continue practicing while in confidential treatment, as does the American Medical Association.

Supporters of such programs say that cases in which patients are harmed by doctors in treatment are extremely rare, and would pale next to the havoc that could result if physicians had no such option.

Because these events are “rare” doesn’t mean they are acceptable.If “rare” translates to one in 1 million, that’s 29 events per year. Not a lot in a population of 300 million, but too many if you or your child is one of the 29 people. But what is “rare”? One in one million? One in ten thousand? What is the the rate of medical malpractice due to addiction?What is the rate due to operating or practicing medicine while intoxicated?

As a patient, I see a physician when I am sick. I want, expect, and am paying for the advice of a competent expert on a potentially life threatening situation.

Perhaps physicians with addictions should be granted some disability compensation while they undergo treatment. It could be bundled with their disability or malpractice insurance – which seems reasonable, if you view addiction as a disability, and given that it also seems reasonable to expect to see a causal relationship between addiction and malpractice.