Physician Health Weekly #2

Welcome to the second edition of Physician Health Weekly. Each issue will highlight relevant developments in physician health and well-being — from policy and legislation to public opinion and professional initiatives.  Weekly News Summary - Week of July 25, 2025

It was a relatively slow week in the physician health world news-wise, so here is a brief summary of the Riverside County Medical Society’s 37th Conference on Physician Well-Being held on July 18th virtually from 8 AM to 12:30 PM:

37th Annual RMCA Virtual Conference on Physicians' Well-Being

The Riverside County Medical Association's 37th Annual Virtual Conference on Physicians' Well-Being brought together experts to address critical issues facing healthcare professionals today. This comprehensive half-day event covered legislative updates, legal considerations, behavioral health approaches, and physician health program initiatives.

Presentation Highlights

Medical Board of California Update on the California Physicians' Health Program
Reji Varghese, Executive Director, Medical Board of California

Mr. Varghese provided crucial updates on AB 408, which authorizes the Medical Board of California to establish a Physician Health and Wellness Program. The legislation, supported by the Federation of State Physician Health Programs and California Medical Association, focuses on early intervention and aligns with national best practices. The program will be administered by a 501(c)(3) organization and includes provisions for referral in lieu of discipline (except for cases involving patient harm or sexual misconduct), confidentiality protections, and civil immunity for reporting.

Well-Being Committee Legal & Legislative Update
Shelley Carder, Esq., Attorney specializing in medical staff law.

This session examined key legal developments affecting physician well-being committees, including important case law defining "investigation" versus routine review. Carder highlighted the Wisner v. Dignity Health decision, which established that investigations must be "formal targeted processes" related to specific practitioner competence. The presentation covered confidentiality protections, medical staff authority, and recent legislative changes affecting advanced practice providers and scope of practice issues.

Approaches to Unprofessional Behavior
Karen Miotto, MD, Clinical Professor of Psychiatry at UCLA and Director of the Physician and Faculty Wellness Program

Dr. Miotto presented a comprehensive framework for addressing unprofessional conduct, emphasizing that such behaviors often stem from multifactorial causes rather than character flaws alone. Key findings included data showing that certain specialties (surgery, emergency medicine) report higher rates of unprofessional behavior, often linked to high-pressure environments. The presentation outlined organizational approaches including graduated interventions, the critical role of well-being committees, and evidence-based resources for professional development and coaching.

Navigating Legal Considerations When Addressing Disruptive Behavior
Shelley Carder, Esq.

This focused legal session explored the framework for addressing disruptive physician behavior while maintaining due process protections. Ms. Carder emphasized the importance of connecting behavior to patient care impact, proper documentation, and the non-disciplinary role of well-being committees. The presentation highlighted Joint Commission requirements and the balance between public protection and physician rehabilitation. 

Why Physician Health Programs Matter
Edwin Kim, MD, President Elect, Federation of State Physician Health Programs

Dr. Kim provided an overview of the 50-year evolution of physician health programs, from the 1958 call for assistance programs to today's sophisticated network of 50 state programs serving nearly 10,000 physicians annually. He presented compelling outcome data showing 78% successful completion rates and emphasized the "triad of confidentiality" - regulatory protection, record protection, and application protection - that enables physicians to seek help without career-ending consequences.

Medical Staff Professionalism: Creating and Supporting a Culture of Safety William Perry, PhD, Professor and Vice-Chair for Program Development, Dept of Psychiatry UCSD Medical Center, Medical Staff Professionalism Committee Chair and a core member of the PACE Program

Dr. Perry's presentation examined how unprofessional behavior undermines patient safety and organizational effectiveness. Using case studies, he demonstrated how disruptive physicians create environments where healthcare team members become afraid to speak up about safety concerns, leading to medical errors and adverse outcomes. Key statistics showed that 12% of healthcare staff leave their positions annually due to disruptive colleague behavior, and 7% of medication errors can be attributed to disruptive physician behavior.

The presentation outlined both systemic and individual factors contributing to unprofessional behavior, including organizational culture issues, high-stress environments, and personal factors such as burnout, cognitive difficulties, and lack of self-awareness. Dr. Perry emphasized that addressing professionalism requires a comprehensive approach including clear policies, data tracking, early intervention, and structured remediation programs.

He presented data showing strong correlations between unprofessional behavior and malpractice claims, noting that 90% of malpractice claims are attributed to physicians with disproportionate numbers of patient complaints. The presentation concluded with practical frameworks for creating professionalism committees, implementing graduated interventions, and measuring outcomes to create sustainable cultures of safety.

Key Themes and Principles

Several important themes emerged across all presentations:

Early Intervention is Critical: Multiple speakers emphasized that addressing physician wellness and behavioral concerns early - before they escalate to disciplinary issues - produces better outcomes for both physicians and patients.

Multifactorial Approach: Unprofessional behavior rarely stems from a single cause. Successful interventions consider personal factors (personality, mental health, neurodiversity), environmental factors (workplace stress, organizational culture), and temporal factors (sleep deprivation, life circumstances).

Legal Protection Enables Help-Seeking: The confidentiality protections built into physician health programs and well-being committees are essential for encouraging physicians to seek help before problems become patient safety issues.

Evidence-Based Interventions Work: Data consistently shows that structured physician health programs achieve remarkably high success rates - far exceeding general population recovery rates for similar conditions.

Collaboration is Essential: Effective physician wellness requires coordination between well-being committees, physician health programs, medical staff leadership, and legal/regulatory systems. 

Looking Forward

The RMCA conference highlighted both challenges and opportunities in physician wellness. While California continues working toward establishing a comprehensive physician health program, existing well-being committees and organizations like CPPPH provide crucial support infrastructure. The emphasis on legal protections, evidence-based interventions, and early identification creates a framework for sustainable physician wellness initiatives.

The Riverside County Medical Association's Annual Conference on Physicians' Well-Being occurs each July. Watch for announcements typically released in the second quarter for the following year's program.

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Disclaimer: The views and opinions expressed in this blog are solely those of the author and do not necessarily reflect the official policy or position of any organization, institution, or entity with which the author is or has been affiliated.

#Physician wellbeing #PHPs #Physician health #AB 408 #RCMA