Physicians Helping Physicians
They’re the folks we depend on when we’re ill: doctors, nurses, and other people working in the healthcare industry. As highly trained as they are, these professionals are still people, making them just as susceptible to substance use disorder as anyone else.
But what happens when the men and women we count on to help us get well struggle with addiction themselves? Where do they turn for help? More and more frequently, they’re heading to an office on the shores of Lake Michigan in Chicago.
That’s where the Positive Sobriety Institute is located. Its team of addiction experts design individualized, sciencebased comprehensive treatment plans for professionals. Its work is the result of one of its founders having been there himself.
Back in 1982, Dr. Daniel Angres was a recovering physician. He got the treatment he needed. But the experience profoundly impacted his career. He began working in addiction medicine with a specialty of treating fellow physicians in 1984, and later coauthored the book “Healing the Healer.”
“Doctors are also susceptible to addiction,” explains Dr. Kathy Angres, the Institute’s Director of Multidisciplinary Assessments and a family therapist. She’s also Dr. Daniel Angres’ wife. “It doesn’t matter what your career is. Addiction doesn’t care what you do for a living. But it can be especially hard when you’re a doctor. Many programs say they treat physicians and other medical professionals, but physicians tend to do better with other physicians. They can show more empathy to each other.” That’s at the heart of what the Positive Sobriety Institute does. Dr. Angres is now its medical director, where he combines his personal experience with professional care.
“When a physician is in trouble,” Dr. Kathy Angres continues, “it’s effective to have a multidisciplinary assessment. They take an objective approach and look at why there are concerns in the first place.”
The Multidisciplinary Comprehensive Assessment Program is an intensive two-day process. Physicians and people in other professions are typically referred because they have displayed some sign of trouble. “It can be anything from having increased complications in their practice to smelling like alcohol,” Dr. Kathy Angres says. Most referrals come from physician health programs.
The assessment team includes two psychologists and psychiatrists, an internist, and a social worker. “The assessments are so much more than a person coming in for a psychiatrist to come up with a diagnosis. The team looks at their life and talks to them about all aspects of it.,” Angres says. “They conduct lab tests. Besides the typical urinalysis, they also perform PETH (finger stick blood test) and take hair and nail samples.”
At the conclusion of the two days, an assessment is made that the professional is either fit or unfit to continue practicing. When it’s the latter, the person is referred to a specific treatment plan. The results are sent to the referral source.
“It’s a respectful, kind process for the individual,” Angres notes. “It’s also a fact-based process, and not someone pointing a judging finger at them.
The Institute’s approach takes time. It averages about two assessments each week. A total of 90 assessments were performed in 2018.
Dr. Angres remembers one physician whom she calls “Mike.” “He suffered from depression his entire life and used alcohol to address both it and his insomnia. He was drinking in his car one day, and as Mike began walking to work, his program director stopped him and warned him not to go into the hospital. Mike was sent here for an assessment. They recognized him as having alcohol use disorder.
“Mike underwent treatment and now says this is the first time he hasn’t been depressed since high school. He’s also found a community of like-minded doctors in recovery and says he feels clearer headed than he’s been in years.”
The Institute’s unique work has received media attention over the years, including coverage on The Oprah Winfrey Show. While that’s gratifying, Angres says the focus remains on assisting people get the help they need. “The assessment can act as the first step in turning someone’s life around, and that’s especially rewarding.”
Positive Sobriety Institute was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.