What exactly is a “drinking problem?”

Martin Merritt, Esq.

You may have heard the phrase, “a drinking problem and a professional license don’t mix.” While I think we can all agree on this, the real question for most, however, is one of definition. Particularly for those in denial, or those social drinkers who might wish to parse words over what exactly constitutes a “drinking problem?”

We could have a discussion about that, but I think I can better help you with some pointers and insight into how the Texas Medical Board treats this question; having represented a number of doctors before the Texas Medical Board who have entered the Texas Physician Health Program (“PHP”), which is the state agency in Texas tasked with monitoring doctors who may not be able to practice safely due to an impairing or potentially impairing health condition.

Number one, if you land either at the Texas Medical Board or the Texas Physician Health Program, either from a self-report or a third- party report, with the word “alcohol” in the complaint, you automatically have a “drinking problem.” It doesn’t matter that you agree.

Importantly, and I can’t emphasize this enough, “it’s not about you.” Even though it is. The Texas Medical Board views this situation as one in which “it’s about them” as they now have your “drinking problem.” They are not going to mess around with “definitions” when it comes to patient safety. Assuming no one has been injured, or you are not an immediate threat to public welfare, you will be offered the opportunity to voluntarily enter the PHP program. If you don’t accept this offer, you can go the disciplinary route, which will probably land you right back in the PHP program, for reasons that will become obvious.

Experts at the Texas Physician Health Program state on the PHP Website, that the “work environment” is typically the last place problems with alcohol show up. The aim here is to halt any kind of drinking problem, on whatever level it might be, before it threatens patient safety.

Number two, if you land at the PHP program, your drinking days are likely over. The typical concern of a doctor in this situation is often one of personal embarrassment and possibly concern over lifestyle implications. This might not seem fair. You might be right. These agencies are not trying to be “fair.” They are trying to make sure you are not a danger to the public. It just makes sense, if they are going to risk getting this wrong, it will be on the side of caution.

Number three, as mentioned above, if you enter the program, whether you agree you have “a problem,” is irrelevant. They are going to make sure that you are not a problem. You will be given every test available, from hair follicle analysis (which is both qualitative and quantitative for substances), a lie detector test, and an in-person interview. (I could be wrong here, but I think the lie detector test is less diagnostic, and more to help ensure that you tell the truth in the interview.)

Number four, unless all the tests are negative, you likely will be asked to sign a contract in which you agree to refrain from drinking for a period of time, five years is common, and you will be required to go to AA meetings.You will also likely be required to agree to monitoring for some period of time and random toxicology testing.

Number five, if you fail any of the agreed upon terms of your PHP contract, you will be reported to the Medical Board for disciplinary action, which could include either an active or probated suspension of you license, until you demonstrate that you are compliant.

If all this seems a bit harsh, you must see this from the viewpoint of the Texas Medical Board. The board members aren’t prescient and can’t tell from talking to you whether you are going to harm a patient due to alcohol. But, if you quit drinking, and you know the medical board will find out if you start again, then you are far less a concern to the board, and far less likely a danger to the public.

Martin Merritt is a health lawyer and health care litigator at Martin Merritt PLLC, as well as past president of the Texas Health Lawyers Association and past chairman of the Dallas Bar Association Health Law Section. He can be reached at Martin@martinmerritt.com.