Medical Marijuana - A Prescription for Trouble?

CPHP
This Newsletter is published annually by
Colorado Physician Health Program
 Medical Marijuana...................1
 Economy & Physician Stress....2
 Training Programs...................2
 Commonly Held Myths...........3
 Clinical Team FAQ..................4
 Conferences & Presentations ....5
 Profile of Jack A. Klapper, MD....7
Medical Marijuana - A Prescription for Trouble?
Doris C. Gundersen, MD – CPHP Medical Director
Those in the healing profession have prescribed cannabis,
known in the vernacular as Marijuana (MJ), for at least five
millennia. MJ was prescribed in China as early as 2737 B.C. for
ailments ranging from “absentmindedness” to “female weakness.” In the United States, physicians routinely prescribed
MJ until the late 1930s when it seemed to fall out of favor.
It was not until 1970 that the law would intervene and proscribe all use. In 1975 the Compassionate Use Program for MJ
was established by the Food and Drug Administration (FDA)
and reserved for patients suffering from cancer, glaucoma and
multiple sclerosis. Four years later, the Controlled Substance
Act was established and classified MJ as having a high abuse potential and no safe medical use. In 1986 a synthetic form of tetrahydrocannibanol (THC), the main psychoactive
substance in MJ, was offered in an oral form. Marinol was placed into Schedule II by the
Drug Enforcement Agency (DEA), making it accessible to patients in need and also for
research purposes. However, proponents of medical MJ argue that Marinol is less effective
than the natural herb and have lobbied hard to have the botanical legalized.
Research on the use of MJ for medical purposes is lacking, partly because it is currently
classified as a Schedule I drug, making it virtually impossible to conduct the randomized,
double-blind, placebo-controlled prospective studies that normally precede the availability
of a new drug to the public. Most studies that have been done are small in number, retrospective in nature and confounded by uncontrolled variables including concomitant use of
tobacco and/or co-morbid diseases.
While the Institute of Medicine stated that MJ was effective in lowering intraocular pressure
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 2008-2009 Donors.............8-10
 Client Testimonials................11
The CPHP Board of Directors
 Hospital Testimonial.............13
 Spirit of Medicine Awards......14
 CPHP’s Research Mission......15
The mission of CPHP is to assist physicians,
residents, medical students, physician assistants
and physician assistant students who may
have health problems which, if left untreated,
could adversely affect their ability to practice
medicine safely.
(Back row: L-R) John H. Genrich, MD, Douglas Speedie, MD, Jim E. Keller, M.P.H., PA-C, Thomas G. Currigan, Jr.
(Middle row: L-R) Steven Summer, Lawrence Varner, DO, George D. Dikeou, Esq.
(Front row: L-R) Michael Michalek, MD, Caroline M. Gellrick, MD, Larry A. Schafer, MD
(Not pictured) James P. Borgstede, MD, Maureen J. Garrity, PhD and Debbie Lazarus
Testimonial from a Physician Client
Volume 9 Issue 1 • Summer 2010
899 Logan Street, Suite 410
Denver, CO 80203
303.860.0122 • 800.927.0122
www.cphp.org
Doctors do get sick. Many times they get “stuck” because they do not know how to ask for help.
As physicians we are focused on the health of our patients—but in the process, we neglect our
own health. This is easy to do because patients have such high expectations of us and want the
absolute best care. They also expect a perfect result. When things don’t go perfectly, many times
patients blame us and in turn we blame ourselves. This is an uncomfortable predicament for
any doctor. I want to continue my support of CPHP and The Spirit of Medicine Campaign so
that doctors who get “stuck” can get the proper attention from CPHP so they can get “unstuck.”
The Economy and Physician Stress
Scott A. Humphreys, MD – CPHP ASSOCIATE Medical Director
The current economic atmosphere is
profoundly different than it has ever
been in the past. This is especially true
for physicians. Like everyone else, we
are subject to constant media coverage
of the recession and its effects. All of
us have patients, friends and relatives
who have been hit hard financially
and they realize the consequences of
this uncertainty. People are making
changes and the future is not as bright as it once was. In general
medicine is considered to be in a “recession-proof industry”. While
it is true that our incomes do not see the lows so rampant in the
general business world, our financial security is threatened more
directly than it has been in recent history. Our tenuous relationship with Medicare is now severely strained with cuts, refusal to
pay providers, and stagnation. The ramifications of the recently
passed healthcare reform bill for us are unclear. The guarantee of a
certain lifestyle is now a wavering promise. It is impossible not to
feel some stress and demoralization.
Most of us did not come to medicine for money. The decision to
become physicians was made during a time in our lives we looked
for a field that could offer intellectual challenge and allow us to
care for our fellow man. As we progressed on the path to become
physicians and establish ourselves in practice, our own economic
realities developed.
Freshly-minted physicians face a unique matrix of financial issues.
We emerge from medical training with massive student loan debt.
It is a common practice for new physicians to take advantage of a
“doctors mortgage.” Newly graduated from residency and anxious
to get on with our lives, we bought houses with minimal or no
down payment. This led many young physicians to find themselves
“under water” on their mortgages. Fortunately, most physicians are
able to meet their financial obligations. But uncertainty looms in
the future of our profession.
Physicians in long-term practice have similar concerns. It takes
years to build a successful medical clinic. The value of that clinic
may make up the majority of the physician’s retirement plan. It
is easy to imagine how the sweeping changes in healthcare can
diminish the value of any practice. It is particularly unsettling that
so many of these consequences are completely beyond our control.
Most physicians are in some way dependent on Medicare. Even
those doctors who do not depend on the program directly recognize Medicare as a massive pillar supporting our hospitals and
clinics. It is infuriating and frightening that a huge payer of medical
care can suddenly suspend payments for services already rendered.
Medicare’s proposed cut of over 20% in reimbursements is a serious
concern. Given the low reimbursement schedule already, many
physicians are considering opting out of Medicare. Decisions such
as these will have an obvious impact on the physician’s practice.
More important is the impact on the physician himself. Suddenly,
someone who became a physician to care for people now must
make the decision to abandon a large number of his patients to
protect the clinic’s solvency. We clearly were not prepared by our
medical training for such wrenching decisions.
We are living in a time where our future is less certain than ever
before. This is unsettling and anxiety-provoking. At CPHP we
are seeing the direct impact of these changes on physicians, their
families, and their health. Physicians stressed by these changes
can be helped by the support of a therapeutic relationship that
focuses on helping the physician better prioritize his worries and
helping the physician to reframe these in order to make them more
manageable. Although little can be done to change the economic
atmosphere, we can control our reaction to it.
CPHP Serves Colorado Training Programs
The following training programs have contracted with CPHP, entitling the residents, medical students and physician assistant students
access to CPHP services at no additional cost:
Colorado Health Foundation Transitional Year Fellowship
at Presbyterian/St. Luke’s Medical Center.
Denver Health Emergency Medicine Residency Program
Fort Collins Family Medicine Residency Program
Red Rocks Community College Physician Assistant Program
Rocky Vista University College of Osteopathic Medicine
Southern Colorado Family Medicine Residency Program
St. Anthony Family Medicine Residency Program
St. Mary’s Family Practice Residency Program
St. Joseph Hospital Graduate Medical Education
University of Colorado Denver Graduate Medical Education
University of Colorado Denver Physician Assistant Program
University of Colorado Denver School of Medicine
CPHP is so pleased to have welcomed Rocky Vista University College of Osteopathic Medicine as its newest training program in 2009-10.
If your training program is interested in establishing a contract with CPHP, please contact Sarah R. Early, PsyD, Executive Director, at
303-860-0122, ext.232. Additional information about program services is available on our website, www.cphp.org.
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Commonly Held
About CPHP
Myth #1
Myth #5
“CPHP is only for those with substance abuse problems.”
“CPHP takes only mandatory referrals from the Colorado
Board of Medical Examiners.”
Reality
CPHP helps medical professionals with a host of problems:
family issues, work-related stress, burnout, physical
conditions and emotional problems.
Reality
CPHP accepts referrals from a variety of sources within the
medical community. This may include hospital committees,
leadership in practice groups, hospitals or medical societies
as well as self-referrals, and referrals by family members or
practice partners. It should also be noted that the majority
of cases are self-referrals.
Myth #2
“If you go to CPHP, the Board of Medical Examiners will
know.”
Reality
CPHP does not disclose the identity of, or information
about any current or former participant without a written
release of information except in rare instances.
Myth #6
“Once you get involved with CPHP a significant time
commitment is required.”
Reality
CPHP’s diagnostic conclusions will extend so as to ensure
that the client is connected in appropriate and adequate
treatment. The treatment recommendations will ultimately dictate the time requirement. Once health is stabilized
and ability to practice safely is confirmed, then continued
involvement with CPHP may conclude.
Myth #3
“CPHP is only for physicians.”
Reality
Myth #7
CPHP serves not only physicians, but also residents,
medical students, physician assistants and physician
assistant students.
“CPHP is expensive—if you go there, it will cost you.”
Myth #4
“CPHP provides treatment.”
Reality
Because CPHP is funded for all Colorado licensed physicians
and physician assistants, direct services are free. Residents,
medical students and physician assistant students may also
be eligible for free services through contracts between CPHP
and various Colorado-based training programs. However,
participants/their insurance are responsible for costs of any
additional evaluations and treatment outside of CPHP.
Reality
CPHP conducts diagnostic evaluations of a participant
and makes recommendations for treatment or other interventions (such as education). In addition, CPHP provides
support services for family members. Efforts are made to
refer participants to community-based treatment and/or
other resources in areas in which the physician/physician
assistant resides so that he/she is able to continue practicing
while receiving the necessary treatment.
Myth #8
“CPHP is available only for Denver medical professionals.”
Reality
CPHP serves Colorado as a whole and undertakes extensive
education and outreach efforts by direct visit, consultation
and presentation services to all four corners of the state of
Colorado.
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The CPHP Clinical Team Responds to Some Common Questions
What do you evaluate at CPHP?
Why am I assigned a Clinician and an Associate Medical Director?
Cae Allison, LCSW, Director of Clinical Services, states that CPHP
evaluates any health issue including medical, psychiatric, emotional
problems or situational stresses. A client is assigned to members of
the clinical team who will manage their case during the course of
their involvement with CPHP.
Cindy Hudson, MA, CACIII, Clinician, opines that CPHP
actually functions as a group collaborative model with multiple
levels of input from the clinical team. However, the main point of
contact for our clients will be an assigned Clinician. The Clinician
will obtain all of the critical background collateral information and
obtain treatment updates from treatment providers. The Clinician
ensures that all case management including information gathering
and any needed reports and credentialing information is completed
on a timely basis.
How long will the initial evaluation last?
Sally Moody, LCSW, Clinician, states that the initial appointment
with CPHP will last approximately two hours. The client will be
asked to complete a client questionnaire and undergo a psychiatric
interview with their assigned clinical team. However, depending
on the health issues that are addressed, additional evaluation by
CPHP over a period of time may be recommended.
What is involved in the evaluation process?
Moody states that CPHP typically requests to speak with others
who know the client, usually a professional contact and personal
contact. CPHP uses these collateral interviews to help deepen our
understanding of a client in various contexts.
What are some other things I should know about the
evaluation process?
Dwayne Spinler, LPC, Clinician, comments that CPHP assesses
clients and provides professional guidance to help its clients regain
their health and make the adjustments necessary to accommodate
their condition. Identification is the first and often most difficult
step. CPHP provides assistance that can help its clients confront
and overcome problems and also offers support to families.
What is involved in an initial CPHP evaluation?
Lynne Klaus, LCSW, CACIII, Clinician, indicates that typically,
CPHP evaluations take place over time, in general 30-45 days, in
order to gather background collateral information from colleagues,
workplace, family, etc., but potentially 90 days (if an extended
evaluation is warranted). CPHP is aware and understanding of
the timeline often associated with residents/workplaces, such as
probation or contact renewal. We are committed to working with
the physician and referral party to complete these evaluations in a
timely manner.
What information DO I NEED to bring to my initial evaluation?
Klaus further states that any medical or other records pertaining to
your evaluation should be gathered and presented to CPHP during
your initial meeting.
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May I communicate with CPHP through e-mail or text messaging?
Hudson further states that due to CPHP’s very strict levels
of confidentiality, we are disallowed per CPHP policy from
communicating by email or text messaging. This ensures that
sensitive personal health information will remain private.
How is my confidentiality protected at CPHP?
Allison emphasizes that maintaining participant confidentiality is
an integral element of CPHP. She stresses that we operate under
the strictest guidelines pertaining to confidentiality in medicine.
CPHP has structured our confidentiality policies after 42 CFR,
Part 2 guidelines. These guidelines are the strictest confidentiality
guidelines that can legally be followed and are applicable for all
cases.
If I have been referred to CPHP by my workplace or residency
program/medical school, what information does CPHP
provide to them?
Moody concludes that CPHP typically communicates with these
referral sources and provides only the information they need, i.e.,
ability to practice, but does not provide specific details of a client’s
circumstance. CPHP serves as a “buffer” between the information
the client provides CPHP and information that the workplace
receives. This way workplaces receive information necessary to
assure patient safety, while a client is afforded the most privacy
possible.
We are so grateful to all of Colorado’s medical professionals and
organizations that support CPHP’s annual Spirit of Medicine
Campaign. Your renewed support of this year’s current 2009-10 campaign that concludes
in October 2010 would be greatly appreciated.
Your support of medical professionals saves careers, families and even lives. Thank you!
CPHP Conferences
CPHP remains committed to reaching out and serving all four corners of Colorado’s medical community by exhibiting at various medical
conferences and meetings throughout the year. Attendees of the conferences and meetings recognize the organization as a valuable resource
to the Colorado medical community.
Colorado Hospital Association (CHA)
Fall 2009 Annual Meeting
Colorado Society of Anesthesiologists (CSA)
Fall 2009 Annual Meeting
Colorado Association of Medical Staff Services
(CAMSS) Fall 2009 Annual Conference
Sarah R. Early, PsyD, CPHP Executive Director, presenting
a raffle prize gift basket to Traci Link, Director of Medical/
Surgical Nursing Services at The Children’s Hospital
Carol Goddard, Executive Director of the Colorado Society of
Anesthesiologists, stops by the CPHP booth.
Amanda Parry, CPHP Executive Assistant, presenting a raffle
prize to Nancy Brunton, CPCS, Manager, Credentialing
Department at ONYX M.D. Elite Physician Staffing Solutions.
Colorado Academy of Physician Assistants (CAPA)
2010 Annual Winter Meeting
Colorado Society of Osteopathic Medicine (CSOM)
2010 Midwinter Conference
Colorado Chapter, American Academy
of Pediatrics Spring 2010 Annual Meeting
(L-R) Kyle Kirkpatrick, M.S., PA-C, CAPA President, 2009-10,
Todd Weiss, CPHP Development Specialist.
(L-R) Terry Boucher, MPH, CSOM Executive Director,
Kristin Stepien, CIC, Account Executive at COPIC
and Adrian Clark, Director of Communications and
Public Relations at Rocky Vista University.
(L-R) Todd Weiss, CPHP Development Specialist and
John Genrich, MD, CPHP Board Director.
CPHP Presentations
CPHP provides exceptional presentations to the medical community throughout Colorado regarding the services offered at CPHP and
physician health related issues. Physicians and CPHP personnel who are experts in the field of physician health conduct these presentations.
Below is a listing of presentation topics that CPHP provides. In addition, CPHP can tailor presentations to discuss the issues that are unique
to any organization. Presentation topics include:
CPHP Services and Physician Health
Physician Stress/Physician Self Care
Professional Boundaries
The Disruptive Physician
Substance Abuse and Addiction
Women in Medicine
Physicians in Relationships and Families
Occupational Hazards of Physicians and Medical Students
Physician Depression and Suicide
For additional information about CPHP presentation services or if you are interested in scheduling a presentation, please visit our website
at www.cphp.org and click on presentation services. Then you may click on the Presentation Request Form icon.
5
continued from page 1
(IOP) in patients suffering from glaucoma, it is estimated that a patient would need to smoke about a dozen “joints” per day for efficacy.
While IOP may be successfully lowered and the risk for blindness reduced, the patient is likely to suffer side effects, including significant
cognitive impairment. No study has demonstrated that MJ can lower IOP as effectively as drugs already on the market.
There is some evidence that smoked MJ relieves neuropathic pain related to HIV, but less evidence that medical MJ is helpful in controlling
chronic/severe pain. Smoked MJ is also used to combat the wasting syndrome of AIDS and relieve nausea related to chemotherapy. While
several reports support its efficacy, patients with these conditions are already physically compromised and unnecessary exposure to potentially dangerous substances should be avoided. MJ contains most of the hazardous substances found in tobacco smoke. It also inhibits T cell
functioning and runs the risk of further compromising an immune-suppressed patient.
Those supporting the legalization of MJ tend to portray this complex alkaloid mixture of more than 400 compounds as a reasonable
“natural” alternative to conventional drugs. But its organic nature does not preclude the need for scientific investigation. Despite legislation
across the states relaxing laws governing the possession or use of MJ, the scientific community remains concerned about its risks.
The medical literature is replete with evidence that MJ use can be complicated by abuse and dependence. Ten percent of regular MJ users
become addicted to it compared with 15% with alcohol, 32% with nicotine and 26% for opiates. The number of adults with substance
abuse disorders is trending upward and expected to double by the year 2020. There is concern that increasing access and availability to
another addictive substance will only aggravate this trend. Of MJ confiscated in the US, the potency (percentage of THC) has increased
dramatically since 1975, raising additional concerns about increased abuse potential.
The largest demographic of MJ users includes adolescent and young adult males. Colorado ranks fifth in the nation for adolescent MJ use.
The younger children are when first exposed to MJ, the more likely they are to use cocaine and heroin and become dependent on drugs in
adulthood. MJ poses other mental health hazards. The risk for developing psychosis is increased by 40% for those who have used cannabis.
Good research shows that smoked MJ makes anxiety, depression and disorders of attention worse. University of Colorado researcher Hon
Ho, MD and his associates conducted a large longitudinal study of cannabis use in adolescents. They discovered that smoked MJ is
associated with the subsequent development of depression, not the reverse. Slowed cognitive processing, impaired judgment and short-term
memory, impaired inhibitory control, loss of sustained concentration or vigilance, impaired visuospatial processing and perception are doserelated side effects of smoked MJ. Heavy MJ use (daily for a month) is associated with residual neuropsychological effects even after a day of
supervised abstinence. It is unknown whether this is related to residual drug in the brain or frank neurotoxicity.
MJ smoke contains many of the same carcinogens and co-carcinogens found in tobacco smoke. Because inhalation is deeper and more prolonged with MJ compared to tobacco, more tar-containing benzopyrene exposure occurs. Both acute and chronic bronchitis are associated
with smoked MJ. Long-term cannabis use increases the risk for lung cancer as well as head and neck cancers. There exists scientific evidence
that long-term MJ smoking alters the reproductive system. MJ use also increases heart rate. According to Harvard University researchers, the
risk of a heart attack is five times higher than usual in the hour after smoking MJ.
Aside from the individual health risks associated with MJ use, it is important to consider the societal costs incurred when abusable, cognitive
impairing substances are made readily available to the public. Studies employing computer controlled driving simulators reveal that cannabis
acutely impairs driving-related skills in a dose-related fashion. The National Transportation Safety Board studied 182 fatal truck accidents
in 1990 and learned that just as many accidents were caused by drivers using MJ as were caused by drivers impaired with alcohol. MJ is also
implicated in a high percentage of workplace accidents. Drug use also contributes to crime. A large percentage of those arrested for crimes
test positive for MJ. Nationwide, 40% of adult males tested positive for MJ at the time of their arrest.
Amendment 20 was meant to provide legal access to MJ for those suffering from debilitating conditions refractory to conventional treatments. A small scale enterprise was envisioned. Instead, storefront MJ dispensaries have sprouted like weeds (pun intended). Rumor has it
that there are more MJ dispensaries in metro Denver than liquor stores and Starbucks coffee shops combined!
In reviewing medical MJ cards issued in Colorado, only 3% belong to people with cancer and only 1% for those with HIV/AIDS. Ninety
percent of medical MJ cards have been issued to individuals presenting with severe chronic pain, a highly subjective qualifying condition.
Of concern, 70% of medical MJ cards have been obtained by men, the majority being between the ages of 25 and 34 years, the demographic
most likely to have addictions. At the time of this writing, approximately 20,000 medical MJ cards have been issued and, according to the
Colorado Department of Public Health, a backlog of 50,000 existed. Either our state is experiencing an epidemic of severe pain in youthful
males or Amendment 20 is being exploited, making a mockery of responsible medicine. Attorney General John Suthers testified before the
Joint Judiciary Committees that while 800 physicians have signed for patients to receive medical MJ, 75% of patients received their recommendation from one of only 15 physicians and of these physicians, at least five have had disciplinary actions taken against them. SB109 is
expected to cut down on the abuses reported by the Department of Public Health of some physicians making medical MJ recommendations
in the absence of adequate evaluation or continuity of care.
Any physician making recommendations for medical MJ must hold a valid, unrestricted license to practice medicine as well as a valid,
continues on page 12
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Did you know CPHP assists with any health-related concern?
Depression
Stress
Behavioral Problems
Relationship Issues
ADHD
Chronic Pain
Neurological Problems
Emotional Problems
Bipolar Disorder
Eating Disorders
Sleep Disorders
Retirement Stress
Family Concerns
Substance Dependence
Financial Problems
Legal Problems
Psychiatric Issues
Career IssueS
Medical Problems
Cognitive Concerns
Substance Abuse
Malpractice Issues
Professional
Boundary Issues
Profile of Jack A. Klapper, MD
An Important Figure in CPHP’s History
A bright-eyed boy named Jack A. Klapper
arrived in Denver from Kansas City,
Missouri when he was in the 6th grade. He
sailed through his elementary and junior
high years and then landed at Denver’s
East High School. Upon graduation, with
the full support of his parents, young Jack
turned his ambitions to medical school
where he aspired to become a physician.
Jack enrolled in the University of Colorado
Medical School where he completed his
residency in both psychiatry and neurology.
Dr. Klapper became a member of the Board
of Medical Examiners in the early 1980s
and was also part of an important cadre of physicians in Denver who realized that
physicians needed a resource in times of trouble. “After all, big companies had
Employee Assistance Programs (EAPs) and it made sense for physicians to have
such a structured outlet in times of difficulty,” stated Dr. Klapper.
From 1986 to1988, Dr. Klapper was a CPHP Board Director. He fondly recalls
the ongoing physician health work of Steve Dilts, MD, a primary founder of
CPHP and its first Medical Director; Michael Sturges, MD, also a CPHP founder,
Board Director and Associate Medical Director; Ed Casper, MD, another CPHP
Board Director and Chairman of the Psychiatry Department at Denver Health; and
Bruce Jensen, MD, also a CPHP Board Director. Dr. Klapper recalls Drs. Dilts,
Sturges, Casper and Jensen all being at the forefront of the CPHP movement and
helping many Colorado physicians who were dealing with a number of personal
and medical problems.
In 1988, Dr. Klapper was in private practice and soon ascended to the presidency of the Denver Medical Society where he continued to champion the cause of
CPHP. He knew that the young nonprofit start-up would be here to stay and fully
supported its place in the medical community.
Dr. Klapper reiterated, “A physician health program such as CPHP became such an
obvious benefit to physicians in Colorado.” He further explained that the Board of
Medical Examiners is of benefit to the public, but that physicians need their own
physician health resource as well. “Having healthy physicians also directly affects
the public, too.”
Since the 1990s Dr. Klapper has continued to follow his passion in neurology
and medical research, founding the Mile High Research Center in Denver. He
and his team conduct research and currently are engaged in conducting numerous
pharmaceutical trials focusing on a cure for Alzheimer’s disease.
Dr. Klapper concludes by saying how pleased he is with CPHP’s evolution and that
with such good physicians and leaders as Drs. Dilts, Sturges, Casper and Jensen
involved in its infancy, he fully expected the organization to become a mainstay
within the medical community. “I didn’t expect anything less from CPHP and I
knew it was the right organization for physicians to have in difficult times,” stated
Dr. Klapper.
A portion of Dr. Klapper’s e-mail address sums up his life’s work and ongoing
passion in medicine…headdoc!
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2008-2009 DONORS
Colorado Physician Health Program (CPHP) is proud to recognize the following individuals and organizations who
contributed to our annual Spirit of Medicine Campaign during campaign year 2008-09. We are truly grateful for their
generosity, which helps provide crucial support to CPHP as we strive to provide exceptional physician health care services and meet the
ever-growing demand for our services throughout Colorado.
Thank
LivingWell Giving Society
CPHP extends special appreciation
to the following members of the
LivingWell Giving Society. This
group of donors have pledged
an annual contribution for
five successive years, providing
continuous funding for our work.
$25,000
Colorado Permanente Medical Group
$5,000
Anonymous
$1,000
Valley View Hospital Medical Staff
In-Kind
Patricia and Al Babb
Annual Donors
$1,000 and above
Anonymous (3)
Dr. Eric and Mrs. Linda Carlson
Jennifer H. Caskey, MD
Harvey M. Cohen, MD
Michael H. Gendel, MD
Dr. and Mrs. Michael Michalek, MD
Alfred Nitka, MD
Margaret M. Norsworthy, MD
Drs. Charles Raye and Louise
Schottstaedt
John R. Steinbaugh, MD
Russell C. Tolley, MD
Edward H. Wood, MD
$500 — $999
Anonymous (5)
Dr. and Mrs. James Borgstede
Michael R. Bowen, MD and Reneal B.
Bowen, RN
William J. Bowman, MD
Mercedes Cameron, MD
Jeanine M. Compesi, DO
Paul D. Cooper, Esq
James E. Davidson, Jr., MD
George D. Dikeou, Esq
John H. Drabing, DO
Patrick Faricy, MD
Drs. Michael and Mary Glode
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David A. Grunow, Jr., MD
Dr. and Mrs. George R. Helsel
Drs. Scott and Sarah Humphreys
Curtis and Judy Kimball
Dr. Janet Legare and Dr. Vivek
Balasubramaniam
David S. Lennon, MD
Donna M. Nelson, MD
Dr. James and Mrs. Carolyn O’Donnell
Dr. and Mrs. Gregg Omura
Dr. Debra Parsons and Dr. David Downs
Nigel Pashley, MD
Perry Rashleigh, MD
Dr. and Mrs. Wagner J. Schorr
Paul D. Simmons, MD
Robert L. Swanson, MD
Steven J. Thorson, MD
Drs. Robert and Sara Tonsing
Lawrence Varner, DO
Kay Wagner, MD
David S. Wahl, MD
Jonathan E. Walter, MD
Drs. Michael and Patrice Whistler
Bruce H. Wilson, MD
Frederick Y. Yu, Esq
Karen Zarlengo, MD
$250 — $499
Anonymous (3)
Jandel T. Allen-Davis, MD
Dr. and Mrs. Sanford E. Avner
Dennis J. Battock, MD
William and Ana Cristina Brown
Mary Ellen Caiati, MD
Michael V. Calvin, PA-C
Curtis Clark, MD
David K. Cobb, MD
Thomas G. Currigan
Douglas Dart, MD
Stephen L. Dilts, MD
Sarah R. Early, PsyD
Dr. and Mrs. Alan Feiger
John Fleagle, MD and Diane Chicoine
Elizabeth A. Fries, PA-C
Maureen Garrity, PhD
Doris C. Gundersen, MD
William A. Holm, MD
Drs. Jack and Nahid Hotchkiss
Jacob G. Jacobson, MD
Paul B. Jones, MD
Dr. Jeremiah Kaplan and Dr. Kristin
Brousseau – Boulder Neuropsychiatry
Dr. and Mrs. Peter Kim
Thomas B. King, MD
Victoria King, MD
Dr. Sally Knauer and Mr. Greg With
David L. Koets, MD
Dr. Jeremy and Mrs. Debbie Lazarus
Bennett R. Leslie, PsyD
Dominic L. Meylor, MD
Frederick M. Miller, MD
Gary S. Milzer, MD
Dr. Robert and Leslie Nathan
Drs. John Gallagher and Ruth Nauts
Barbara and Anton Nesse, MD
Dr. Michael and Theresa Paranka
Stuart A. Plummer, MDiv
Richard W. Presnell, MD
Antoinette G. Quigley, MD
Robert N. Rice, MD
Sheldon Roger, MD
John and Kass Schwappach
Dilworth ‘Buz’ Sellers, MD
Dr. Marc Sorkin and Laurie Sorkin
Dr. Donald and Mrs. Mary Spradlin
Kristina Steinberg, MD
Tamara J. Stoner, MD
Ahmed R. Stowers, MD
Edna Stuver Webster, MD
Libby and Jeff Stuyt
Drs. Sue and Ron Townsend
Dr. Richard and Mrs. Jacqueline Troy
Paul and Doris Wall
Leonard Wheeler, MD
Ms. Constance B. Wood, Esq and
Lawrence G. Wood, MD
Charles F. Yeagle, MD
$100 — $249
Anonymous (46)
Cae L. Allison, LCSW
Robert Alsever, MD
Tracy Anderson, MD
Nancy Arko, MD
Charles O. Arnold, MD
Nelson E. Bachus, MD
Larry and Margaret Ballonoff
Drs. Elizabeth Bayliss and Simon
Hambidge
Harold T. Becher, MD
Joel J. Bechtel, MD
Michael and Sheila Berman
Francesco G. Beuf, MD
Bill and Martha Bevan
W. Gerald Bissell, MD
Dr. and Mrs. Matthew Blomquist
Geza S. Bodor, MD
Susan Bograd, MD
Rob and Marilyn Bradley
James D. Brooke, MD
Dina Brudenell, MD
Michael W. Brunko, MD
Stephanie E. Buller, PA-C
Duncan C. Burdick, MD
Glen E. Burmeister, MD
Jeffrey Cain, MD
Robert E. Carlton, MD
Julie Carpenter, MD
Debbie R. Carter, MD
John Cartier, Jr., MD
Dennis M. Chalus, MD
Jeffrey K. Chapman, MD
David W. Claassen, MD
Amy Clark, MD
Dr. and Mrs. Benjamin K. Clarke
Phil Cohen, MD
Richard A. Cohn, MD
Toby P. Cole, MD
Michael K. Comstock, MD, PC
Laurie A. Coryell, MD
Kevin E. Cowperthwaite, MD
William F. Cox, Jr., MD
James M. Cusick, MD
Donald A. Daeke, MD
William Dahlberg, MD
E. Earlene Dal Pozzo, MD
Allan B. Davidson, MD
Arthur J. Davidson, MD
John E. Delauro, MD
Dr. and Mrs. Jack T. Dillon
Robert E. Donohue, MD
Barbara Dutmers, MD
Phillip L. Engen, MD
Danny W. Englund, PA-C
Joel Ernster, MD
William M. Espey, MD
Dr. and Mrs. F. R. Everhart Jr.
Sally L. Fabec, MD
Joseph H. Fillmore, MD
Bruce G. Fineman, MD
Dr. Suzanne Fishman and
Dr. Thomas Cain
Gordon H. Fleischaker, Jr., MD
David Flitter, MD
Susan R. Frederick, MD
Dean L. Furry, MD
Theodore J. Gaensbauer, MD
Dr. Donald and Mrs. Barbara Gazibara
Bernard F. Gipson, Sr., MD
Ms. Carol A. Goddard
Dr. and Mrs. David Goldstein
John Graves, MD
Darrin Green, MD, PC
Drs. Jeannette Guerrasio and
Deborah Lehman
Steven Gunberg, MD – Diversified
Radiology
Susan H. Hamstra, DO
Michael W. Hanson, MD
Ian M. Happer, MD
Wendell and Charlotte Hatfield
Jeffrey E. Hawke, MD
Kerry L. Hildreth, MD
Dr. S. Adam Hill and
Dr. Annie Chang Hill
Dr. and Mrs. Alan Hopeman
Joseph R. Horn, MD
Harriet H. Howell, MD
Donald Hudson, MD
Robert D. Hunter, MD
Evelyn Hutt, MD
Dr. and Mrs. William Inkret, Jr.
Lynn James, MD
Randal Jernigan, MD
Daniel B. Jinich, MD
Stephen Johs, MD, FACS and
Nancy Madinger, MD
David Jones, MD
Carl J. Judge, MD
Durand J. Kahler, DO
Robert J. Kahn, MD
John F. Kelly, MD
Ruth S. Kempe, MD
Spencer King, MD
Richard A. Knackendoffel, DO
Kimi L. Kondo, DO
Drs. Gregorio and Haydee Kort
Martin A. Koschnitzke, MD
Dr. and Mrs. Pat W. Kosmicki
Cynthia J. Kuehn, MD
Richard C. Lamb, MD
Diane M. Lanese, MD
Ronald M. Laub, MD
Alan and Debby Lazaroff
Dr. and Mrs. David Lehman
Paul M. Levisohn, MD
Ellen Lewis, MD
Yaron J. Lidor, MD
Philip J. Lightstone, MD
Anthony J. LoGalbo, MD
David M. Long, MD
B. J. Longenecker, MD
Alice Cook Madison, MD
Dr. David and Mrs. Catherine
Manchester
James Marquardt, MD
Joseph Maruca, MD
David S. Matthews, MD
Jack G. May, MD
Sam Mayeda, MD
Louise L. McDonald, MD
Valerie McElroy, PA-C and
John McElroy, PA-C
Bruce D. McFarland, DO
Rex McGehee, MD
Donald O. McIntyre, MD
Kim McMillin, MD
Thomas and Jean Merrick
Jeffrey L. Metzner, MD
Dr. Ron and Jean Meyer
Jane Miceli, MD
Joyce Michael, DO and
Michael Trumbull, PhD
Merle Miller, MD and
Alex Maslanka, MD
James B. Mosby, Jr., MD
Dr. and Mrs. James T. Murphy
Alan Nelson, MD
Glenn Niebling, PsyD
Dr. and Mrs. Theodore C. Ning
Lisa Nowak, MD
Mark R. Olson, MD
Mr. Dennis J. O’Malley
Dr. and Mrs. Samuel V. Origlio
Leticia M. Overholt, MD
H. Leon Oxman, MD
Pamela S. Parks, MD
Mark F. Pattridge, MD
Mark Petrun, MD
Thomas L. Petty MD
Dr. and Mrs. Peter J. Philpott
T.M. Pickard, MD
Michael Prochoda, MD
Lucille Queeney, MD
Richert E. Quinn, Jr., MD
Ralph G. Ratcliff, MD
Catherine G. Reedy, MD
Linda Reinstein, MD
Marv Robbins, MD
Cynthia Rose, MD
Adam A. Rosenberg, MD
Herb Rothenberg, MD
Charles E. Roy, MD
Jarvis D. Ryals, MD
Noel E. Sankey, MD
Steve Sarche, DO, PC
Susan Savage, MD
Christopher Scneck, MD and
Patricia Braun, MD
Stuart A. Schneck, MD
Walter R. Schreck, MD
Dr. and Mrs. Cosimo G. Sciotto
Nancy Seibolt, MD
Dr. and Mrs. Graham J. Sellers
Mani K. Shahidi, PA
James T. Shallow, MD
David R. Sharer, MD, PC
Dr. and Mrs. James H. Shore
Jay H. Shore, MD
Dr. and Mrs. Richard D. Shuger
Peter Silvestri, MD
Donald A. Singer, MD
Kathleen A. Sloan, MD
Cheryl L. Stearns, MD
Mary F. Stephenson, MD
Dr. and Mrs. Richard H. Stienmier
Stephen L. Stoll, MD
Steven G. Sullivan, MD
George O. Thomasson, MD
Gerard J. Tomasso, MD
Drs. Kevin and Audrey Tool
Mark B. Trubowitz, DO
Leigh Truitt, MD
Robert Tyson, MD
Dr. Christopher and Sonya Unrein
Patricia L. Vandevander, MD, MBA
Usha Varma, MD
Dr. Michael and Mrs. Laura Volz
Hallet N. Watz, MD
Dick and P.J. Wenham
Richard P. Wetzig, MD
Wallace White, MD
Mark Wienpahl, MD
Patrick N. Williams, MD
Dr. and Mrs. Laird S. Wolfe
James N. Wolff, MD
Robert N. Wolfson, MD, PhD
Jay M. Wolkov, DO
John F. Wolz, MD
Philip Yarnell, MD
Teresa Youtz, MD
Theodore R. Zerwin, MSW
Claire Zilber, MD
Joshua J. Holmes, MD
Lawrence D. Horwitz, MD
John S. Hughes, MD
Herbert L. Jacobs, MD
Jill H. Jamison, MD
Thomas F. Jenkins, MD
Joseph S. Jensen, MD
Dale L. Kemmerer, MD
Samuel J. Kevan, MD
Anita Khanna, MD
Lynne Klaus, LCSW, CACIII
Richard Koken MD
Karen L. Ksiazek, MD
Patricia A. Laman
David L. Lenderts, MD
Dennis L. Lower, MD
John D. Mahoney, MD
James Martau, MD
Marcee L. Morris, PA
Joseph M. Murphy, MD
Carol M. Newlin, MD
Leo J. Nieland, MD
William and Elizabeth Oligmueller
Amanda L. Parry
Janice L. Petersen, MD
Mary and Dr. Peter Peterson
T.J. Puskas, MD
Dr. and Mrs. Ray Rademacher
Scott E. Raub, DO
Dr. David and Marci Rosenthal
Eric J. Rothgeb, MD
F. J. Rust, MD
Emanuel Salzman, MD
Richard Sanders, MD
Mark D. Schane, MD
Stan Siefer, MD
Richard C. Simons, MD
Harriet Stern, MD
Richard E. Stiefler, MD
William J. Thulin, MD
Alisabeth Thurston-Hicks, MD
Christopher Tromara, MD
Will Van Derveer, MD
Heather Varnell, MD
Joanne Vitanzer, MD
Hue Ngoc Vo, MD
William J. Waggener, MD
Dr. and Mrs. WM. Warkentin
Jerry Weil, MD
Gerald N. Weiss, MD
Todd R. Weiss
William J. Williams, MD
William B. Wilson, Jr., MD
Sara D. Winter, MD
Daniel Witten, MD
Dr. and Mrs. Bert Wong
Vern Berry and Dr. Jennifer Wood
Ann Yanagi, MD
Asa G. Yancey, Jr., MD
k You!
Up to $100
Anonymous (24)
John Alston, MD
Jose M. Angel, MD
Mary Arthur, PA
Dr. and Mrs. Steve Ayers
Christina Bammes, MD
Edward L. Bender, MD
Deane S. Berson, MD
Robert M. Brayden, MD
Paul Bregman, MD
Elisabeth Brozovich, PA-C
Susan M. Brugman, MD
Lynnann Bulter-Sanchez, LPC, CACIII
Barbara J. Chase, MD
Karen B. Chipley, MBA, CPA
John Chisholm, MD
Mark P. Cilo, MD
Deborah Clendenning, PA
Leah M. Cooper, MD
Carole M. Crawford, APRN
Richard Dart, MD, PhD
Martin P. Dumler, MD
William E. Ellinwood, MD
Claudia Elsner, MD
Truman G. Esau, MD
John C. and Eloise Faul
Chris Flynn, MD
John J. Ford, III, MD
Dr. Gary and Jan Friedland
Drs. John and Kerstin Froyd
Bert S. Furmansky, MD, PC
Arthur D. Garfein, MD
John H. Genrich, MD, PC
Alfred Gilchrist
Richard Glassman, DO
Barry M. Goldmuntz, MD
Joyce E. Gottesfeld, MD
Elizabeth S. Grace, MD
Joan and Allan Graham, MD
Larry Green, MD
Daniel J. Greenholz, MD
Dr. and Mrs. James Hardee
Robert D. Hartley, II, MD
Marcus T. Higi, MD
John E. Holder, PA-C
9
Organization Donors
$5,000 — and above
Centura Health
Colorado Medical Foundation Trust
St. Mary’s Hospital and Medical Center
The Medical Center of Aurora
Medical Staff
$1,000 — $4,999
Aspen Valley Hospital
Boulder Community Hospital
Medical Staff
CarePoint/Beacon Medical Services
Craig Hospital
Exempla Good Samaritan Medical Center
Medical Staff
Exempla Lutheran Medical Center
Exempla St. Joseph Hospital Medical Staff
Littleton Adventist Hospital
Longmont United Hospital Medical Staff
North Colorado MC/Medical Staff
Foundation
North Suburban Medical Center
Medical Staff
Northern Colorado Anesthesia
Professional Consultants, LLP
Peak One Surgery Center
Penrose-St. Francis Hospital
Physicians Defense Fund Trust
Presbyterian/St. Luke’s Medical Center
Medical Staff
Rocky Mountain Urological Society
Rose Medical Center Medical Staff
Rose Medical Center
Sky Ridge Medical Center Medical Staff
St. Mary-Corwin Medical Center
Medical Staff
St. Mary-Corwin Medical Center
St. Thomas More Hospital
Swedish Medical Center MSO
The Children’s Hospital Medical Staff
University of Colorado Hospital
Vail Valley Medical Center Medical Staff
Up to $1,000
Arapahoe - Douglas - Elbert Medical
Society
Arkansas Valley Regional Medical Center
Arkansas Valley Regional Medical Center
Medical Staff
Avista Adventist Hospital Medical Staff
Avista Adventist Hospital
Colorado Plains Medical Center
Community Hospital Medical Staff
(Grand Junction)
Delta County Memorial Hospital
Denver Health Medical Center
Medical Staff
Diversified Radiology of Colorado, PC
Estes Park Medical Center Medical Staff
Family Health West
Gunnison Valley Hospital
10
Internal Medicine Associates
Kennedy, Childs & Fogg, P.C.
Lakeview Family Medicine
Lincoln Community Hospital
Medical Staff
Littleton Adventist Hospital Medical Staff
Longmont United Hospital
McConnell Siderius Fleischner
Houghtaling & Craigmile, LLC
McKee Medical Center Medical Staff
McKee Medical Center
Memorial Health System
Mercy Regional Medical Center
of Durango
Montrose Memorial Hospital
Montrose Memorial Hospital
Medical Staff
National Jewish Health
Parker Adventist Hospital
Parker Adventist Hospital Medical Staff
Parkview Medical Center
Platte Valley Medical Center
Platte Valley Medical Center
Medical Staff
Porter Adventist Hospital Medical Staff
Pueblo County Medical Society
Rocky Mountain Health Plans
Rottman Eye Care, PC
Senior Care of Colorado, PC
South Denver Obstetrics and
Gynecology, PC
Spalding Rehabilitation Hospital
St. Anthony Central Hospital
St. Thomas More Hospital Medical Staff
The Children’s Hospital
The Denver Institute for Psychoanalysis
The Denver Psychoanalytic Society
Yuma District Hospital
2008-09 CPHP
Board Directors
James P. Borgstede, MD
Chair
George D. Dikeou, Esq
Vice-Chair
Stephen L. Dilts, MD
Immediate-Past Chair
Larry A. Schafer, MD
Treasurer
Caroline M. Gellrick, MD
Secretary
Maureen J. Garrity, PhD
Director-at-Large
Bruce H. Wilson, MD
Director-at-Large
Michael V. Calvin, PA-C
Thomas G. Currigan
John H. Genrich, MD, PC
Alfred D. Gilchrist
Debbie Lazarus
Michael Michalek, MD
Lawrence Varner, DO
Former CPHP
Board Directors
Paul D. Cooper, Esq
Mr. Dennis J. O’Malley
John H. Drabing, DO
Samuel V. Origlio, DO
Ms. Carol A. Goddard
Stuart A. Plummer, MDiv
Robert D. Hartley, II, MD
Richert E. Quinn, Jr., MD
Ms. Bunkie Inkret
James H. Shore, MD
Ms. Patricia A. Laman
Leigh Truitt, MD
Alan Lazaroff, MD
Theodore R. Zerwin, MSW
Louise L. McDonald, MD
The CPHP Team
Cae L. Allison, LCSW
Director of Clinical Services
Mary Ellen Caiati, MD
Associate Medical Director
Sarah R. Early, PsyD
Executive Director
Michael H. Gendel, MD
Medical Director Emeritus
Doris C. Gundersen, MD
Medical Director
Scott Humphreys, MD
Associate Medical Director
Lynne Klaus, LCSW, CACIII
Clinician
Amanda L. Parry
Executive Assistant
Jay H. Shore, MD
Associate Medical Director
Elizaberth B. “Libby” Stuyt, MD
Associate Medical Director
Todd R. Weiss
Development Specialist
Please Note: This donor recognition list reflects gifts received
at time of printing. We have
made every effort to give
proper recognition to those
who financially supported
CPHP’s mission in 2008-09.
If we have made an error, we
sincerely apologize. Please
contact CPHP’s Development
Specialist at (303) 860-0122,
ext. 221, so we may correct
our records.
2010 Recognition
of COPIC
COPIC is generously
sponsoring CPHP’s 2010
Annual Newsletter.
COPIC has been an ardent
supporter of our program
since our inception in 1986.
We feel very fortunate to
have such strong support
from a long-time ally.
We also wish to extend our
appreciation to COPIC for
their consistent generosity
to the annual Financial
Assistance Fund that directly
assists physician clients in
need of CPHP services who
otherwise would not be able
to afford such care.
THANK
YOU!
Did You
Know?
CPHP direct client
services are FREE to
all Colorado medical
licensed physicians
and Colorado
licensed physician
assistants.
CPHP services
are statewide.
In Their Own Words — Testimonials from Physician Clients
I
first learned about CPHP as a resident (1998-2001) so I had
some previous exposure to CPHP. In 2003 I was confronted
with a malpractice suit. It was a real shock and very devastating to
me. As you can imagine, it was very isolating. Prior to this everything had been going really well and I was rated as one of the top
physicians in our practice.
I was quite anxious and definitely not acting like myself. It seemed
like a number of legal issues just kept popping up. During the malpractice suit I started practicing defensive medicine. I suppose this
is a natural response. Each patient I was treating began looking like
a lawsuit to me. My personal life was severely affected. My energy
level for social situations was terribly depleted. I didn’t know what
was coming next.
In 2005 I finally referred myself to CPHP. Once I scheduled my
initial meeting with CPHP I was really looking forward to my
visit. Although I must admit there was some trepidation. Perhaps
even some fear. I questioned myself. Am I a bad doctor? But I soon
realized my fear was irrational.
When arriving at CPHP I entered the door and was now in the
waiting room. I was still a little anxious, wondering if CPHP could
really even help me with legal issues and the associated stress I
was dealing with. Once I met with the assigned Associate Medical
Director and Clinician I felt like they really cared and understood
my situation. They certainly normalized the situation. I suddenly
felt like I wasn’t alone. CPHP assured me that they see this all the
time. Now I felt validated and felt that I was being looked upon as
a peer physician. They really treated me respectfully and it was at
that moment that I knew I was in the right place!
With CPHP’s help I worked with a treatment provider, and that
was very helpful. CPHP was also helpful in communicating with
my workplace. Now I felt like I had a home base and that whenever I needed something I knew CPHP would be there as a resource
to help me.
I still meet with CPHP at least twice a year even though it is not
required. I continue to feel like it’s a place that has made me feel
whole again. The monitoring was never intrusive and the process
was about making me feel comfortable. So I feel like I am working
on my strengths. If there are weaknesses in my situation I feel like
I can work with treatment providers and this helps me to stay on
top of the situation to be a better doctor.
I have communicated to other physicians about going to CPHP
and let them know it is a resource to help support us and back us
up during troubled times.
The group that truly represents physicians is CPHP. They allow us
to be human and get the help we need.
Many of my colleagues in residency didn’t understand what CPHP
was all about or how to utilize the services. However, I realized later
on that many of them were able to receive help during troubling
times, too.
One thing I would say to other physicians is that going through
legal issues is common in our field. When it does happen, CPHP
is one of the best resources to tap into.
Before coming to CPHP I felt as though I might be the worst
doctor in the world. Even after all of the hard work. CPHP helped
me with the situation to really identify that I am normal and that
this is just a legal jungle that I have been exposed to.
This whole process has allowed me to more acutely see the human
side of patients. I have a new perspective on their emotions. This
has really opened my eyes and allowed me to better connect with
patients.
I
was experiencing some serious and complicated family
problems that were spiraling out of control. This was affecting
my personal and professional life in a very significant way. This
was a very difficult time to be practicing.
Due to personal family problems I was experiencing, unfortunately it was affecting my career so I was mandated to seek the services
provided by CPHP. I was very apprehensive about making this
initial contact as this was my first encounter with CPHP. However,
I called CPHP and was able to get an appointment within 30 days.
Prior to meeting with CPHP I did not know anything about the
organization.
It was highly disappointing to find myself under a microscope
after such a long and solid career. If I were not a physician I am
sure I would not have to go through this scrutiny and monitoring,
although I understand the need for it. This was very hard for me
to deal with. Thank goodness that I got through it.
For someone who had never had family problems or been mandated for an evaluation, the whole process was very unusual and painful, but CPHP ameliorated the discomfort as much as possible.
When I spoke with the Clinician and Associate Medical Director
assigned to my case I knew they were objective as they had to come
to their own conclusions, but they were very kind, understanding
and helpful to me.
CPHP has helped resolve my situation and all of the worries and
problems have been cleared up. What a relief to not be in the spotlight now! The Clinical Team helped me in every way within their
power and made this painful process more manageable and bearable. During the time I met with the Associate Medical Director
and Clinician I brought up my personal issues and how my family
situation affected me as a person. They kindly offered some recommendations within their treatment provider network if I decided
to proceed forward…if I needed additional help.
I would absolutely recommend CPHP and their Clinical Team
to other physicians and physician assistants because CPHP can
exert a positive impact. They will always do their best for you and
keep the process scrupulously anonymous. Given the responsicontinues on page 12
11
continued from page 11
bility that we have as medical professionals, CPHP offers a very
helpful process. We are scrutinized on a daily basis and sometimes
in the medical community we do not have the support that we
need. That is where CPHP is very helpful as one of those support
services. Hopefully physicians and physician assistants will have
the courage to take advantage of CPHP before any issues develop.
The real issue for me was that I had not previously had any contact
with CPHP. I had never had any problems as a physician or as a
person. I just didn’t know what was available. When medical professionals go through the process of working with CPHP it is less
intimidating and much more helpful than they might anticipate. I
am personally thriving now. What I went through was incredibly
difficult. I hope CPHP will continue reaching out to the medical
community and promoting their services.
Because I survived my situation I desire to be an advocate and let
people know that if there are complicated family problems or any
other type of problems that medical professionals are experiencing
there are resources available and CPHP is an outstanding resource
to utilize.
continued from page 6
unrestricted DEA license. The physician must establish that a patient has a debilitating medical condition and would benefit from
medical MJ. The evaluating physician should review all pertinent
treatment records thoroughly, consult with other treatment providers involved in the patient’s care, obtain a thorough history and
conduct a physical examination before rendering a diagnosis or
treatment recommendation. A bona fide doctor-patient relationship is established in this scenario. Follow up care for monitoring
the effectiveness of medical MJ and changing recommendations
when indicated should occur. All of this constitutes the practice
of medicine, which means that the physician must abide by the
Medical Practice Act, including practicing within one’s scope of
expertise, maintaining adequate malpractice coverage and engaging in continuing education to maintain one’s competency.
Physicians must consider carefully which patients are appropriate
for a medical MJ trial. While remaining sensitive to the population
Amendment 20 was intended to help, we must also abide by the
Hippocratic Oath and protect our patients from harm. Medical
MJ has not been studied the way other remedies offered to the
public are. MJ purchased from dispensaries has not been formally
investigated for safety and efficacy. No standardizations for therapeutic dosing have been established. The THC content in MJ can
range from 1 to 10%. Consequently, MJ is dispensed in unknown,
varying strengths. It is not monitored for purity. No testing for
the presence of contaminants (e.g., pesticides, herbicides or molds)
occurs. Importantly, unlike medications approved by the FDA, no
post-marketing surveillance will be conducted to track unforeseen
adverse side effects of MJ. It will not be subject to liability regulations and will be exempt from quality control standards. Despite
being a Schedule I drug, MJ has bypassed the Colorado Prescription Drug Monitoring Program. For all these reasons, physicians
recommending medical MJ to patients should provide careful informed consent identifying the risks, benefits and alternative treatments available. People requesting medical MJ should be screened
for their vulnerability to addiction and other mental illnesses.
Physicians making medical MJ recommendations should also consider the liability of such a recommendation for patients working in safety-sensitive employment (for example, the healthcare
and transportation industries). Finally, it will be important for all
physicians to carefully examine their motives for recommending
medical MJ. It should be solely for the patient’s benefit. Financial
incentives and personal political views should not influence treatment recommendations.
Of course, conflicts of interest, such as investments in dispensaries or financial kickbacks for referrals, are ethically and legally
proscribed.
What is unfolding in Colorado is less about compassionate care
for people with serious diseases and more about decriminalizing
MJ. Those protagonists for liberalized MJ rules have strategically
placed physicians smack in the middle of a political, not medical,
debate. In the end, this tactical maneuver may prove to be a successful strategy for the complete legalization of MJ and other drugs,
taking physicians out of the loop entirely. If not, state and federal
regulators will need to ramp up efforts to ensure that the public is
truly protected from indiscriminate dispensing practices and those
physicians who interpret the law too loosely creating broad access
to a substance with high abuse potential. Stay tuned!
(For article references, please go to the CPHP website at cphp.org.)
Recognition of Treatment Providers
CPHP always considers positive feedback and encouraging words regarding our physician health program
from the medical community a high honor. By extension we would like to recognize and thank the
outstanding treatment professionals who implement treatment and direction to the medical professionals
directly served by CPHP.
These exclusive individual treatment providers within our network are vital to physician and physician
assistant recovery. We express our sincere appreciation to them and share with them the positive testimonials
of grateful medical professionals who have been served throughout Colorado.
12
Testimonial From a Hospital
My commitment to our patients is to assure they receive quality
patient care. This means ensuring that our physicians are safe to
practice medicine. When a practitioner reports a health concern,
our goal then is to see that every opportunity is at his/her disposal to address the health concerns to assure they can re-enter
the workforce in a positive, capable manor. Rarely do we look at
a health issue as career-ending. It is an opportunity to promote
positive health, education and well-being so that the practitioner
can continue to be a valued member of our Medical Staff.
The director of Medical Staff Services, upon the recommendation
of the Medical Staff President and Chief Medical Officer, facilitates
a referral to CPHP.
CPHP is a primary point of contact when we are faced with a
physician health issue.
In our particular hospital, CPHP has helped us when physicians
are dealing with alcohol/drug or psychiatric-related issues as well as
other problems such as disruptive behaviors.
Our Medical Staff Bylaws encourage physicians to self-report their
health problems and remind them that we promote a process of
rehabilitation where confidentiality is maintained, which is key in
developing a level of trust with the involved practitioner.
When behavioral issues have surfaced, CPHP’s evaluation process
will help identify underlying issues or concerns that may have contributed to the behavior issues. We monitor and trend behavioral
issues, as they are just one tool to help identify concerns that may
need to be addressed.
It has been my experience that the majority of our practitioners
work well with CPHP and they remain on Staff as a valued member
after they have received CPHP’s assistance and subsequent treatment. That is why it is so important to have a good monitoring
process in place to help identify an issue or concern early on.
CPHP has provided presentations to our Medical Executive
Committee meeting. CPHP’s direct communication with our Medical Staff Leadership gave them the insight to help identify issues
and the confidence to direct the practitioner(s) to your program.
Leadership feels comfortable with the process followed by CPHP
and the communication that CPHP provides to the facility.
CPHP has been a good partner to work with and they share appropriate information with the appropriate release of information.
Our leadership feels confident that they can trust the recommendations of CPHP and base their decisions on information received.
We all understand how delicate and sensitive health issues are to
those involved. But with CPHP at our disposal, an already tried
and true entity of support, everyone feels more at ease the moment
they are notified. I think that speaks volumes to the trust and
support your organization has built over the years. We wouldn’t
want to do our jobs without you!
Gail Winterly, CPMSM
Director, Medical Staff Services
Exempla Good Samaritan Medical Center
The CPHP Team
(Back row: L-R) Denny H. Smith, CPA, MT, Amanda Parry, BBA, Jay H. Shore, MD, Sarah R. Early, PsyD, Dwayne G. Spinler, MS, LPC
(Middle row 1: L-R) Lynne Klaus, LCSW, Doris C. Gundersen, MD, Scott A. Humphreys, MD, Mary Ellen Caiati, MD
(Middle row 2: L-R) Todd Weiss, BA, Sally Moody, LCSW, Michael H. Gendel, MD, Tracy-Sue Walters
(Front row: L-R) Joyce Muniz, BSB/PA, Julie Guhl, BA and Cae Allison, LCSW
(Not pictured) Elizabeth Brooks, PhD, Elizabeth B. “Libby” Stuyt, MD and Cindy Hudson, MA, CACIII
The CPHP Board of Directors and
Staff would like to offer
their appreciation to
James P. Borgstede, MD, for his
service on the Board of Directors
and in recognition of his
chairmanship of the 2010-11
CPHP Board of Directors.
13
Our Special Appreciation to Donors of $5,000 or More to the Spirit of Medicine Campaign/Living Well Giving Society
St. Mary’s Hospital and Medical Center
Receiving a Spirit of Medicine Award
Centura Health Receiving a Spirit of Medicine Award
Bruce Wilson, MD, Past CPHP Board Director, presenting the Spirit
of Medicine award to Robert Ladenburger, then President and CEO
of St. Mary’s Hospital and Medical Center in Grand Junction.
(L-R) Steven T. Brown III, MD, CME-Centura, CMO-St. Mary-Corwin, Pam Nicholson, VP of Advocacy, Centura,
George Dikeou, Esq., CPHP Board Director, Gary Campbell, President and CEO, Centura and
Sarah R. Early, PsyD, CPHP Executive Director
Colorado Medical Society Receiving the Spirit of Medicine Award
(L-R) Sarah Early, PsyD, CPHP Executive Director, Ben Vernon, MD, Immediate-Past President, CMS, Caroline Gellrick,
MD, CPHP Board Director, Mark Laitos, MD, Current CMS President and Lynn Parry, MD, Past CMS President.
Valley View Hospital Medical Staff Receiving a
Spirit of Medicine/Living Well Giving Society Award
Todd Weiss, CPHP Development Specialist, presenting the Spirit
of Medicine award to the Valley View Hospital Medical Staff and
“Hap” Harold Young, MD, Chief of Staff.
Medical Center of Aurora Receiving a Spirit of Medicine Award
Colorado Permanente Medical Group Receiving a Spirit of Medicine/LivingWell Giving Society Award
(L-R) Alan Aboaf, MD, Past President, Medical Staff at The Medical
Center of Aurora, receiving the Spirit of Medicine award from
Larry Varner, DO, CPHP Board Director
(L-R) Dan Oberg, CPMG Chief Financial Officer, Sarah R. Early, PsyD, CPHP Executive Director, Ruby Kadota,
MD, CPMG Associate Medical Director/HR, William “Bill” Wright, MD, MSPH, CPMG Executive Medical
Director and President, George Dikeou, Esq., CPHP Board Director and Todd Weiss, CPHP Development Specialist.
14
CPHP’s Vital Mission of Research
MICHAEL H. GENDEL, MD – CPHP Medical Director EMERITUS
CPHP remains committed to conducting and supporting research in
the physician health field. From the
beginning, Steve Dilts, MD, our first
Medical Director, confronted our field
with the need for solid empirical data
to guide our activities, promote physician health, and inform public policy.
CPHP published about our organization and its work during the 80s in the
Journal of the American Medical Association and in the 90s in the
American Journal on Addictions.
Under Dr. Dilts’ leadership we organized a national physician
health research conference in 1996. From this conference evolved
the Physician Health Research Planning Group whose charge was
to prioritize and facilitate physician health research nationally. One
product of this work group, which I had the honor of chairing, was
the “national database,” the health screening questionnaire which
we use at CPHP and is used by many other Physician Health Programs (PHPs). This was meant to standardize the data collected
about physicians so that studies could be conducted using a data set
larger than any state could muster. This work group evolved into
the Research Task Force of the Federation of State Physician Health
Programs (FSPHP) where it now plays a vital role. CPHP also organized and hosted a recent national conference of physician health
researchers to take a fresh look at the national research agenda.
This conference was generously sponsored by Kaiser Permanente
Colorado.
CPHP’s commitment to research has been supported by our Board
of Directors and by those physicians who have contributed to our
annual Spirit of Medicine campaign. Though I remain very engaged
in this work, the CPHP research group is now led by Jay Shore,
MD, Associate Medical Director and Elizabeth Brooks, PhD, Principal Researcher, both of whose careers are largely committed to research. Elizabeth is now working as principal investigator on many
of our projects. Libby Stuyt, MD, Associate Medical Director,
Doris Gundersen, MD, Medical Director and Sarah Early, PsyD,
Executive Director, are also very active in the research group.
Recently published articles from our research group include Dr.
Stuyt’s study of tobacco use in our population Stuyt EB, Gundersen DC, Shore JH, Brooks E, Gendel MH. Tobacco Use by Physi-
cians in a Physician Health Program, Implication for Treatment
and Monitoring. American Journal on Addictions 2009, 18(2): 103108; and Dr. Early’s study of gender differences in physicians undergoing PHP monitoring: Hotchkiss N, Early S. The Differences
in Keeping both Male and Female Physicians Healthy. The Health
Care Manager 2009, 28(4): 299-310. Recently published studies in
which CPHP participated in a multisite research include: DuPont
RL, McLellan AT, Carr G, Gendel MH, Skipper GE. How are Addicted Physicians Treated? A National Survey of Physician Health
Programs. Journal of Substance Abuse Treatment. 2009, 37(1): 1-7;
and McLellan AT, Skipper GS, Campbell M, DuPont RL. Five-year
outcomes for a group of physicians treated for substance use disorders in the United States. BMJ 2008; Nov4; 337:a2038.
Manuscripts near completion include a retrospective study of
boundary violations in the CPHP population, a description of the
Colorado site’s findings in the above-captioned five-year study, and
our study of randomly selected Colorado physicians concerning
their patterns of self-prescribed medical care.
Other projects on the table include studying our health screening
questionnaire. This is very important as it potentially opens the
door to a rich source of data for us and the other PHPs using the
national database. We are also looking into the feasibility of studying how CPHP intervention with ill physicians affects the quality
of their medical practice.
We wish to note that all of these studies, past and proposed, utilize
group data in which no individual is identifiable. No study goes
forward without approval of the Institutional Review Board of the
University of Colorado, Denver.
We at CPHP have also been very active in presenting our research
(and learning from others’) in national and international settings.
The American Medical Association (AMA) and Canadian Medical Association (CMA) jointly sponsor an international physician
health research conference every two years. In 2008 the British
Medical Association joined the AMA and CMA in a London conference, and our colleagues in Norway co-sponsored an event in
Oslo some years ago. The FSPHP meets annually. We have been
privileged to participate in all these meetings, learning about physician health problems, working to find the best ways of treating and
supporting those participating in our programs, and finding ways
to help all physicians cope with the stresses of our profession.
Many of you within the medical community have indicated a desire to receive future editions of the CPHP newsletter in an
electronic format. We are so pleased to be moving in this direction to save natural resources and reduce printing and mailing costs.
If you would prefer to receive future editions of the CPHP Newsletter via e-mail, please forward your name, address
and email to our Development Specialist, Todd Weiss, at [email protected]
Thank you!
15
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CPHP Board of Directors, Medical Directors and Staff
2010-2011 BOARD of DIRECTORS
Officers
James P. Borgstede, MD................................................. Chair
George D. Dikeou, Esq........................................... Vice Chair
Thomas G. Currigan, Jr............................................. Secretary
Larry A. Schafer, MD.................................................Treasurer
John H. Genrich, MD.................................. Director-at-Large
Directors
Maureen J. Garrity, PhD
Caroline M. Gellrick, MD
Jim E. Keller, M.P.H., PA-C
Debbie Lazarus
Michael Michalek, MD
Douglas Speedie, MD
Steven Summer
Lawrence Varner, DO
Medical Director & Associate Medical Directors
Doris C. Gundersen, MD.............................. Medical Director
Michael H. Gendel, MD..................Medical Director Emeritus
Mary Ellen Caiati, MD.................... Associate Medical Director
Scott A. Humphreys, MD................ Associate Medical Director
Jay H. Shore, MD............................ Associate Medical Director
Elizabeth B. “Libby” Stuyt, MD......... Associate Medical Director
PROFESSIONAL & ADMINISTRATIVE STAFF
Sarah R. Early, PsyD.................................... Executive Director
Cae L. Allison, LCSW.................... Director of Clinical Services
Elizabeth Brooks, PhD.............................. Principal Researcher
Julie Guhl, BA.............................Receptionist/Program Assistant
Cindy Hudson, MA, CACIII.................................... Clinician
Lynne Klaus, LCSW, CACIII.................................... Clinician
Sally Moody, LCSW.................................................. Clinician
Joyce Muniz, BSB/PA..........................Compliance Coordinator
Amanda Parry, BBA.....................................Executive Assistant
Denny H. Smith, CPA, MT........................Financial Manager
Dwayne G. Spinler, MS, LPC...................................... Clinician
Tracy-Sue Walters....................Administrative/Clinical Assistant
Todd R. Weiss, BA................................ Development Specialist
All material in CPHP News is protected by copyright. Please do not reproduce or use without written permission from CPHP.