Just because you have earned a professional degree does not mean you are immune from impairment due to alcoholism, drug and other addiction, or psychiatric illness. If you are suffering from any of these impairments, help is now available through your professional association. You can begin the recovery process through the Montana Dental Association’s Member Assistance Program. If you are struggling with alcoholism, substance abuse, or mental disorders, you can get help through this advocacy program from colleagues who’ve had similar experiences.
MDA’s Member Assistance Program is based on the following principles:
Early identification of the problem is crucial. The sooner a problem is recognized and treated, the better your chances for full recovery.
Intervention by colleagues who have been there can help you find appropriate treatment and speed your recovery.
Your own circumstances are unique and a treatment plan targeted to your needs, your family, illness, and issues gives you the best chance for recovery.
You can remain anonymous. Your identity, family, and dental practice are protected at all times.
The program telephone number is 1-800-257-4988, 8 am to 5 pm, Monday through Friday. Simply ask for the MDA Member Assistance Program. All calls are strictly confidential. You do not have to identify yourself. You will b put in touch with a concerned colleague who will help you secure the assistance you need.
If you suspect that you or a colleague is unable to practice due to alcoholism, drug abuse, or mental disorder, please call the program. MDA is here is help you.
(This article was written by Mike Ramirez, clinical coordinator for the Montana Professional Assistant Program. Members of MDA's Health and Well-Being Committee encourage any MDA member who is struggling with an addiction illness or who is impaired by mental illness to contact the MPAP.)
The mission of the Montana Professional Assistance Program is to provide advocacy and support services to health care professionals who are impaired. MPAP operates under separate contracts with the Montana Board of Dentistry and the Board of Medical Examiners. Services include community education and outreach, intervention with impaired professionals, appropriate referral, reintegration, and aftercare monitoring for program participants and referrals.
MPAP derives its legal authority to provide help to impaired dentists from section 37-4-311, Montana Code Annotated, which states: "The board [Board of Dentistry] shall establish a protocol for the referral to a board-approved rehabilitation program for licensed dentists who are found to be physically or mentally impaired by habitual intemperance or the excessive use of addictive drugs, alcohol, or any other drug or substance or by mental illness or chronic physical illness."
The intent of the law is to provide an alternative to license discipline where rehabilitation of the impaired dentist might be possible. The statute includes all licensees regulated by the Board of Dentistry, including dental hygienists and denturists. New rules governing the professional assistance program purpose, responsibilities, and reporting requirements for dentists with conditions of impairment were adopted in March 2007.
MPAP has been providing professional advocacy and aftercare monitoring services to licensed dentists in Montana since 1990. Over the years, the program has been involved in 41 cases of suspected impairment involving dentists in Montana. This figure includes a fairly equal distribution of referral cases that were closed short of full program participation and those in which participants proceeded through the system to eventually sign a contract for advocacy and aftercare monitoring services.
Dentists currently represent 16% of the total active MPAP participant caseload. Historically, MPAP has received proportionate funding commensurate with percentage of participant caseload from the Board of Dentistry and the Board of Medical Examiners, through special apportionment on professional license fees that are administered by the Department of Labor and Industry.
MPAP has been involved in community education and outreach directed toward better informing dentist and auxiliary support populations throughout Montana. MPAP staff have attended state conferences of the Montana Dental Association and Montana Dental Hygienists Association and American Dental Association Conference on Dentist Well-Being.
Helping dentists with conditions of impairment represents a special challenge to MPAP primarily because of the circumstances surrounding the structure of private dental practice, which is the norm here in Montana. In many respects, private dental practices represent freestanding, independent healthcare facilities for the care and treatment of dental patients. Most of the dentists who have been referred to MPAP over the years have been in private practice, without the benefit of a group or practice partners. Consequently, addressing the question of obtaining practice coverage for dentists who are referred to the MPAP and require treatment always has been a major concern during the intervention and referral phase.
In many instances, members of the local dental society have stepped in to provide seamless essential care to the patients of their colleague while the participant was away in treatment. Dental support staff has been creative in rescheduling patients to provide essential care while the doctor was away. In other cases, a colleague in another practice has seen patients on an emergency basis. Yet another way that practice coverage has been provided while a dentist was away at treatment was through identification of a locum tenens dentist.
Office staff play a key role in the continued operation of the dental practice while the solo-practice dentist is away at treatment. MPAP educates dental staff regarding the diseases of impairment, and provides ongoing reassurance of progress in treatment, on a need-to-know basis, particularly as the participant approaches discharge and reintegration, and suggests neutral to positive responses to patient inquiries.
Once a dentist has agreed to comply with a recommendation for evaluation and treatment, if necessary, he or she or their designated representative is encouraged to review insurance policies, including practice overhead policy, long-term disability policy, and health insurance policy, to determine the extent of any financial benefits they may be entitled to while the doctor is in treatment.
Another potential obstacle to treatment for an impaired dentist is professional and financial dependence of staff on the solo-practitioner. Experience of MPAP suggests that dental office and support staff often are reluctant to report suspected impairment for fear that they may lose their job. Available data does not support this contention, as 20 of 23 dentists continued their privilege to practice following participation in the MPAP.
Because of the insular environment that surrounds a dentist in private practice, referral of the impaired dentist often comes during the later stages of addiction. Frequently, negative personality traits have become operational and require special attention. These traits may include narcissism, avoidant personality, severe depression, and suicidal ideation. The impaired dentist often feels trapped by the circumstances surrounding the dentist's apparent business failure, and the fact that so many people are depending on the dentist for their livelihood. There is a tendency to seek to soften referral criteria for dentists in need of treatment for chemical dependence. In the experience of MPAP, significant deviation from the standard of care often results in a sub-optimal outcome.
The MPAP is funded through special apportionment on Montana physician and dentist license fees via contracts with the Montana Board of Medical Examiners and the Board of Dentistry. Participant fees have been increased to keep pace with monitoring costs. Peer review protection for MPAP records involving physicians was passed by the 2007 Montana Legislature effective October 1, 2007. MPAP encourages development of these protections for dentists as well.
All donations to the MPAP, which is a 501(c)(3) private non-profit corporation, are tax deductible. In 2006, the program received gifts from ten private individuals for operations and scholarships totaling $5,861.27. Current fundraising account balance is $8,396.98. These monies may be used for evaluation or treatment loans or scholarships for financially bereft colleagues.
Current MPAP Board Members include James Hoag, DDS of Kalispell (President); Randy Johnson, DDS of Victor (Immediate Past-President); Erik Bodtker, M.D. of Bozeman; Robert Caldwell, M.D. of Helena; Richard Moore, M.D. of Sandpoint, Idaho; Ron Hull, M.D. of Helena; Earl Book, M.D. of Helena; James Willis, DDS of Polson; Karen Foster, MBA of Whitefish; and Brian Priest, M.D. of Lewistown. Please contact any of these colleagues if you have suggestions, comments, or questions regarding the MPAP.
MPAP welcomes the opportunity to present information regarding our program to all interested parties. Our dedicated staff remains committed to providing respectful, caring, and effective integrated services to program participants and new referrals. David G. Healow, M.D. serves as Medical Director. Michael J. Ramirez, M.S., CRC continues to serve as clinical coordinator. Mellani Essex is our new administrative assistant. We remain available to discuss common concerns from our office in Billings at 1650 Avenue D, Suite #102, or please feel free to contact us at 245-4300 or 800-697-9349. You also may contact us via e-mail @ firstname.lastname@example.org or visit our website @ montanaprofessionalassistance.com.
Montana Dental Association
38 South Last Chance Gulch, Ste. 205
P.O. Box 1154
Helena, Montana 59624
800-257-4988 (In Montana only)
406-443-2061 (in the Helena area)