The following information serves as a resource for providers treating patients in the Iowa Physician Health Program. The following roles may exist within an IPHP participant’s treatment.
Provider Roles
The monitoring physician regularly assesses IPHP participants with a mental health or substance use diagnosis in a face-to-face setting. The monitoring physician’s responsibilities with the IPHP are to report quarterly on the attendance and productivity of sessions with the participant and recommend any necessary changes in treatment or medication, as well as provide a statement that the participant is stable to practice medicine, if this is the case. If the monitoring physician judges that the participant needs to take medical leave or be reevaluated, this should be communicated to IPHP staff.
If the participant has a mental health diagnosis, the monitoring physician is expected to provide an opinion on their psychiatric stability. If the participant has a physical health diagnosis, the monitoring physician should report to the IPHP on the nature of the impairment, whether it’s treatable, and what accommodations may be needed for the participant to continue practicing medicine safely.
The therapist is expected to report quarterly on the participant's attendance in sessions and the productivity of the meetings. The therapist should report any recommendations for treatment changes or medication adjustments to the IPHP, and confirm that the participant is stable to practice medicine, if that’s the case. The therapist is also responsible for communicating the participant’s need for medical leave or reevaluation to the IPHP, if needed. Reports from the therapist can exclude details from psychotherapy sessions unless the therapist believes the information is vital to management of the case, in which case the therapist should discuss this with their patient before they include it in their reports. Therapists are also encouraged to communicate with the participant’s monitoring physicians if they have concerns about the participant’s wellbeing.
The aftercare provider’s role is to assess and report on the participant’s participation and progress in treatment, as well as progress in group and individual sessions (if applicable). They will also report quarterly on the participant’s prognosis and compliance with their contract, including the attendance and productivity of sessions. The aftercare provider is responsible for making recommendations for changes in treatment, providing a statement of stability to practice medicine if applicable, and noting a need for medical leave or reevaluation of the participant, if necessary.
A worksite monitor is a designated individual, present in the participant’s workplace, that will monitor and report on the participant’s performance at work, including punctuality, professional demeanor, etc. These evaluations will not be based specifically on the participant’s illness or competency, but instead their performance and demeanor at work. Worksite monitors are responsible for reporting any inappropriate behavior, questionable medical practices, or inappropriate workplace conduct they notice in the participant. If the monitor has any concerns about the participant’s ability to safely and skillfully practice medicine, this should be reported to IPHP staff.
How Providers and IPHP Staff Work Together
The many roles included in a participant’s recovery all exist to give the participant the best chance at success. In addition to serving in the roles listed above, providers will also submit quarterly reports to the IPHP so our staff can monitor the participant’s progress and identify any areas of concern.
IPHP staff doesn’t typically reach out to providers unless necessary. If you need assistance from IPHP staff at any point, please do not hesitate to reach out to us. We’re available to discuss any concerns you have about the participant for whom you’re providing care.
Providers for participants in the IPHP are asked to submit quarterly reporting forms.
How to Help an Impaired Patient Who is Not in the IPHP
If you’re a physician or therapist working with a physician-patient that you know or believe may be impaired, there are ways you can help. As a medical provider in a physician-patient relationship, you are excluded from the Board’s mandatory reporting requirements, but you can encourage them to reach out for help and self-report. Let them know that the IPHP can help them before their safety to practice medicine is compromised. Direct them to this website as a tool they can use to learn about our program and self-report when they’re ready.
