It is almost impossible to keep these people from working. I have seen Hospitals renew prevledges when it is known that a Doc has serious issues. The concern is that the hospital will get sued for not allowing the doctor to work at their institution without "due process".

This is a real problem. What implimentation of "iron fist" would/could be used Jason?

An additional problem is that the harder the penalties, the more the offenders are tempted to not seek help and recognize their problem.

That said, the failure for medical systems to treat patient safety as the prime directive (remember "first do no harm") underlines that profit and power structure are the main forces driving them.

The ease with which physicians have access to addictive medications without careful monitoring has been addressed somewhat but not completely.

When physicians are subject to random UDS screens as a requirement for licensure is when there might be a better handle on the problem.

When physician health care is a specialty, health screening with mandatory health certificates (much as we do for Airline Pilots, Commercial Truck Drivers, etc.) a part of obtaining and renewing a license, AND an established system for managing provider substance abuse that crosses state lines, then you have a chance of better managing physician impairment.

Norway has the best program, other countries such as UK, Australia have less robust programs.

I agree with you epador, but unfortunately most physicians would probably not agree with us.

Monitored Aftercare Programs work only after physicians have been caught/committed an error and only if they are truly MONITORED.

I wonder if the urine drug screen would be an un-necessary search and lawsuits abound. Some of the people I have known during my career would certainly not pass the UDS test.

That is what the Airline Pilots said before their program was established through the FAA. That's what its gonna take.

Oh look the AMA snakes are very very venomous