Sunday, Dec. 11, 2005 | 7:34 a.m.
Dr. Kurt Buzard had a chance to clean up his act -- but was it a fair chance?
The Las Vegas ophthalmologist, who has been under investigation by the state medical board since he was arrested for cocaine possession two years ago, was offered a way to get help and preserve his career: a special program that works exclusively with physicians struggling with addiction.
Instead, Buzard sued the program, saying it was marred by bias and conflicts of interest.
According to a suit filed in District Court in September, the program insisted on portraying Buzard as a drug addict when he wasn't, damaging the doctor's reputation in the process.
Whether cases such as Buzard's are legitimate challenges to a flawed system or cynical attempts to sabotage an important public service -- that is the issue the embattled but little-known physician-treatment program faces.
To Buzard's attorney, it's about time the drug diversion program's assumptions were questioned.
"According to the program, if a physician says they don't have a problem, they must be in denial; if they say yes, they need treatment," lawyer Tony Sgro said. "No physician can ever be assessed as anything but having a problem."
But the addiction program's director says lawsuits such as Buzard's are threatening to derail a needed source of help.
"We are trying to help physicians and preserve their careers while at the same time protecting public health," said Dr. Peter Mansky, a psychiatrist and expert on addiction medicine who heads the Nevada Health Professionals Assistance Foundation.
"These lawsuits are saying our program's no good, but (programs such as ours) have years of success and studies to show that they work," Mansky said.
Buzard's suit is one of four pending against Mansky's foundation, an independent charity that contracts with the Nevada's medical licensing boards. Mansky says such lawsuits threaten to put the foundation out of business.
Most states have a group similar to the Nevada foundation. They were designed in the late 1970s and early 1980s in recognition of the widespread, dangerous and unique nature of doctors' addictions.
Doctors' rates of addiction to alcohol and drugs are about the same as those of the general population. But experts say several factors distinguish addicted doctors from other addicts -- most notably, an impaired physician's actions potentially endangers patients.
"The misuse of drugs and alcohol by physicians is compounded by their critical role as caregivers," Dr. Stephen Ross, a psychiatrist at the New York University School of Medicine, wrote in an American Medical Association brief on physician impairment.
In addition, the high pressure that doctors commonly face may make them susceptible to substance abuse, Ross notes, and they have easy access to potentially addicting prescription narcotics.
Alcohol is the substance most commonly abused by doctors, followed by opiates and cocaine, experts say.
Once physicians become addicted, they may have a harder time than others admitting they need help. Their intelligence may help them mask and rationalize their sickness for long periods of time, while their lofty professional status may make it hard for them to humble themselves, experts say.
"Physicians are clever people," Mansky said. "Their illness is centered around keeping up a front, not letting people know they're using, not allowing people to help them."
Because of these characteristics, physicians with addictions need specialized programs, Mansky said. The Nevada foundation was formed to direct physicians to such programs.
The foundation also sponsors a support group for recovering doctors, the Caduceus Group, with meetings in Reno and Las Vegas. The foundation monitors physicians in recovery to make sure they're clean when they resume practicing medicine.
The foundation currently is following the cases of 101 Nevada physicians, Mansky said.
Doctors who work with the foundation to address their addictions can avoid having their medical licenses taken away. This is thought to be the best way to protect the public, Mansky said.
"The (Federal Aviation Administration) had a policy of immediate removal of pilots caught using drugs, but what they found was that led to pilots concealing their addiction for as long as possible," Mansky said.
When the policy was changed to allow pilots to come forward and get treatment without punishment, the number of takeoff and landing incidents attributed to addiction problems dropped dramatically, Mansky said. The same is true of doctors, he said: Treatment is more effective than punishment.
But according to Buzard's lawsuit, Buzard was not an addict at all.
In August 2003, police stopped Buzard's car for a traffic violation. According to police, Buzard was wearing only underwear, a sheet and a dog collar, and was clearly intoxicated.
About 2.6 grams of cocaine were found in the car, according to police.
Buzard pleaded no contest to a misdemeanor drug possession charge to resolve the case, but the drugs were not his, according to the lawsuit.
The doctor "neither knew of or owned" the "minute amount of contraband" found in the car, the lawsuit states. But because he was the car's legal owner, he had little hope of proving his innocence, so he took the plea.
It was not the first time that Buzard was caught with illegal drugs. In 1985 he was arrested for cocaine possession in Colorado; the charge was dismissed after he went through treatment and performed community service.
After his 2003 arrest, Buzard's Nevada medical license was in jeopardy. The Board of Medical Examiners referred him to the assistance foundation.
To avoid having his medical license suspended, Buzard agreed to undergo examinations at an Atlanta drug-treatment center.
Two of the evaluations he underwent "contained false and defamatory statements and misquoted Dr. Buzard to perpetuate a false assessment of dependence," while another noted "no diagnosis of chemical dependence based on information from the patient," according to the lawsuit.
The lawsuit also cites independent assessments sought by Buzard that allegedly did not find him to have a substance-abuse problem. The lawsuit accuses the foundation, Mansky, the Georgia treatment center, the state medical board members and others of negligence, defamation and breach of contract, and seeks more than $40,000 in damages.
Because Buzard did not complete his mandated treatment, his license is again at risk. His case will come before the board at a hearing yet to be scheduled, according to the board's executive director, Tony Clark.
In the meantime, Buzard continues to practice at his Buzard Eye Institute in Las Vegas. He declined comment for this story.
There are three major problems with the way the foundation operates, Sgro said. First, it presumes all physicians it sees are addicts and has no diagnosis that does not include a drug problem. Second, the foundation refers doctors to the same facilities for both evaluation and treatment, giving the facilities a financial incentive to find that expensive, long-term treatment -- a six-week stay can cost $50,000 -- is required.
Finally, former foundation employees have gone to work for those same treatment facilities and vice versa, creating an incestuous revolving door, he said.
Sgro also is the attorney in two other cases of doctors suing the assistance foundation. Las Vegas anesthesiologist Dr. Karen Giarrusso entered the drug-diversion program as a condition of Nevada licensure in 2003 because she had been convicted of drunken driving in California a year before.
Giarrusso's license was suspended when she allegedly stopped complying with drug testing, but it was reinstated after a hearing before the medical board.
Henderson dentist Dr. Daniel Sims also claims the foundation mistreated him. Sims alleges a broad conspiracy whereby drug-treatment centers bilked well-to-do medical professionals by subjecting them to unnecessary assessments and treatment under threat of license revocation.
The three suits all point to the same problems with the assistance foundation, Sgro says.
"I'm not saying we don't need a program like this to monitor people," Sgro said. "Physicians, like anybody else, sometimes need help, and the public needs to be protected. But in practice, it's an amazing racket."
Mansky, an expert in physician addiction who previously headed New York's physician health program, said he could not address specific allegations in the various lawsuits.
But in general, such lawsuits are merely symptoms of addicts' denial, he said. Rather than face their illness squarely, these doctors are looking to kill the messenger.
"It's their choice," Mansky said. "If they follow our health and wellness orientation, they'll do OK. If they think it's the wrong approach, they can fight it legally. But we know our approach works."
What the foundation needs is a change in Nevada law that would protect it from liability in such matters, Mansky said. Many other states have such protection. For example, Kentucky, which has one of the nation's most respected programs, enacted a law protecting its physicians' health foundation in 1994.
The protection was necessary for the foundation to operate, said its medical director, Dr. Burns Brady.
"We needed that statute to prevent us from being the subject of inappropriate potshots," he said.
Brady cited the example of a doctor who was referred to the program recently when he came to the hospital where he worked with alcohol on his breath. Sent to treatment, the doctor left the program because he did not believe he had a drinking problem, even though it was obvious to everyone else.
Without the protective statute, that doctor might be able to sue the program and keep practicing, possibly harming his patients at the hospital, Brady said.
"We have to be able to do our job," Brady said.
Mansky said Nevada must enact similar legislation.
"All we want is that protection so we can help guide physicians to treatment," Mansky said.
Molly Ball can be reached at 259-8814 or at [email protected].
archive
