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MEDICAL YEAR
IN REVIEW

Update on the Bexar County Medical
Society’s Physician Health and

Rehabilitation Program

By Neal Gray, MD and Danielle Moody

The Physician Health and Rehabilitation Program (PH&R) started Relapse is common among physicians, but can be prevented by fol-
in the 1970s. In the beginning, the program would occasionally inter- lowing the actions outlined in the program’s contract. The five-year
view a physician accused of being intoxicated, but there were few reso- contract was derived to focus on relapse prevention with the objective
lutions. In 1982, Dr. Neal Gray recognized the need and went to a of making sick doctors well, not bad doctors good. It was also created
number of courses at the American Medical Association, partnering to make sure doctors could have access to rehab and be able to get back
with other doctors around the country to create a program for physi- to work. It gives a progress report on the physician, discussing whether
cians. The goal was to return physicians to the safe practice of medicine or not they are in compliance with the contract. Many cases need letters
and to the active privileges at their respective hospitals. of compliance to hospitals written regularly, which BCMS staff assists
In 1983, Dr. Gray volunteered himself to join the Impaired Physi- with. Each physician signs the contract along with the PH&R com-
cians Committee and shortly after became Chairman. He worked with mittee under these guidelines:
staff from across the country to devise a contract for the program. It 1. No usage of alcohol or drugs of issue,
was found that another physician could intervene in the disease pro- 2. Have a primary physician who understands their situation,
gression, and treatment could be offered to physicians for assistance. 3. Attend AA meetings,
The program was a new concept for the state board. The team was 4. Have urine, blood or drug testing frequently,
seeing an average of five to ten patients a month. Dr. Gray explained 5. Work with hospitals and clinics to satisfy working mandates,
that one out of eight physicians struggle with alcoholism. Doctors in 6. Align with the Texas Physician Health Program.
the program struggle with the misuse of alcohol, drugs and opiates. The
physicians who get started on opiates get sick very fast and, in some The PH&R program has been successful in providing assistance to
cases, have died. the physicians in need, and the future of the program is bright. Dr. Gray
The program continued and changed very little since the early days. explained that the program will continue to do the same thing they
It gained enough success that the cities of Austin, Dallas and Houston have been doing for several decades. Physicians can come to the PH&R
started creating similar programs. The state of Texas eventually took Committee; they will respect their confidentiality and will do their
the program and made it into their Texas Physician Health Program. very best to return the physicians to their families and to the active and
Dr. Gray mentioned that most of the PH&R program’s patients have safe practice of medicine.
come from Bexar County, but they have also taken patients from all
over South Texas, including Austin. The program has never turned any- Neal Gray, MD is a retired board-certified Anesthesiolo-
one away, nor has it ever charged a fee. gist and Addictionologist. Dr. Gray was the 1992 President
The process begins with a referral from a family member or hospital of the Bexar County Medical Society and received the
staff to stage an intervention for the physician. Two or three members Golden Aesculapius Award in 2018. He is a life member of the Bexar
from the committee meet with the physician and explain the program County Medical Society.
to them in order to help them get sober. The PH&R program has been
very successful in doing this, now hundreds of times. The Bexar County Danielle Moody is the Editor of San Antonio Medicine.
Medical Society (BCMS) hosts PH&R meetings every month, with
members from a wide variety of specialties. The BCMS patient’s coor-
dinator often receives a phone call from somebody that needs help and
then they are referred to the program. The BCMS provides the meeting
space for the committee and a meeting space for Caduceus which is an
organization composed of recovering physicians.

22 SAN ANTONIO MEDICINE • December 2021