A power struggle that pitted a state agency against the Colorado Medical Board was finally resolved this week after more than a year of tension.
At issue was the state’s contract with a peer counseling organization that for more than 30 years has helped doctors who struggle with depression, burnout, alcohol and drug abuse, physical conditions that affected their work and misbehavior.
The Colorado Department of Regulatory Agencies last summer attempted to yank the contract from the Colorado Physician Health Program and award it to Peer Assistance Services, which is a counseling service for nurses. But the state agency left the medical board out of the conversation and set off a year of controversy and turmoil.
The bureaucratic drama included hundreds of letters sent by doctors and medical students to Gov. Jared Polis’ office, plus a tearful medical board meeting where the board president recused himself after questions over his neutrality.
In November, an administrative law judge determined that the state Department of Regulatory Agencies did not have legal authority to select a new counseling provider. It’s the medical board, according to Colorado law, that is authorized to choose the peer health group that provides counseling, evaluations and other support to physicians across the state.
The decision meant that the contract process began again, this time involving the medical board. And this week, the board voted to recommend that the state award the contract to Colorado’s long-term provider, the Physician Health Program.
The decision isn’t official until the Department of Regulatory Agencies sends a notice of its intent to award the contract, but a DORA spokeswoman said the notice is expected “in the coming business days.”
Throughout the whole ordeal, doctors have continued using the Physician Health Program. The contract was set to expire last November but was extended because of the appeals process that included multiple hearings.
At times, the battle between the state agency and the board it oversees was intense.
In December, the state Attorney General’s Office — which represented the Department of Regulatory Agencies during the appeals process — told the medical board that its president, Dr. Donald Lefkowits, should recuse himself from any further discussion on the contract. A deputy attorney general showed the board emails that Lefkowits had written to medical organizations that the attorney said proved that Lefkowits was working behind the scenes to discredit competitor Peer Assistance Services and show preference to the long-time contractor.
During a medical board meeting filled with tears and emotion from multiple board members, Lefkowits agreed to recuse himself.
Lefkowits, a retired emergency department physician who spent 40 years at Rose Medical Center, said last year that he found out about the contract change last summer via email, leaving him “puzzled and distressed.”
The board then set up two committees — one to review confidentiality rules regarding the peer counseling program and the other to make a recommendation on which of the two programs should get the contract.
Doctors’ objections to last summer’s contract switch centered on the fact that physicians throughout the state trust the counseling program. They wanted to continue to get help from peers — psychiatrists — and not from a group that counsels nurses. Also, physicians feared they would lose the protection of confidentiality.
Since 2018, the Department of Regulatory Agencies had been at odds with the long-time contractor regarding confidentiality. That year, when the Physician Health Program was the sole bidder for the contract, the state agency termed the health program “nonresponsive” because it refused to comply with a requirement that “all client records would become the state’s property and all program participants would be mandated to sign a release of information to the board,” according to a letter to DORA from the health program’s attorney.
The now-dead agreement that the state wrote last summer would have required doctors to sign a release of information to the state medical board even when they seek help voluntarily. It was a change from the long-time contract, which said doctors who go to the Physician Health Program on their own accord will not be reported to the medical board unless there is serious risk of harm to a patient.
The Colorado Physician Health Program, which formed in 1986, has evaluated more than 5,600 doctors for problems ranging from overwhelming sadness over the death of a patient, to the first tremors of Parkinson’s disease, to alcohol abuse that led to inappropriate sexual advances toward a colleague or patient.
About 25% of the physicians who walk into the Denver office are either ordered to do so by the Colorado Medical Board, based on complaints brought to the board, or required to go by their hospital or office supervisor.
The doctors’ medical and mental health issues are kept in confidence if they sought help on their own, and are not reported to the board unless they rise to the level of putting patients in danger. The goal is that doctors will seek treatment before they’ve caused harm and without fear that the board will suspend or revoke their licenses and tarnish their careers.
The program is funded by medical license fees collected by the state.