How Does the Medical Board of California Handle Doctors with Alleged Drug Issues?
The Nursing Board of California has a drug treatment program that is imperfect but it works. The medical board is authorized to have a program but they can't figure out where to draw the line. The line is simple. On one side physicians get treatment without fear of losing their license. On the other side there are license implications but not a severe as if the doctor did not participate in the program. Currently, most doctors hide and deny their addiction. This is normal for people with problems but almost all persons with drug or alcohol issues have moments and even days where they want help - if only help were available and for doctors if only their license was not put at risk. We strongly urge the board to have a non-punitive, protected program for doctors.
The Problem (with a capital P) is that drug issues become public. Here is an example 100% drawn from public records. But first let's look at how the State of California has failed its doctors.
Unlike most states, California lacks a dedicated, confidential "physician health program" (PHP) for early intervention and recovery. Other health professions, such as nurses, pharmacists, and dentists, have access to monitored recovery programs that prioritize treatment over immediate discipline. For physicians, the Medical Board of California (MBC) handles SUD primarily through public disciplinary actions, including probation, license suspension, or revocation.
Public discipline scares addicted doctors but it does not stop the addiction. Searching for help is difficult. Some doctors swear by the PACE program in San Diego. We have seen the State of Washington refer doctors to out of state clinics that this writer (Daniel Horowitz) was a madhouse out of the movie Bedlam. It is not easy to get truly competent treatment.
Meanwhile some hospitals have taken a non-punitive approach out of compassion and wisdom but it is tough path. Recently a physician passed out at the hospital and the sad part of this case is that all reports are that she was a tremendously caring and skilled doctor. The hospital gave her a chance and we hope she succeeds but it simply a fact that a certain number of doctors are going to have issues. Our choice is also simply a fact that with non-punitive programs we can 100% save most of those doctors.
Instead, California ignores the issue. Few doctors get treatment and few get prosecuted. Patients and the addicted doctors suffer needlessly.
As of late 2024, only about 141 physicians were on probation for substance abuse— a number experts consider low given the state's large physician population, suggesting many cases go unreported. Doctors fear stigma, mandatory reporting to the MBC, and career-ending consequences, leading some to hide issues until they impair patient care or result in criminal charges.
The MBC's old "Diversion Program," shut down in 2008 after audits revealed inadequate monitoring and patient harm, has left a legacy of distrust. Recent efforts, including proposed legislation in 2025 (such as AB 408), aim to create a new confidential recovery program to encourage early help-seeking while protecting patients. Advocates argue confidentiality is key to destigmatizing addiction as a treatable illness, but patient safety groups worry it could shield impaired doctors.
Pathways to Recovery and Reform
When SUD is identified, the MBC imposes rigorous conditions: random drug testing, worksite monitoring, biological fluid testing, and mandatory treatment. These "Uniform Standards" aim to rehabilitate while protecting the public, but critics say the process is "blunt" and punitive, delaying recovery.
Experts like addiction specialist Greg Skipper at the Center for Professional Recovery, emphasize that early, confidential intervention—proven effective in other states—could prevent impairment. California's planned 2025 push for a new program reflects growing recognition that supporting physicians benefits patients by maintaining a healthy workforce.
A Call for Balance
Substance use among California's doctors is a complex interplay of professional pressures, access to drugs, and systemic gaps. Addressing it requires balancing public safety with compassionate support. As the MBC moves toward reform, the goal should be a system where physicians can seek help without fear—ensuring they remain capable healers, not hidden victims of the very crises they treat.
If You Need a Lawyer
Daniel Horowitz is a highly experienced medical doctor attorney. If you are facing a medical board investigation or any type of license action, contact our office for expert assistance. Call for an initial appointment at (925) 283-1863
