Dr. Beth Venit joins Dr. Andy Roark to discuss some of the laws and regulations surrounding licensed professionals facing mental health and substance use disorders. They explore how these regulations can often become barriers to seeking the necessary help. Dr. Beth Venit dives into the intricacies of the recently enacted model regulation known as Safe Haven. This innovative program is specifically crafted to assist licensees in seeking support while maintaining their ability to continue working.
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
Federation of State Physician Health Programs, Inc. (FSPHP)
Model Regulations – Safe Haven Program (Download)
LinkedIn: Beth Venit VMD, MPH, DACVPM
Uncharted Veterinary Conference 2023
Dr. Andy Roark Charming the Angry Client Team Training Course
ABOUT OUR GUEST
Dr. Beth Venit VMD is a graduate from the University of Pennsylvania’s School of Veterinary Medicine, Class of 2007. Throughout the area of Washington, DC, she practiced small animal medicine, both ER and GP, as both a full-time associate and a relief veterinarian for the next 12 years. In that time, she earned her Masters of Public Health from the University of Iowa and became a Diplomate in the American College of Veterinary Preventive Medicine. She then worked at the US Department of State, first as a fellow with the American Association for the Advancement of Science, and then as a full-time project manager focused on training foreign partners on biorisk management and the prevention of bioterrorism. In 2022, she joined the American Association for Veterinary State Boards as their first Chief Veterinary Officer.
In her free time, she enjoys hiking in various parts of the world with her husband (past trips include hiking the Grand Canyon Rim to Rim, the Inca Trail to Machu Picchu, several 14ers in Colorado, and a successful summit of Kilimanjaro), and being lazy on the couch with her pittie mix, Eleanor Woofsevelt and maine coon/tiger mix, The Chairman Meow.
EPISODE TRANSCRIPT
Dr. Andy Roark: Welcome everybody to the Cone of Shame Veterinary Podcast. I’m your host, Dr. Andy Roark. Guys, I am here with my friend, Dr. Beth Venit. Beth is the Chief Veterinary Officer at the American Association of Veterinary State Boards. I’ve had her on the podcast before talking about what really happens if and when you have a complaint against your license and she walked me through that and she was wonderful.
She’s got a new program that she’s working on, it’s, called the the AAVSB Safe Haven Program. And she’s working on it with a, group of people in the organization, but it’s all about reporting when doctors or licensed technicians go into substance abuse programs or mental health and wellness programs and things like that.
And Beth and I get all up into what this means and how this works, and then we talk a lot about the Safe Haven Program, which is basically allowing doctors [00:01:00] and licensed technicians to remain anonymous as opposed to being automatically reported to the vet state board if they seek treatment, which is how it has been in a lot of states in the past.
There’s a lot of stuff that I wasn’t really aware of as far as the regulations that are out there. I left the conversation feeling pretty optimistic but also still feeling like we have a little ways to go.
This is an issue that I care a lot about. This is a really good resources from Beth. I hope you guys will like this. I hope you’ll enjoy it.
It will give you something to think about and at least you’ll be up to speed on things to know. If you need to help someone who is in our profession and has a mental health or a substance abuse issue that is going to need some significant treatment. What does that really mean? And how do you protect yourself? And, what do you need to be aware of? That’s mostly it. So anyway, that’s it for me. Let’s get into this episode.
Kelsey Beth Carpenter: (singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark: Welcome to the podcast, Dr. Beth Venit, how are you?
Dr. Beth Venit: I’m good. How are you Andy?
Dr. Andy Roark: I am great. It’s wonderful to have you back on the program. For those who do not know you, you are a veterinarian. You are the chief veterinary officer at the American Association of Veterinary State Boards. You have a master’s in public health.
You went to vet school at Penn. You are a lovely and wonderful person who I have gotten to know in just the last year and I really enjoy you. You came on and talked to me about what the process was if you have to deal with a state board complaint and you’re a doctor and I just so enjoyed it.
You have a passion project that you’ve been working on recently that I wanted to bring you on. It’s something that you’ve been working on and really taking the lead on at AAVSB. And it’s called the Safe Haven Program. Why don’t you just lay out at a high level, kind of, what is that?
Dr. Beth Venit: So the safe haven program is actually, it’s a model regulation that we wrote. So we write at AAVSB we create programs to help licensees [00:03:00] maintain their license, but we also work with our regulatory member boards to create resources to help them consider new ways of doing things better. And this safe haven program is meant to let licensees, both veterinarians and veterinary technicians, who are suffering from a substance use disorder or mental health illness to, it’s geared to reduce the stigma of getting treatment sooner. Because, the idea of if you can get treated sooner then, overall, you’re more successful to become healthy, a healthier individual.
But really it’s just to support the licensee and to help the regulatory boards help the licensee through that process.
Dr. Andy Roark: I want you to talk for a little bit more about what you mean about reduce the stigma of getting treated sooner. Can you lay out the landmines or the difficulties from a licensing perspective for people who are dealing with substance abuse issues or mental health?
Dr. Beth Venit: First of all, there’s a [00:04:00] social stigma, you think it, nope, it’s hard to admit that you have a problem and then, as people have noted, it’s hard to go into treatment. There’s a social stigma of getting, going into treatment, which I think in, we’re, as a society, we’re moving away from that stigma.
We’re embracing mental health a little bit more. We’re embracing substance use disorders more. So I think that’s hopefully decreasing specific to licensees, veterinarians and veterinary technicians and also doctors, nurses. So this, problem isn’t isolated to veterinarians.
It’s for a lot of the health physicians or health professionals. When you go into, for a lot of jurisdictions, and I have to say everything I say… it all depends on the jurisdiction. So if you have questions about your jurisdiction ask, research because every jurisdiction is different in a lot of jurisdictions if you’re a health provider of any sort and you go into… you either self refer so if you [00:05:00] self refer into a physicians health program, which I’ll talk about in a little bit in a second.
So if you go into treatment for a substance use disorder or a mental illness treatment program, the board must be notified of your activity. The that can cause stress or concern on the part of the licensee that if their activity or they’re going into treatment program is reported to the board that the board will suspend their license.
So the Safe Haven idea is that if you go into a treatment program, even if there is a requirement for reporting that reporting requirement could be fulfilled if you are just reported to the Physician’s Health Program instead of to the board. So, the board will receive a notification that one of their licensees is in a program, but it is anonymized.
Dr. Andy Roark: Okay.
Dr. Beth Venit: If, and that’s the big caveat is, if the licensee continues their path towards [00:06:00] recovery. So if they relapse or, don’t abide by the treatment or monitoring requirements, then the board will be notified that there is a concern.
Dr. Andy Roark: Gotcha. Okay.
Dr. Beth Venit: And we can kind of dig into this more if you want, because it’s really complicated.
Dr. Andy Roark: I want to start, with a good understanding of the basics. So you’re saying that if there was a veterinary or a licensed technician out there who needed to be who needed to be checked in for a rehabilitation program, that they’re obligated to let the state board know, “Hey, I’m seeking treatment for substance abuse issues” Is that an obligation on them? And, the idea has been if they don’t self report that I’m seeking treatment, that’s been problematic in the past.
Dr. Beth Venit: So there’s two different ways that a licensee can enter into these treatment programs. The first one is through a disciplinary process, in which case the board knows,
Dr. Andy Roark: Sure. Of course. I get that. Yeah, I get that.
Dr. Beth Venit: The second way is the self referral. The licensee will refer themselves to the treatment programs. It is on the part of the [00:07:00] treatment programs to report the licensee’s activity to the board. It’s not the licensee who reports it. It would be the treatment program.
Dr. Andy Roark: And, they were generally required to let the board know that, “Hey, this person who’s a veterinarian has checked into our program.”
Dr. Beth Venit: By law.
Dr. Andy Roark: Wow!
Dr. Beth Venit: In a lot of jurisdictions. So some, but not all.
Dr. Andy Roark: Yep. Okay.
Dr. Beth Venit: And this, pertains to physicians or pertains to nurses because that they are in a sensitive, what do they call it? Safety sensitive worker. So if, they are, suffering from substance use disorder or mental health issue that can become a public protection issue.
And in order to protect the public that activity will need to be reported.
Dr. Andy Roark: That’s gotta be a barrier to people seeking, if you, I mean, it, this, to add to the problems you’d be having that, would bring you to, starting a program for substance abuse or for mental health and wellness and to men like, oh, if I go here, they’re going to let the state [00:08:00] board know, ah, that’s awful.
I get it.
Dr. Beth Venit: So that’s exactly right. So the Safe Haven program that we developed and I’m going to say, I’m going to say we call it Safe Haven program. It’s developed from Ohio. So they kind of developed the Safe Haven program and that’s their model that I plagiarized. Directly but other jurisdictions, already have this kind of baked into the process.
So, many jurisdictions, they don’t report to the board, they consider the requirement for reporting obligated if they report directly to the Physician’s Health Program. Okay, so the board doesn’t know. What the board will receive is anonymized patient, XYZ and they’ll receive, a lot of boards will receive like a green, yellow, or red status of a licensee.
So they’ll say licensee one, two, three, four, five is in green status, and they’ll, and then that means that they’re doing well. That’s what the [00:09:00] board hears a lot in these instances where it is anonymized. In those instances, the board is only notified if the licensee violates the term of the agreements of the treatment program.
And that means, they fail a drug or alcohol test, they don’t show up for randomized testing, they have an active relapse. So those are instances where the licensee, is no longer on the path to recovery and will then, may potentially pose a risk to the public as a result of their disease.
The board only needs to know if there’s an actual public protection problem.
Dr. Andy Roark: That makes sense.
Dr. Beth Venit: So those are instances where the licensee, is no longer on the path to recovery and will then, may potentially pose a risk to the public as a result of their disease.
The board only needs to know if there’s an actual public protection problem.
Dr. Andy Roark: That makes sense.
What does the, doctor or [00:10:00] the technician need to know for their part? Does this all kind of run in the background at this point? Is it something that you need to be aware of? If someone was saying, I’ve been struggling with depression and, may need to be hospitalized.
Is this something that I need to be aware of? Or is this going to be taken care of without me even, having to, engage?
Dr. Beth Venit: This is the beauty of the physician’s health program. So in other jurisdictions, it’s called many different things: health professionals recovery program, health care professionals foundation, peer assistance program, professional assistance program sometimes these are run through the VMA, sometimes these are run through the board, so , it’s all called different things, but essentially they’re physician’s health programs.
So what these programs do, they have four tenets, and I can share them with you. They support the early detection, evaluation, and treatment of impairing conditions. So substance use disorder, mental illness. physician’s health programs oppose discrimination based on a history of an impairing condition.
They promote the [00:11:00] use of supportive services rather than disciplinary action. So they get the licensee help and only if they are not able to use that help, are they disciplined and only until that they are able to practice safely again. And then the PhD supports the maintenance of the confidential relationship between the PHP and the participants.
And that’s something that we were just talking about. what the PHP does is if a licensee self refers into this, they say, “You know what, I think I have a problem. I think I need help. I don’t know what that is.” The PHP, which is staffed by mental health physicians, substance use order experts, like these are the experts, to help people get the help they need. They will evaluate the licensee, determine how severe this disease is. Determine, oh, you might need to be hospitalized. You can, you, maybe you just need outpatient. Maybe we can just get you into a 12 step program. They kind of are a concierge.
To help [00:12:00] the licensee get the help they need. So do they need a psychiatrist? Do they need medication? Do they need actual hospitalization? So they help. Kind of, get them where they need to go, and they answer questions like this. If you’re a licensee and you say, and you’re thinking to yourself, “gosh, I think I may have a problem, but I’m not sure.”
You can call them and say, “What is the process? Do you report? Is it mandatory reporting to my board? What will happen to me if you report?” So they’re, there to actually answer all these questions for you and help you guide you through the process.
And it’s, they’re great. I mean, they’re so passionate.
The other place that I would refer people to look is the F. S. P. H. P., which is the Federation State Physicians Health Program. And they’re kind of like the national non profit that kind of helps people get to their health in each jurisdiction. So they can also answer questions.
Dr. Andy Roark: Hey guys, you know, probably the number one plea for help that I get from [00:13:00] medical directors, from practice managers, from practice owners, from lead technicians, and especially lead CSRs is, “Hey, Andy, help me, help my staff to deal with angry and complaining clients. They need ways to help these people because angry clients, complaining clients, they need help is what they need. And, our people aren’t empowered or they aren’t trained in how to do that.”
And so why isn’t there more training for this? Why aren’t there more resources that make teams good at dealing with angry and complaining clients?
Well, the number one reason really is, the way that feels natural for your team, the skills that they have that they would bring into the situation, they’re different in every practice. So there’s not a bullet pointed. This is how you do it way.
Which is why I end up in this place where people are like, “Andy How do I do this?”
Listen, I made a course it’s called ‘Charming the Angry Client’ and it is my course meant for teams or groups to work together [00:14:00] on all about dealing with angry and complaining clients.
I use what’s called the Davidow model of organizational response, which is a super peer reviewed, empirically tested way, of addressing angry and complaining clients.
And, I break it up into pieces so that it’s easy to digest. You can scatter it across a number of meetings, it is made to be watched with a couple people together. And then there’s discussion questions about how do we do this in our practice? What does this look like for us? What, when, think about a time that this happened and we saw it. How did we handle it?
Ooh, I also put a bunch of, example videos in there of me being an angry client. So I, I will just give it to ya. As here’s Andy with his pet, and he is upset, and then you can pause it, and then you can talk about right there, “What would we do with this? How would we handle this, guys?” And it is a great, low stakes way of getting your team to talk about what they would actually do.
Guys, there’s nothing more powerful than your team. Talking about what they would actually do and comparing notes, sitting and getting lectured at is nothing close to your team, whether it’s just your [00:15:00] CSRs, whether it’s four of your technicians working together, whether it’s a whole staff meeting and a manager or owner or medical director leading the meeting and being the facilitator guys, I put a whole facilitator guide in there too. There is a whole hour long broken up in a module section on how to run an active training program using this course.
And that’s all laid out there and how I do it, how I work with big groups, how it works, small groups, all that information is there. Anyway, it’s called Charming the Angry Client. It is on the Dr. Andy Roark website. I’ll put links directly to it in the show notes. Guys, I hope you will enjoy it.
I think it’s really valuable. It is, honestly the most popular course I have ever put online. Grab yourself a copy. I hope you’ll get a lot out of it.
Let’s get back to this episode. Is there any sort of long term tracking if you go into these programs? I mean, is it something where if you do everything that you were supposed to do when you say, you know I’m in a bad [00:16:00] place or, these things have happened or this is where I am in my life .,And I’m doing the responsible thing.
I’m going to go get help. I’m self reporting, in an anonymous way hopefully. Do I need to be concerned about long term, you know, repercussions. Am I going to be on a watch list somewhere for the rest of my career? Anything like that?
Dr. Beth Venit: Not always, but typically an individual is in these programs for about five years. The treatment and monitoring program typically lasts for five years. Some actually, some licensees actually choose to extend that. So they say, “I’m thriving in this. I feel like I needed a little bit more time of your help before I can graduate.”
It’s about five years. And then after that, it’s up to the licensee is my understanding. And that’s the average, but everybody’s different, right? I will tell you some great news about these PHP programs. So the, the bad news is that physicians and healthcare providers are at higher risk of [00:17:00] a substance use disorder than the general public, so that’s bad news.
The good news though is that… there was a study done for these PHP programs and the after at a five year follow up the response rate of health care providers in these programs was way better than the general public. So, I believe this statistic is general public. Usually their success rate is like 50 percent. For these PHP programs they had a success rate of 78 percent or higher.
Dr. Andy Roark: Wow.
Dr. Beth Venit: There is a study that said at a five year follow up 78 percent were still working, and still maintain their license. And ,only 11 percent had their license revoked after this experience. So dramatically higher success rate. And it’s because of this support that people get, in these programs.
Dr. Andy Roark: When does the Safe Haven program get started? Is it in effect now?
Dr. Beth Venit: So in Ohio, it’s in effect now. They, I think they passed it this year. Again, this is done at the regulatory [00:18:00] level.
Dr. Andy Roark: Mm hmm.
Dr. Beth Venit: The requirement for reporting if you’re in a program or not is set at the law level. So it’s in statute and that’s set by the legislature. Okay. So the, state Congress, they pass a bill and they say, “Oh, this needs to be reported.”
The boards are the ones that write the regulation and they pass regulations. So the boards, the veterinary state board and medical board or whatever, they’re the ones that determine how to meet this requirement state set by the state congress. Like I said, Ohio is a Safe Haven program, but many other different jurisdictions have similar anonymous carve outs in their reporting but it, really just does, it depends on the state.
Some fulfill the requirement by just reporting to one person on the board and that, person doesn’t tell any, everybody else, it’s, very, different. Some states, I will say, still require reporting directly to the board. [00:19:00] That’s why I say, if you think you have a problem or if you think that your friend or your relative or loved one may have a substance use disorder, illness ask questions, so talk to the board, talk to the VMA call the FSPHP to find out information just on how it’s handled within your jurisdiction.
Dr. Andy Roark: So if you don’t know the way that your state operates and you’re interested, you would say the best way is to reach out directly to the state board and just say, “Hey, I have questions about reporting for substance abuse programs or mental health programs or things like that.”
Dr. Beth Venit: Yep, you call them and you can even say, “I’m calling for a friend” like you don’t need give any information.
Dr. Andy Roark: Say, can you, do a fake voice and a mustache and…
Dr. Beth Venit: Yeah with a mustache on the phone that will help. But yeah, you call them and so a lot of these a lot of this information is also online. So if you go to there, I think North Carolina is an example they have it on their website.
So if you scroll down on their website, they’ll have their monitoring program on there. [00:20:00] So a lot of times you can get the information that way, and there may be FAQs. Call the board, call the VMA. So some of these programs are actually run through the VMA, so they may be able to give you information, the state VMA.
And then also the Federation for State Physicians Health Programs can give you information as well.
Dr. Andy Roark: If your state doesn’t have something that allows for anonymous reporting or things like that and you were in that state and you wanted to try to affect change, how would you go about doing that, Beth? who would you reach out to or what steps could you take to say,” Hey, as a person affected by this program, I would like to vote for a change.
How would you start that, that kind of push?
Dr. Beth Venit: Yeah, so you don’t even have to admit that you have a problem or a disease like that. You could just say,” Hey, how do we make this different?” That could be just a phone call to the executive director of the state board. You can say, as part of that conversation, “Hey, is there anonymous reporting?”
And if they say no, you can say, [00:21:00] “What are the steps to take to get there? Or is there a way that we can have this regulation reconsidered.” You can talk to your VMA about how to get regulations reconsidered. Some boards have a lot of ownership over the regulations and some of them don’t.
So again, it all depends on the jurisdiction, how they can enact change within their regulation. So again, you can talk to them, you could talk to the VMA and ask,” What steps are required for this?”
Dr. Andy Roark: Beth, there’s a lot of things that you could do with your time and there’s a lot of things for you to work on.
What motivates you to pick this up?
Dr. Beth Venit: I, don’t know of any veterinarian that hasn’t been touched with substance use disorder in some way or any person, frankly. I mean, this is a really big problem in the U. S. One, statistic I looked at was one out of seven people have a substance use disorder. So everybody we know has one, everyone we know knows someone who has something like this.
[00:22:00] On a personal level though, the, actually the weekend that I wrote this with, help with our committees and our board of directors. My husband and I actually lost a close family member to substance use disorder and he was only 30, this is not something that Anyone is safe from it’s it affects everybody and I think as veterinarians as we said everybody veterinarians are at higher risk of this than the general public and so I, you know, it’s just something that I’m It’s really important,
Dr. Andy Roark: I thank you for doing this. It’s, something that, that we’ve talked about before in the past about reporting and things like that. And so I’m just, I love, that you’re working on this. I love this is something that the the AAVSB is, looking at.
We talked about the FSPHP, we talked about sort of state boards. Are there any other resources or things that you think would be valuable for people to hear about or know that are out there?
Dr. Beth Venit: Those are, gosh, those are the big [00:23:00] ones. Talk to them.
Dr. Andy Roark: Where can people find you online if they want to, if they have questions or if they want to learn more about you, keep up with your exploits?
Dr. Beth Venit: I’m on this little known website called LinkedIn. I don’t know if you’ve heard of it.
Dr. Andy Roark: I’ve been there before.
Dr. Beth Venit: You’ve been there before. But we, also have, if anybody does want to read our the safe haven model regulations, it’s actually on our website. So if you go toAAVSB.org and you, can go to, it’s under, I think the practice act model tab and scroll down there and all of our model regulations are there.
The Safe Haven program is on that.
Dr. Andy Roark: I will go and see if I can get a direct link so people can take a look or just write out their show notes.
Dr. Beth Venit: Yeah, that’d be great.
Dr. Andy Roark: Well, cool. Beth, thanks so much for being here. I always appreciate you and your time. Guys, thanks for tuning in and listening. Take care of yourself, everybody.
Dr. Beth Venit: Yeah. Thanks.
Dr. Andy Roark: And that’s what we got. Guys, I hope you enjoyed it. Thanks so much to Beth Venit for being here. She is amazing. Yeah, thanks a lot for being here. Like I said, this is [00:24:00] an interesting issue for me. It’s one that I have thought about a number of times. It’s a hard position of balancing public safety and then also not throwing up barriers and not discriminating against people who have had challenges, who have had struggles, who have done what they can to, get back on their feet and to get, things sorted out for themselves.
And so anyway, this is challenging, but I appreciate Beth talking through with me where we are in setting an optimistic vision for where we might go in the future. So I would like to help paddle in that direction.
Take care of yourselves. Okay? Be well. Bye.
