DUI – Doctors Under the Influence – and the Consequences (Part I)

Driving under the influence of alcohol or drugs is a serious crime and doctors, who seem to have about the same rate of substance use disorders as the general population, are not immune. The consequences for DUI have become more severe, especially for physicians and other licensed health professionals, particularly in some states. And for good reason. The CDC reports that in 2016 10,497 people died in alcohol-impaired driving crashes (accounting for 28% of all traffic-related deaths in the USA). That same year, according to FBI arrest statistics, there were more than 1 million drivers arrested in the United States for DUI (called DWI or OWI in some states). The CDC collected data that showed that only about 1% of the 111 million self-reported episodes of alcohol-impaired driving results in a DUI arrest. Rounding off these figures it appears that on average an individual drives drunk about 100 times before being arrested for DUI and about 1 of every 100 DUIs results in a fatality. So maybe that’s why so many people “roll the dice” and drive after drinking, because they only stand a 1 in a 100 chance of being arrested and only a 1 in 10,000 chance of killing someone. But for those who are arrested and especially for those who kill someone the consequences are dire and are becoming more significant as harsher laws are imposed. For physicians, in addition to the harsh criminal punishments, they also must deal with the administrative law issues imposed by state licensing boards. And state medical boards have taken an increasingly harsh position against doctors who are arrested for DUI, however, there is wide variation in how states boards handle this issue (to be discussed in more detail in Part II).

A question frequently asked is, “Why would a licensing board have any right to discipline a doctor who gets a DUI arrest when he/she is off duty?” many regulatory boards have adopted rules that consider any conviction of any offense “substantially related to the qualifications, functions, or duties of a licensee” to constitute unprofessional conduct, which can be cause for disciplinary action. Therefore, if a physician, or any other licensed health professional, is arrested or convicted for DUI, depending on the particular state and board, they should know that their license, and thus their career and livelihood, could be in jeopardy. Many physicians are not aware of this.

But how do the boards find out about the arrest or conviction. Ironically, when a doctor is arrested for DUI one of the first things doctors say to the arresting officer, in an attempt to obtain leniency, is “I am a doctor.” The arresting officer can then report the arrest directly to the regulatory board. Also, in most states, it is required that arrests or convictions be self-reported to the board within a period of time, usually 10-30 days (see individual state board rules, to be discussed in Part II, for exact requirements). Failure to report may result in additional cause for disciplinary action. In addition to self-reports, boards find out about licensee DUIs through colleagues, family or anyone else, or the court system, notifying the board of the arrest.

In California, where approximately 10% of all physicians in the USA reside, the Medical Board has become very aggressive. California Business and Professions Code section 2239 empowers the Medical Board of California to discipline a physician for dangerous use of alcoholic beverages or drugs. The statute provides that conviction of even a misdemeanor offense involving the consumption of alcohol or dangerous drugs “constitutes unprofessional conduct” and that the record of conviction “is conclusive evidence of such unprofessional conduct”. Such a conviction can be a single drunk driving conviction or even a reduced, “wet reckless,” conviction. And if the board can prove the alleged unprofessional conduct based upon the arrest evidence, a conviction may not be required at all. This means that even if you are not convicted of the DUI the administrative court, that controls your license, may consider the evidence and has a much lower standard of proof than criminal court and a disciplinary action may be imposed, even if the criminal action was dismissed.

There is no good data showing the incidence of DUIs among physicians, however, the number seems to be substantial and is a common cause of medical license discipline. That is no surprise since studies have shown that physicians have about the same rate of substance abuse as the general population and alcohol is the most frequent substance of abuse (about 50% of physicians identify alcohol as their primary substance of abuse).

If you are a physician, or other licensed health professional, and you are arrested for DUI you should obtain an administrative law attorney and you will usually be referred for a thorough addiction medicine evaluation at a program that evaluates health professionals. Determining if you have an alcohol use disorder and obtaining appropriate assistance to address the problem can save your career. The courts and the board typically take into account that someone has faced that they have a problem and are willing to take appropriate steps to treat the problem, if it exists, and put into place safeguards to protect the public.

Part II will discuss more details regarding various states and their requirements.

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