Recent publicity has led to increased scrutiny of confidential, state-run rehabilitation programs for physicians, the Associated Press reported Dec. 19.

An estimated 8,000 doctors with addiction problems are enrolled in treatment programs; most states have them, and California's medical board made headlines last year when it voted to abolish its physician-assistance program after a review found that it didn't help doctors recover and could put patients at risk.

"Patients have no way to protect themselves from these doctors," said Julie Fellmeth, head of the University of San Diego's Center for Public Interest Law and an opponent of the California program.

Supporters say that the programs need to be confidential to get doctors to participate, and that botched procedures involving doctors undergoing treatment are rare. In fact, critics have been unable to cite a single case where a participating doctor erred in the operating room, although detractors say the secrecy surrounding the rehab programs makes such investigations difficult. Some doctors who took part in addiction treatment programs have been involved in unethical or incompetent practices, but no causal link has been made to alcohol or drug problems.

Addiction experts worry that, absent a confidential treatment program, doctors with addiction problems simply won't get help, possibly putting more lives at risk.

Without the assurance of confidentiality, some say, addicted doctors will go underground and continue to practice without getting any treatment at all. "I was never intoxicated taking care of patients," said Jason Giles, a California physician who grappled with addiction problems. "It didn't get to that -- but would have if I didn't avail myself of that rope dropped from the helicopter," he said, referring to the confidential treatment program that helped him get sober.