Gregory Skipper and Robert DuPont are right to note the important role Physician Health Programs (PHPs) play in treating drug-addicted M.D.'s. In Brent Cambron's case, it's difficult to know much about that role (which is why I didn't address it in my article). According to some people who were close to him, Cambron felt that the PHP that monitored his recovery was more of a hindrance than a help, questioning his commitment to recovery in such a way that he himself began to doubt it. Unfortunately, due to the confidential nature of the program, the director of the PHP in Massachusetts Physicians Health Services was unable to tell me his program's side of the story; indeed, the director couldn't even confirm for me that the PHP had helped Cambron in his recovery efforts.

But there's no denying the growing body of literature Skipper and DuPont cite documenting PHPs achievements. One important question about PHPs that remains open--and that I did try to briefly address in my article--is whether they should redirect drug-addicted anesthesiologists in recovery toward other, lower-risk medical specialties or whether they should facilitate their returns to anesthesia. Keith Berge, an anesthesiologist at the Mayo Clinic, recently argued in Anesthesiology in favor of a "one strike, you're out" policy for drug-addicted anesthesiologists under which, even after they've emerged from a treatment program, they're prohibited from returning to the practice of anesthesia. Berge believes the risk of relapse is simply too great. Of course, one of several arguments against a "one strike" policy is that, without the hope of eventually returning to their specialty, drug-addicted anesthesiologists might resist seeking treatment before overt impairment or overdose. But I do think it's an important question--and one that deserves more debate and research.

Jason Zengerle is a senior editor at The New Republic.

Click here to read Dupont and Skipper's response to Zengerle's original article.