Although medical professionals are seen as models of health and wellness, they are not immune to substance abuse. Doctors are just as susceptible to alcohol, narcotic and sedative addiction as the general public. Statistics have shown at least one in 10 physicians will develop a problem with drugs or alcohol at some time during their career – in some cases leading to a potentially fatal error given the purview of their medical expertise and occupation.
In an effort to intercede and prevent a serious accident from happening and improving overall safety in hospitals, patient safety advocates suggest doctors, like anyone one else in a major industry in the US – such as workers in nuclear power plants and airline employees – should be subjected to regular drug and alcohol testing.
The recommendation to mandate testing for substance abuse, especially after an unexpected patient death or significant event, comes from two Johns Hopkins physicians and a rehabilitation expert in a commentary published in The Journal of the American Medical Association.
Authors Dr. Julius Cuong Pham, an emergency medicine physician at The Johns Hopkins Hospital, and Dr. Peter J. Pronovost, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality, as well as Dr. Gregory E. Skipper, of the drug and alcohol treatment center Promises, in Santa Monica, California contributed their insights.
The authors recommend in their commentary that hospitals take a number of steps. First, if not already in place, implement a mandatory physical examination and drug screening before medical staff is appointed to a hospital. Second, orchestrate random alcohol-drug testing. Third, require testing for all physicians involved in a sentinel event subsequently leading to a patient’s death.
The authors felt testing standards by an accredited body should be established and adhered to by all facilities.
They wrote, “Patients might be better protected from preventable harm. Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem.” In cases in which a physician is found to be impaired, a hospital could suspend or revoke privileges and, in some cases, report this to the state licensing board. Impaired physicians would undergo treatment and routine monitoring as a condition for continued licensure and hospital privileges, according to JAMA.
In the event a physician is either caught, or wilfully acquiesces to treatment for some manner of substance abuse they receive a level of rehabilitation that supersedes the average person. According to a report published in the Journal of Addiction and Medicine, reviewing health programs, Harvard Medical School’s J. Wesley Boyd and John R. Knight compared rehab centres for doctors versus the average addict.
The facilities available for a doctor’s rehabilitation are expensive, running nearly $40,000 or more, and many of the programs last upwards of 90-days – three times the average stay. Additionally, Boyd and Knight addressed the coercive attribute of the treatment as, “physicians have little choice but to cooperate with any and all recommendations if they wish to continue practicing medicine.”
As such, there is typically an 80 per cent success rate versus the abysmal rates some facilities fail to report as the success rate immediately completing a program is vastly different that the rates of the same people seen months or a year later. But again, doctors have an incentive to cooperate or else never practice again.
Doctors also have the right to confidentiality, in that if they attend rehabilitative care – you may never know about it. A news report stated back in 2007, most addiction specialists favour allowing doctors to continue practicing while in confidential treatment, as does the American Medical Association.
Would you want to know if your doctor ever underwent rehabilitation for drugs or alcohol? Would it skew you from partaking of his/her services?