Physician Impairment and Drug Screening
In our featured article last month we addressed the issue of the importance of performing routine criminal background checks for physicians as a condition of licensure and appointment. We discussed how these checks could play a vital role in ensuring patient and workplace safety, and contribute to improved healthcare outcomes. This month, we'd like to continue that discussion by extending it to physician drug screening initiatives.
Testing (Your Luck)...
According to a study published November 4, 2008 by the British Medical Journal, roughly 12% of practicing physicians in the United States struggle with substance abuse disorders. Yet, when it comes to mandatory random alcohol and drug testing, medicine is highly underregulated in contrast to almost every other high-risk industry. For example, the United States Department of Transportation Office of Drug & Alcohol Policy & Compliance mandates that 25% of safety sensitive employees serving in regulated commercial transportation operations (aviation, railroad, transit, etc.) submit to random drug testing on an annual basis, while the healthcare industry is largely self-regulated. The Journal of the American Medical Association recently released an article highlighting this point, stating that "[w]hile some state and individual health system regulations exist, they tend to be weak... and vary in their mandate, authority, reporting requirements, and activities." In their JAMA article, doctors Julius Cuong Pham, M.D., Ph.D., Peter J. Pronovost, M.D., Ph.D., and Gregory E. Skipper, M.D. call for hospitals, surgical centers, and other healthcare organizations to institute new regulations mandating strict drug and alcohol testing programs to support patient safety initiatives.
New physician drug screening measures would include:
- Compulsory drug testing before medical staff appointments to hospitals
- Ongoing random drug testing programs
- Routine drug and alcohol testing for healthcare professionals and physicians in connection with sentinel events leading to death, or serious adverse outcomes
- "Establishment of testing standards by a national hospital regulatory or accrediting body. The steps could be limited to hospitals and their affiliated physicians at this time, since hospitals have the infrastructure to conduct adverse event analysis and drug testing, note the authors. Hospitals also have the governing bylaws to guide physician conduct and an existing national accrediting body, The Joint Commission, the authors add."¹
The Impaired Physician
Physicians are routinely required to perform procedures that require a level of precision, focus, and attention to detail that simply cannot be achieved and sustained when under the influence of drugs and alcohol. The impairment of a physician often carries with it grave, even deadly consequences. One recent example of this fact is embodied in the recent news regarding Dr. Christopher Duntsch, of the Texas Neurosurgery Institute in Plano, TX. Duntsch, a graduate of the University of Tennessee Medical School, had his license indefinitely revoked by the Texas Medical Board, citing that he posed a "grave danger to patients," and is "unable to practice medicine and reasonable skill and safety due to impairment from drugs and alcohol."² Duntsch is responsible for the deaths of at least two patients, and has either paralyzed or horribly injured two others over a sixteen month period beginning January 2012. He repeatedly misdiagnosed patients, botched procedures, and even left medical instruments and surgical implements inside the bodies of some victims. During at least one procedure Duntsch was described as "distracted" and "disoriented" by operating room personnel.
The shocking story of Dr. Christopher Duntsch's negligence should serve as a wake up call for the healthcare industry to reevaluate current policies and procedures regarding drug and alcohol testing. Patients depend on their doctors and caregivers to ensure their safety and to deliver positive healthcare outcomes where medically possible. To do this effectively requires oversight, compliance, and strict enforcement at every organizational level.
Need to Reassess Your Drug Screening Program? Contact us to learn more about how PreCheck works to protect patients from impaired physicians.
¹ All hospitals should require drug testing for physicians. Johns Hopkins Medicine. May 7, 2013.
² License No. N-8183, Order of Temporary Suspension. Texas Medical Board. June 26, 2013.
Photo credit: e-Magine Art.