Many doctors don't report impaired colleagues
A study suggests that a third don't believe they should intervene if another physician is impaired or incompetent.
If your doctor had a drug problem or was impaired in some other way, you would probably hope that colleagues would intervene and see that he gets help. A new survey suggests that doesn't happen very often.
A study in the Journal of the American Medical Association said a survey of physicians found that while most support the professional commitment to report other physicians who they feel are incompetent or impaired -- such as from alcohol or drug use -- many did not follow through on making a report when faced with such a situation.
"Many states have mandatory reporting statutes, requiring physicians and other health care professionals to report to appropriate authorities those physicians whose ability to practice medicine is impaired by alcohol or drug use or by physical or mental illness," the authors wrote.
But data suggest that the rate of reporting by physicians is far lower than it should be, they said, given the estimated numbers of physicians who become impaired or who are otherwise incompetent to practice at some point in their careers.
Dr. Catherine M. DesRoches, of Massachusetts General Hospital in Boston, and colleagues conducted the study to assess physicians' beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine. Data for the study were derived from a nationally representative survey of 2,938 physicians practicing in the U.S. in 2009. Overall, 1,891 physicians (64.4%) responded.
Looking the other way
Among the findings of the survey, only 64% of those who responded agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice.
The most frequently cited reasons for not reporting an impaired or incompetent colleague included:
- The belief that someone else was taking care of the problem.
- The belief that nothing would happen as a result of the report.
- Fear of retribution.
- The belief that reporting was not their responsibility.
- The belief that the physician would be excessively punished.
"These national data regarding physicians' beliefs, preparedness, and actual experiences related to impaired and incompetent colleagues raise important questions about the ability of medicine to self-regulate," the authors wrote. "More than one-third of physicians do not completely support the fundamental belief that physicians should report colleagues who are impaired or incompetent in their medical practice.
"This finding is troubling, because peer monitoring and reporting are the prime mechanisms for identifying physicians whose knowledge, skills, or attitudes are compromised."
Solving the problem
The researchers offered several suggestions for improving physician reporting systems, including:
- Making external regulation stronger.
- Designing reporting systems to protect the confidentiality of the reporting physicians.
- Providing physicians with confidential feedback about the outcomes of any actions taken based on their reports to address the concern that nothing will happen as a result of the reports.
"All health care professionals, from administrative leaders to those providing clinical care, must understand the urgency of preventing impaired or incompetent colleagues from injuring patients and the need to help these physicians confront and resolve their problems," the authors said.
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