Your doctor could be drunk, addicted to drugs or outright incompetent, but other physicians may not blow the whistle.A new survey finds that many American physicians fail to report troubled colleagues to authorities, believing that someone else will take care of it, that nothing will happen if they act or that they could be targeted for retribution.
A surprising 17 percent of the doctors surveyed had direct, personal knowledge of an impaired or incompetent physician in their workplaces, said the study’s lead author, Catherine DesRoches of Harvard Medical School.
One-third of those doctors had not reported the matter to authorities such as hospital officials or state medical boards.
The findings, appearing in Wednesday’s Journal of the American Medical Association, are based on a 2009 survey of 1,891 practicing U.S. doctors.
Reporting a problem doctor can trigger important changes. Twenty-one years ago, a colleague smelled alcohol on a young physician’s breath and anonymously reported him to the head of the residency program. A now-sober Dr. A. Clark Gaither is grateful.
“I wish I knew who reported me,” Gaither said. “I’d like to give them a big ol’ hug and thank them for saving my life.”
Programs exist for retraining doctors with weak skills and getting addicted ones into treatment. But the survey results suggest doctors are not confident in the system, DesRoches said.
The American Medical Association and other professional groups say doctors have an ethical obligation to make such reports.
And many states require doctors to tell authorities about colleagues who endanger patients because of alcoholism, drug abuse or mental illness.
Despite that, many doctors do not know what to do or where to start, DesRoches said.
In an accompanying editorial, one ethics expert called the findings “jarring.”
“I don’t think there’s any excuse for less than 100 percent of physicians holding true to these ideals,” said Dr. Matthew Wynia, director of the AMA Institute for Ethics.
He called for better protections for whistleblowers and more education for doctors on how to report a colleague.
The survey did not specify the type or severity of the impairment or incompetence, asking:
“In the last three years, have you had direct, personal knowledge of a physician who was impaired or incompetent to practice medicine in your hospital, group, or practice?”
Most states have programs that not only get doctors into treatment but also advise their colleagues how to intervene.
Most will keep reports anonymous. Some use the threat of medical board sanction to persuade doctors to go to rehab.
About 200 doctors a year are referred for alcoholism, drug addiction, anger-management problems and depression.
Gaither, said doctors worry that their troubled colleagues will lose their licenses and livelihoods if reported.
“I ask them, ‘Would it be better if they lost their money, their marriage, their home, their cars, their license and then their life?'” he said.