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Duty to report impaired physicians

Medical Staff Leader Connection, October 16, 2003

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Dear Medical Staff Leader:

The challenge presented to medical staff leaders by disruptive and impaired physicians is no longer a secret confined to the health care industry. Over the past several years, as the media published the results of important medical errors research and the mistakes of troubled physicians stole headlines, the health care industry has been forced to confront this troubling problem head-on. A recent article in "New Yorker" magazine delved into the topic--further publicizing a problem with which hospitals across the country struggle.

The article presented evidence that physicians, like other professionals, have difficulty handling the pressure of their job. Despite physicians' high level of education and skill, alcoholism and drug addiction is just as pervasive in the medical field as it is in the business word. According to the article, approximately 32 percent of the general working-age population develops at least one serious mental disorder--such as depression, mania, panic disorder, psychosis, or addiction. These disorders are no less common among physicians. And, like the patients they treat, physicians become ill and old. These realities of life can distract physicians from their tasks and lead to medical errors. The "New Yorker" article states that although not all physicians with such problems are dangerous, an estimated three to five percent of practicing physicians are unfit to see patients.

"Even when the problems are obvious, colleagues can take a long time before doing anything decisive. There are both honorable and dishonorable reasons for this. The dishonorable reason is that doing nothing is easy . . . The honorable reason, and probably the main reason, is that no one really has the heart for it."

The above statement brings to the public an obstacle with which many physicians have struggled. It is difficult for colleagues to confront one another regarding quality of care issues, and risk ending the career of a respected physician. However, the consequences of remaining silent can be disastrous. The fact is, a physician's colleagues often have the best vantage point for noticing when impairment, mental health, poor health, or incompetence begins to create problems for him or her. It's essential that physicians know they cannot merely stand by and keep silent. Physicians have an ethical duty to intervene. In most states, intervention is also a legal duty.

To read more about physicians' duty to react appropriately when concerns arise regarding a colleague's performance, turn to the column written by Wendy Maneval, Esq., partner at the Philadelphia-based law firm of Post and Schell, in the December 2002 issue of the HCPro, Inc. newsletter "Medical Staff Briefing."

That's all for this week.

All the best,

Hugh Greeley
http://www.greeley.com/seminars/

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