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Surgeon loses privileges after appearing drunk before surgery

Patient Safety Monitor Alert, March 9, 2004

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A Massachusetts physician with a history of drunken driving lost his medical staff privileges this week after he allegedly arrived drunk to perform surgery at the hospital, according to the Associated Press. The incident underscores the importance of addressing disruptive and impaired physicians promptly and effectively.

Officials at Caritas St. Elizabeth's Medical Center, Cambridge, MA,  would not confirm the allegations. They released a statement March 8 saying that they would not discuss personnel issues in public, but added that the physician, orthopedic surgeon Robert Mark Caulkins ''does not have medical staff privileges at this time.''

The surgical patient was not at risk, however, because the surgery never got underway, the Associated Press reported.

Caulkins has faced drunken driving charges three times, according to a March 9 report in the Boston Globe, citing information it obtained from the Massachusetts Board of Registration in Medicine. Caulkins had not been subject to any hospital disciplines in the past 10 years, the Globe reported.

Disruptive or impaired physicians can put your patients' safety at risk, and make your hospital vulnerable to litigation.

Disruptive behavior may be caused by a mental illness or substance abuse problem, says John Henry Pfifferling, PhD, a Durham, NC-based anthropologist who specializes in changing disruptive physician behavior.

Other times, it's a "cry for help," says Maureen Mondor, vice president of risk management for ProMutual Group in Boston.

Regardless of the cause, a disruptive physician's intimidating or unusual behavior makes other care providers uncomfortable with questioning the physician's judgment offering information that the physician may need to make an informed treatment decision.

This can create a dangerous situation for your hospital and its patients. Hospitals can reduce this risk by developing a strict code-of-conduct policy, encouraging open communication, and encouraging leaders to swiftly address disruptive behavior and unusual behavior.

Click here for an update on this story.

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