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Article challenges states to create physician monitoring system

Ambulatory Safety Monitor, January 26, 2006

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An article in the January 17 Annals of Internal Medicine outlines plans for states to create monitoring systems for physicians with mental or physical problems. The system would ensure these physicians receive help or are otherwise kept from performing on patients, according to a according to a press release from the Harvard School of Public Health.

Any system would have to include standards for performance and behavior, monitoring and identification of physicians with depression, anxiety, or other impairing conditions. The goal is to catch problems before they lead to patient harm.

An independent or governmental system is required because traditionally, physicians have been unwilling to confront colleagues with impairment issues.

According to the release, to create such a system you would

• "Adopt explicit performance standards of behavior and competence, standards set at the national level.
• "All physicians would be required to acknowledge that they have read and understand the standards and will follow them and understand that persistent failure will lead to loss of privileges and dismissal.
• "Adherence to the standards would be monitored annually by formal evaluation, and results of the evaluations should be provided confidentially to each individual. And if there are deficiencies, the department chairman would be responsible for prompt response, including further evaluation, counseling or referral for treatment.
• "In cases that threaten patient welfare, department chiefs and hospitals would take immediate action to limit practice during assessment and rehabilitation.
• "Finally, assessment and treatment programs must be available for management of all underlying cause of substandard performance: substance abuse, psychiatric problems, behavioral problems and lack of competency."

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