Even though physicians are ethically bound to report a colleague who is incompetent or impaired by drugs or alcohol, more than a third of physicians responding to a nationwide survey don't fully agree with the concept, according to a study published in the July 14 issue of the Journal of the American Medical Association.
Conducted by a team from Massachusetts General Hospital in Boston, the study used data from a 2009 national survey of close to 3,000 physicians practicing in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics and psychiatry. When asked whether physicians should report such cases, 64 percent of primary-care physicians and specialists said they "completely agreed." Another 31 percent said they "somewhat agree" with the statement "physicians should report all instances of significantly impaired or incompetent colleagues," lead author Catherine DesRoches, DrPH told MedPage Today.
Hypothetically, 69 percent of the respondents said they felt prepared to deal with colleagues who were significantly impaired, and 64 percent said the same about incompetent colleagues.
However, among the 17 percent who said they had encountered an impaired or incompetent colleague in the past three years, only 67 percent had actually reported the case through appropriate channels, DesRoches and colleagues wrote.
Physicians working in hospitals or medical schools were more likely to report an impaired or incompetent colleagues compared with those working in smaller practices, perhaps because that larger practice settings have better systems in place for reporting colleagues, DesRoches said. The authors also noted that physicians who are a racial or ethnic minority or who graduated from non-U.S. medical schools were less likely to report a physician colleague.
The top reasons that physicians did not report colleagues, according to the report, were beliefs that someone else would do it and that reporting incompetence wouldn't actually make any difference, in addition to the fear of retribution.
According to DesRoches, the system in which physicians report compromised physicians to licensing boards, medical societies, clinical supervisors and hospital peer-review groups can be successfully improved. "By targeting these two main issues--the belief that someone is taking care of it or that nothing will come of the report--we can increase the numbers of physicians who are both willing to report and feel prepared enough to do so," she told the Los Angeles Times.
She proposes education on the responsibility of physicians to report impaired or incompetent colleagues and the development of systems that both ensure confidentiality and notify the reporter when the issue has been addressed, the newspaper says.
To learn more:
- see this article in the Los Angeles Times
- check out the piece in MedPage Today
- here's the Wall Street Journal Health Blog post
- find the abstract in the Journal of the American Medical Association