Safety experts: Hospitals lacking in doc substance abuse policies

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All hospitals should randomly test physicians for drug and alcohol use to enhance patient safety, according to a recommendation from two Johns Hopkins physicians and patient safety experts in a commentary published online recently in The Journal of the American Medical Association.

Unlike employees in other high-risk industries--such as airlines, nuclear power or railways--physicians aren't tested for alcohol and other drugs following a sentinel event, the commentary notes.

However, physicians tend to have a higher rate of alcohol and drug abuse than the general public, Sherry Franklin, M.D., president of the San Diego Medical Society, told NBC San Diego in March. The high demands of medical school, residency and medical practice can often lead to burn-out, depression and anxiety, which can contribute to substance abuse, FiercePracticeManagement previously reported.

In fact, 15 percent of surgeons suffer from alcohol abuse or dependence, according to a February 2012 study in the Archives of Surgery.

Given the prevalence of alcoholism among doctors, the patient safety experts also call on hospitals to implement mandatory physical examination, drug testing or both before appointment to the hospital medical staff.

They also recommend routine drug-alcohol testing for all physicians involved in a sentinel event leading to patient death, as well as creating a national hospital regulatory body comprised of hospitals and their affiliated physicians to conduct adverse event analysis and drug testing.

Such policies could eliminate quality of care issues and expenses related to employee substance abuse, the commentary notes.

"Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem," write authors Julius Cuong Pham, an emergency medicine physician at The Johns Hopkins Hospital, and Peter J. Pronovost, M.D., Ph.D., director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality, according to a research announcement released yesterday.

For more:
- here's the research announcement
- check out the JAMA article
- read the NBC San Diego article

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