Should hospitals require drug and alcohol tests for doctors?

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Would random drug and alcohol tests for doctors improve standards for patient safety in hospitals?

Two Johns Hopkins physicians seem to think so.

In a commentary published last week in the Journal of the American Medical Association, Julius Cuong Pham, MD, PhD, and Peter J. Pronovost, MD, PhD, say that random, mandatory drug and alcohol tests should be administered to doctors who have recently experienced an unexpected patient death or other significant challenging event.

Pham is an emergency medicine physician at Johns Hopkins Hospital, and Pronovost is the director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality.

Doctors susceptible to addiction too

Currently, mandatory drug and alcohol testing for doctors involved in a patient death or sentinel event - where an incident causes a patient serious physical harm or death - is not conducted. But Pham and Pronovost say that doctors are just as vulnerable to alcohol and drug addiction as others.

A study published last year in Archives of Surgery found that 15 percent of surgeons struggle with alcohol problems, with younger surgeons and females particularly at risk for dependency.

Recommended guidelines for better outcomes

Pham and Pronovost - with the help of Gregory E. Skipper, MD, of the drug and alcohol treatment center Promises in Santa Monica, Calif. - proposed new guidelines for hospitals to follow to ensure patient safety. They include mandatory physical examinations, random alcohol and drug testing and a policy that would require alcohol and drug testing for physicians involved in patient deaths or sentinel events. The doctors explained:

Patients and their family members have a right to be protected from impaired physicians. In other high-risk industries, this right is supported by regulations and surveillance. Shouldn't medicine be the same? A robust system to identify impaired physicians may enhance the professionalism that peer review seeks to protect.

They also recommend that testing standards be adopted by an accrediting organization.

If a physician fails a drug or alcohol test, the hospital could reserve the right to "suspend or revoke privileges and, in some cases, report this to the state licensing board."

Source: Science Codex

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