In a survey published in JAMA in July 2010, 17% of nearly 1900 responding physicians reported having had direct personal knowledge of an impaired or incompetent physician in their hospital, group, or practice in the 3 preceding years. Of those, one third didn't report the individual. Those who kept silent said they believed someone else was taking care of the problem (19%), didn't think reporting the problem would make a difference (15%), feared retribution (12%), felt it wasn't their responsibility to report (10%), or worried that the physician would be excessively punished (9%). "We physicians have a sort of thinking in the back of our mind all the time of 'there but for the grace of God go I,'" explains Rebecca Hafner-Fogarty, MD, a primary care physician consultant with Physicians Wellness Services, a company that helps healthcare organizations manage behavioral and performance-related issues, and a member of the Minnesota Board of Medical Practice. "There's also a sense of wanting to respect a colleague's privacy. As more and more physicians become employees of big, often multistate, health systems, there's feeling that 'it's not my job' as an individual physician to report." Failing to report an impaired colleague, or one who's suspected of being impaired, is neither an act of mercy nor a professional courtesy, Dr. Hafner-Fogarty notes. Physicians have both a legal and an ethical obligation to report colleagues they suspect to be impaired. Those who aren't reported are often left to practice until something happens that ruins their career -- a patient is injured, there's a criminal incident, there's an arrest for DUI -- or worse. In 2010, nearly 60% of drug overdose deaths involved pharmaceutical drugs, according to the Centers for Disease Control and Prevention. Another reason that physicians don't report their colleagues, researcher Lisa Merlo says, is because medical schools fail to educate them about the disease of addiction. Most medical schools include only a lecture or two on addiction, she says. By contrast, the University of Florida requires all third-year students to complete a 2-week rotation in addiction medicine. "Every physician in the United States has to deliver a baby to graduate, but how many of them are ever going to deliver babies in practice?" she asks. "But every doctor is going to see addicted patients." Source
