Study: Some Docs Unprepared to Report Impaired Colleagues

July 15, 2010

You may have an obligation to report a colleague who is impaired or incompetent, but it turns out most of you are reluctant to do so. Why? Because physicians are “unprepared” to deal with it.

You may have an obligation to report a colleague who is impaired or incompetent, but it turns out most of you are reluctant to do so.

Why? Because physicians are “unprepared” to deal with it.

In a new study, published in the most recent edition of the Journal of the American Medical Association, of physicians who knew a colleague was unfit to perform medicine, only two-thirds reported this to the relevant authorities, leaving one-third who let it go unreported.

The authors of the research did ask those who shunned reporting impaired or incompetent colleagues why they chose to stay mum. Of those offering an answer, 19 percent said they thought someone else was taking care of the issue. Another 15 percent said they thought nothing would come of being a whistleblower and 12 percent feared some kind of retribution.

The study defined “impaired” and “incompetent” based on several factors, including drug addiction to those unaware of the latest ways to treat a patient’s condition.

The JAMA article notes that peer monitoring and reporting are “primary mechanisms” for identifying docs who cannot or should not perform medicine and 64 percent of the 2,938 eligible respondents (covering practices like family practice, internal medicine and pediatrics) agreed with their duty to respond. But only 69 percent reported being “prepared” to effectively deal with an impaired colleague and 64 percent to deal with an incompetent doc in their practice.

The authors recommend promoting further education on who to call and how to report at both practices and hospitals as a way to increase awareness.

Now this study is not going to allay any fears by the small amount of patients who may already have misconceptions of medical professionals for one reason or another.

The fact is that only 17 percent did not report the issue, meaning potential patients should not be too worried. But the bigger question raised by the study is: How do we “prepare” docs to report without fear of retribution or apathy?

Perhaps the study will prompt some policy discussions at your practice (If it does, let us know below).

I look at it like I look at reporting a possible drunk driver on the highway. We all have cell phones. We all know the number for 911. But when a drunk, or otherwise incompetent driver, zooms past us or catches our attention, how many of us pick up the phone and place that call?

Not a lot. And for the most part, it is for the same reasons docs in the study stayed quiet: Someone else will call, or the police won’t come or even the likelihood of confronting that person later is reason enough to keep motoring along.

So while the study results are interesting, they are not shocking, because when it comes to confrontation, in one of the many forms it takes, some are prepared and others are not. But the bottom line is that more times than not, we can prevent something bad from happening by just speaking up.

It takes just a few minutes to report, but a lot longer to regret any negative consequences.