Hospitals urged to alcohol and drug test doctors

Patient safety experts are urging hospitals to randomly test physicians for drug and alcohol in a bid to better protect patients. 

The experts also recommend that medical institutions take a cue from other high-risk industries, like airlines, railways and nuclear power plants, and mandate that doctors be tested for drug or alcohol impairment immediately following an unexpected patient death or other significant event. 

“Patients might be better protected from preventable harm. Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem,” write authors Dr. Julius Cuong Pham, an emergency medicine physician at The Johns Hopkins Hospital, and Dr. Peter J. Pronovost, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality. Dr. Gregory E. Skipper, of the drug and alcohol treatment centre Promises, in Santa Monica, California, also contributed. 

The recommendation was made in a commentary published online on 29 April 29 in The Journal of the American Medical Association. 

The authors noted that “mandatory alcohol-drug testing for clinicians involved with unexpected deaths or sentinel events is not conducted in medicine,” even though physicians are as susceptible to alcohol, narcotic and sedative addiction as the general public. A sentinel event is an incident which results in death or serious physical harm. 

The doctors recommended in their commentary that hospitals take a number of steps as a model to address this overlooked patient safety issue.  

These include: mandatory physical examination, drug testing or both, before a medical staff appointment to a hospital, which already occurs in some hospitals and has been successful in other industries; a programme of random alcohol-drug testing; a policy for routine drug-alcohol testing for all physicians involved with a sentinel event leading to patient death; and establishment of testing standards by a national hospital regulatory or accrediting body.  

The steps could be limited to hospitals and their affiliated physicians at this time, since hospitals have the infrastructure to conduct adverse event analysis and drug testing, noted the authors. 

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