With television shows such as "Nurse Jackie" and "Grey's Anatomy" regularly depicting physicians and nurses with substance abuse problems, some patients might begin to wonder whether in real life anyone is monitoring the people who provide lifesaving care. Perhaps not. Or, if workers are being monitored, they're not being monitored closely enough to fit some researchers' way of thinking.
A doctor survey study published online Tuesday in the Journal of the American Medical Assn. suggests that workplace monitoring of impaired or incompetent physicians is not what you'd call common.
Conducted by a team from Massachusetts General Hospital in Boston, the study used data from a 2009 national survey of close to 3,000 physicians practicing in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics and psychiatry.
Physicians were questioned in three areas: about their responsibility to report physicians who were incompetent or impaired by drugs or alcohol, about their preparedness and comfort level in doing so, and about their experiences with colleagues with these issues.
"Self-regulation is the main way to protect patients from harm and make sure that impaired and incompetent physicians get the help that they need," said Catherine DesRoches, lead author of the study, in a phone interview.
About 70% of physicians said they feel prepared to report impaired physicians, and 64% said they were prepared to report incompetent ones. But more than one-third, 36%, said they do not feel obligated by professional commitment to do so.
Physicians with less experience, 10 years or fewer, were most willing to report impaired or incompetent colleagues. Those with greater experience, 20 years or more, were less likely to feel that it was their responsibility to do so.
"It's possible that there's a real cultural issue here. It's a topic that might not have been addressed back when they were in medical school, so they do not know how to handle it," said DesRoches, an assistant professor at the Mongan Institute for Health Policy at Harvard Medical School.
Pediatricians and family practice doctors were the least likely to say they felt prepared to deal with impaired or incompetent colleagues; anesthesiologist and psychologists apparently felt most prepared.
