The speaker was a physician involved with his state’s physician impairment program. He related that while in his residency he was called in late one night to care for a patient because the attending doctor showed up drunk.

Concerned for the attending physician, he approached a senior member of the medical staff the next day and asked what could be done to help him.

“Don’t worry about him” came the reply. “As soon as we get one more documented instance we’re getting rid of him.”

Of course, that documentation soon followed and the physician was dismissed. Several months later he died from an alcohol overdose.

The speaker said that experience led him to a life-long commitment to finding ways to help physicians in trouble, particularly those dealing with substance abuse issues.

Physicians have a higher-than-average rate of addiction. About 15% of them suffer from some form of it at some time in their lives. They also have a phenomenal rate of success with treatment. Statistics indicate that between 80 and 90 percent recover and learn to live sober.

So report the matter? Absolutely. I agree that it should be reported both to hospital administration and to the state medical board. A practitioner who drinks on the job is not safe and should not be permitted to care for patients.

However, in the process let’s not forget that we’re dealing with a valuable human being who needs help and may well be willing to accept it and get better.

Rita Schwab, CPCS, CPMSM
MSSPNexus Blog
http://msspnexus.blogs.com/mspblog/

The one exception I would make to this is immediate patient endangerment, eg, a surgeon shows up obviously drunk to the OR.

I might have asked to speak to the nursing supervisor or the administrator on call. In our hospital, there is a roaming nurse who is “in charge” at night and there is an administrator on call who could have come in to make their own observations.

A letter now is better than nothing. If it is the only thing that ever shows up in this guy’s file, then nothing will happen. But what if 20 people that month smelled it, and all 20 wrote in?

I’ve known several impaired physicians… none of which I EVER suspected at the time. In retrospect, some of their erratic behavior fits the pattern, but at the time I just felt they were eccentric.

It’s hard enough working when you’re not at the top of your game, whether from circadian dysrhythmia, or illness (I’ve worked a few shifts with an IV in my arm). In those cases, you do what you have to do to endure those things that aren’t within your control… but there is no excuse for cheating your patients of your best by engaging in substance abuse on the job.

This doc needs to go get some help, and he may require an “intervention” by the hospital to push him in that direction. Either way, it serves neither the patient, nor the physician to keep silent about the matter.

But since there’s a delay, I would recommend calling the hospital’s administration office, say you have a concern about a physician, and ask to either speak or write directly to either the departmental chairman or chief of staff, with a copy or call to the one you’re not writing directly to. You may be told to write a complaint letter which depending on the hospital may work wonderfully or be totally useless, so I think writing to a couple of docs with some responsibility would be a better bet. If the one doc knows you wrote to the other they will be much more likely to check it out.

I have no idea as to legal liability but I would think notifying a hospital of a possible impaired physician would be a fairly safe thing to do.