• Doctors, health care officials, medical ethicist call for doctor drug testing to protect patients Wednesday, July 23, 2014

    By J.G. Preston

    “To improve patient safety, hospitals should randomly test physicians for drug and alcohol use in much the same way other major industries in the United States do to protect their customers.”

    The foregoing statement does not come from proponents of California’s Proposition 46, the Troy and Alana Pack Patient Safety Act. It comes from a press release issued by Johns Hopkins Medicine, the prestigious healthcare system affiliated with Baltimore’s Johns Hopkins University. And it shows that, even though doctors and hospital executives in California have been adamantly opposed to Proposition 46, some of the smartest and most ethical minds in the medical profession understand that doctor drug testing plays a crucial role in making health care safer.

    Johns Hopkins' Dr. Peter Pronovost

    Johns Hopkins’ Dr. Peter Pronovost

    The press release followed a commentary published in the Journal of the American Medical Association written by, among others, Dr. Peter Pronovost, a physician who is director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality and one of the leading physician proponents of improving patient safety. “Patients and their family members have a right to be protected from impaired physicians,” Pronovost and his colleagues wrote. “In other high-risk industries, this right is supported by regulations and surveillance. Shouldn’t medicine be the same?”

    Proposition 46 would make California the first state in the nation to require random drug and alcohol testing of doctors who have hospital admitting privileges, as well as automatic testing of all doctors involved in treatment of a patient who suffered an adverse medical event, such as an unexpected death or a wrong-site surgery.

    The drug testing provision addresses a significant problem with patient safety. A California Medical Board publication estimated the lifetime risk of healthcare professionals developing a problem of drug and alcohol abuse may be as high as 18 percent, with one to two percent needing treatment for substance-abuse disorders at any given time (see pages 5 and 6 of the document) — meaning that as many as 2,000 physicians in California right now may be abusing drugs or alcohol.

    Calls for mandatory testing have come from health care officials in government as well.

    The Inspector General of the U.S. Department of Health and Human Services, Daniel Levinson, called for requiring random drug tests on all health care workers with access to drugs in a March op-ed in The New York Times, titled simply, “Why Aren’t Doctors Drug Tested?”

    U.S. Department of Health and Human Services Inspector General Daniel Levinson

    U.S. Department of Health and Human Services Inspector General Daniel Levinson

    “This is hardly a radical suggestion,” Levinson wrote. “By federal law, many workers in transportation or other safety-sensitive areas are already subject to random drug tests. These include pilots, school bus drivers, truck drivers, flight attendants, train engineers, subway operators, ship captains and pipeline emergency response crews.”

    A leading researcher in the field, Lisa Merlo of the Center for Addiction Research & Education at the University of Florida College of Medicine, says physicians are about as likely as members of the general public to abuse alcohol or illegal drugs but are five times as likely to abuse prescription drugs.

    “Because they have access — and because there’s this false thought that because they’re medicines, they’re somehow safer — they are more likely to become addicted to prescription drugs,” said Dr. Ethan Bryson. “And when they do, the consequences are severe.”

    Bryson is an anesthesiologist whose book, Addicted Healers, addresses prescription drug abuse by medical professionals. He supports mandatory drug testing for doctors.

    Addicted Healers“I think it’s mind-boggling that I can walk into the Home Depot with my 12-year-old son and feel confident that the person who operates the forklift in this working warehouse is not on drugs,” he told Canada’s Maclean’s magazine. “But we walk into the hospitals and they don’t have policies which require random testing.”

    USA TODAY reporter Peter Eisler quantified the problem with prescription drugs in an April story. “Across the country, more than 100,000 doctors, nurses, technicians and other health professionals struggle with abuse or addiction, mostly involving narcotics such as oxycodone and fentanyl,” Eisler wrote. “Their knowledge and access make their problems especially hard to detect. Yet the risks they pose — to the public and to themselves — are enormous.”

    Eisler noted that, without testing, impaired physicians are extremely unlikely to be caught.

    “Safeguards to detect and prevent drug abuse in other high-risk industries rarely are employed in health care,” he wrote. “Disciplinary action for drug abuse by health care providers, such as suspension of a license to practice, is rare and often doesn’t occur until a practitioner has committed multiple transgressions. Only a sliver of the health care practitioners who use drugs get caught.”

    Arthur Caplan, director of the Division of Medical Ethics at New York University’s Langone Medical Center and one of the nation’s most prominent medical ethicists, supports both random drug and alcohol testing for doctors and mandatory testing after an adverse event.

    “When something serious happens, shouldn’t the people involved be subjected to mandatory drug testing?” Caplan asked. “Because we know that impairment is a problem in a small but significant percentage of physicians, we need to establish whether drugs, alcohol, or some other type of abuse played a role in a medical mistake.”

    While there’s no way to know exactly how many California doctors are practicing while impaired, a number of reports have emerged:

    Doctor drug and alcohol testing is essential to achieving the patient safety improvements Prop 46 looks to achieve.

    “If we are going to push safety forward and make it a priority,” said NYU medical ethicist Art Caplan, “then we have to get on board with the notion that drug testing has a role in our healthcare facilities.”

    J.G. Preston is press secretary for Consumer Attorneys of California, an organization whose members include some attorneys who represent victims of medical malpractice. CAOC supports Proposition 46. Some members of CAOC are on the board of directors of the group that funds ProtectConsumerJustice.org.

  • Prominent medical ethicist calls for drug testing of doctors
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  • A (small) victory for medical patients, and ethics
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  • A look at how the underinsured would benefit from health care reform proposal

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One Response to “Doctors, health care officials, medical ethicist call for doctor drug testing to protect patients”

  1. America has the 32nd best healthcare system in world for the highest price in the world thanks to substance abusing 100,000 doctors and 2,700,000 nurses and 50,000 clinicians.


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