HEY DOCTOR! Would you tell if you knew another doctor was incompetent, drunk or mentally ill?
Would you report a physician whom you felt would end up hurting a patient?
Dear reader, do you believe that your doctor would answer "Yes" to those questions? Think again. About one-third of you are wrong.
OVER ONE-THIRD WON'T REPORT A BAD DOC
More than one in three American physicians don't think they're responsible for reporting colleagues who aren't fit to practice. This is one of the findings from a new study by researchers at the Mongan Institute for Health Policy at Massachusetts General Hospital, reported in the July 14 issue of JAMA (Journal of American Medical Association.)
The study was based on survey responses of 1,900 physicians throughout the U.S. specializing in internal medicine, pediatrics, cardiology, general surgery, family medicine, psychiatry and anesthesia. About 36 percent of those who responded said it was not their professional obligation to report any colleagues who were significantly impaired, due to substance abuse or mental illness, or incompetent.
"I'M NOT RESPONSIBLE"
Compared with other doctors, the anesthesiologists were most responsible, followed by psychiatrists. Pediatricians were the least responsible.
The researchers warned that self-regulation in the medical field may not be enough to ensure that ill-equipped physicians aren't potentially harming patients.
WHY? THE REASONS DOCTORS GAVE
Why did doctors keep quiet? Some said they believed that someone else would report on failing physicians. Others reported a lack of confidence that anything would actually result from a report or feared that they would suffer some retribution once the transgressing doctor discovered who reported them.
Lead author Catherine DesRoches was asked by NPR (National Public Radio) why doctors don't speak up more often when they see something wrong. Her response:
"In smaller practices, doctors are very dependent on referrals, so they may worry that if they report a colleague they'll face some kind of retribution. Their number of referrals or professional reputation might suffer."
To improve the situation DesRoches offered that doctors need to know exactly how to report: the specifics of who to call and where to go. Physicians also need to know that reporting systems are confidential, that they'll have anonymity.
STATES VARY WIDELY ON MANDATED REPORTING
Interestingly, states very widely on how they handle incompetent doctors. Only some states mandate reporting.
The reports findings were that a large number of practicing physicians do not support the current process of self-regulation -- peer monitoring and reporting. This system is underused and has major shortcomings.
PREVENTING PATIENT INJURY IS URGENT
"The report concludes: "All health care professionals, from administrative leaders to those providing clinical care, must understand the urgency of preventing impaired or incompetent colleagues from injuring patients and the need to help these physicians confront and resolve their problems. The system of reporting must facilitate, rather than impede, this process."
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by Sharon McEachern
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