There’s an old nurses’ joke that goes like this:
- Q: What do you call the medical student who finishes dead last in every one of his classes all through med school?
- A: “Doctor”
But what happens when these docs are eventually let loose upon the unsuspecting public as professionals with the letters MD after their names? Who keeps an eye on substandard doctors?
The alarming results of a study published in the Journal of the American Medical Association this month reveal that, although most physicians believe that their medical colleagues who are “significantly impaired or incompetent to practice medicine” should be reported, the reality is that a disturbing number actually chose instead to sit by and do nothing even when they admitted they had “direct personal knowledge” of such incompetence.
Last year, researchers at Massachusetts General Hospital in Boston surveyed almost 3,000 physicians working in anaesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Here’s what they found:
- 64% of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice.
- 69% reported being prepared to effectively deal with impaired colleagues in their medical practice
- 17% reported having direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. Of those with this knowledge, only 67% reported this colleague to the relevant authorities.
- physicians who are under-represented minorities and graduates of foreign medical schools were less likely than their counterparts to report, and physicians working in hospitals or medical schoolswere most likely to report.
By now, you may be asking yourself: if 64% of physicians believed that it is their “professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice”, why didn’t they take action when they did have “direct knowledge”?
The Boston study found that the most frequently cited reasons for taking no action were:
- the belief that someone else was taking care of the problem (19%)
- the belief that nothing would happen even if they did report (15%)
- fear of retribution (12%).
There are a couple alarming results in this study: first of course is that frightening admission that almost one third of docs who have “direct personal knowledge” of significant impairment or incompetence among their fellow docs do not report these dangerous situations.
But what also caught my eye was the very first finding reported, that 64% of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice.
This sounds like pretty good news until you realize what it really means: that over one third of physicians do not agree with the need to report colleagues who are significantly impaired by drugs or alcohol, or incompetent to practice medicine.
If this is indeed true, why isn’t that the news headline?
A physician who knowingly protects a colleague who is unfit to safely treat patients should be considered equally incompetent.
Read more about this study called Physicians’ Perceptions, Preparedness for Reporting, and Experiences Related to Impaired and Incompetent Colleagues published in the Journal of the American Medical Association. (July 14 2010 JAMA. 2010;304(2):187-193. doi:10.1001/jama.2010.921)