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Do doctors rat on each other?

If a doctor knew that a colleague was incompetent, drunk or high on drugs, would they turn them in? A new survey has some disturbing answers to that question.

Researchers at the Massachusetts General Hospital in Boston analyzed data from a nationally representative survey of 2,938 doctors practicing in the United States in 2009 in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics and psychiatry.

The good news is that 64 percent agreed that they had a professional obligation to report colleagues who were significantly impaired or incompetent to practice for some reason, according to a report in Wednesday's issue of the Journal of the American Medical Association. Sixty-nine percent said they were prepared to deal with impaired colleagues and 64 percent said they were prepared to deal with incompetent colleagues.

Now the disturbing findings: Seventeen percent reported having direct personal knowledge of an impaired or incompetent physician in their hospital, group or practice in the last three years, and only 67 precent of these physicians reported that individual to a hospital, clnical, professional society or other relevant authority. The most common reasons for not reporting was the belief that someone else was taking care of the problem, that nothing would happen anyway, that it was not their responsibility, that the doctor would be punished excessively, or that they were afraid of retribution.

Based on the findings, the researchers say better regulation is needed along with better reporting systems that protect confidentiality. In an editorial accompanying the study, Matthew Wynia of the AMA's Institute for Ethics agreed the findings show that the system needs fixing.

By Rob Stein  |  July 14, 2010; 7:00 AM ET
Categories:  Alcohol and Drugs , Bioethics , General Health , Hospitals , The Business of Health  
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Comments

And until physicians show that they are capable of policing their own ranks, there should be no tort reform.

Posted by: sasquatchbigfoot | July 14, 2010 11:16 AM | Report abuse

Listen, if docs were totally ethical, and read the Hippocratic oath, there would be no reason to have any outsiders intervene.
However, that does not seem to be possible, especially in the VA. As an example, an investigation by the VA Inspector General regarding the delay of cancer treatment and death for a patient at Zablocki Milwaukee VAMC.

SEE : http://www4.va.gov/oig/54/reports/VAOIG-09-01348-49.pdf

It appears that gross medical malpractice was performed by 2 radiologists, a radiation oncologist, a surgeon , and an internal medicine doctor, all of whom are faculty at Medical College of Wisconsin. You might say a comedy of medical errors but the patient died.

What is apparent is that a coverup was in the works when the IG was called. This is similar to what is happening in St. Louis, nothing happens until it hits the front page of the newspaper. Veterans sacrifice their lives at the war front and to get this type of care at home is immoral. Unfortunately, at the VA, moral ethical docs and workers are losing the war in giving good care to vets.

Posted by: billklein1 | July 14, 2010 11:34 AM | Report abuse

It is not just doctors who do not report doctors, it is administrators, who sometimes opt to promote "up and out" rather than report.

Posted by: khmaio | July 14, 2010 4:40 PM | Report abuse

Wait, so 17 percent knew and 2/3 of those reported? It sounds like the answer to your question is yes, doctors do rat on each other.

Question: Do journalists rat on each other?

Posted by: kevnet | July 14, 2010 5:00 PM | Report abuse

First off, I am in my office all day... I don't know what some other doc is doing, or not doing in HIS office...

Second, if somehow I do know I might disagree how a doc is handling a case in the hospital but:
1. It is not my case and HIPPA forbids me from snooping into that patient's chart or I go to federal prison... In my hospital we have 100% electronic records.. I, even as a physician on staff, cannot get the computer to show me some other patients record - it will however set off an alarm in the IT department that "I" am attempting to break into a patients chart that I do not have the legal rights to view... For me to view that chart requires a very specific set of procedures involving the top administrator of the hospital, the vice president of medical affairs, and the department chief...

2. Further, if I do know what orders the doc is giving that I disagree with, I might be wrong - he might be right in his medical decisions... Those patients have chosen him as their doc, not me... Can you pronounce the word, 'civil tort'... Check with you family lawyer, he will explain...

Now, as to my ignoring a doc who is drunk, or high, or whatever - it does not happen on my watch, regardless of what the cynical on here may think...

Those of you who are not physicians on medical staff have zero knowledge of how many sets of eyes watch every move I make, every order I write, every room I walk into making rounds, in the hospital... There may be bad hospitals somewhere that allow some impaired doc to roam the halls, but in my hospital there are no bad doc's, we do not put up with them...

dr. o

Posted by: ad4hk2004 | July 14, 2010 8:00 PM | Report abuse

The next time you have an appointment, you may want to bring a breathalyzer and set of questions to ask your doctor.

http://scallywagandvagabond.com/2010/07/there-are-more-drunk-doctors-than-you-thought/

Posted by: kathrynmcdermott | July 14, 2010 8:12 PM | Report abuse

The good news and the bad news presented by this article are pretty much the same...67% of those actually faced with knowledge of impaired or incompetent colleagues took some action and this is right in between the percentages that said they were prepared to do so (i.e., 64-69%). Looks to me like those who are talking the talk are walking the walk.

The real bad news is that just over 1/3 of doctors are not willing to report a colleague who is impaired or incompetent. I can understand why but it doesn't mean that the situation is acceptable.

Posted by: cdphelps | July 14, 2010 9:24 PM | Report abuse

Is there someone who seriousley thinks 64% is a high number?

Posted by: evolutiontotalwellness | July 15, 2010 12:09 AM | Report abuse

Weird study. First, incompetent and impaired were lumped, which defies logic. Then they separated incompetent and impaired in the "prepared to deal with" question.

As far as the end sum, it looks like less than 6% of either incompetent or impaired docs aren't reported, but again, was it impaired or incompetent?

Is anyone else bothered by lumping impaired and incompetent? I assume impaired is slurring and stumbling. But what is incompetence? You don't like his course of treatment for his patient for whom you have little/no knowledge?

Posted by: atb2 | July 19, 2010 12:09 PM | Report abuse

No kidding the AMA dept. of Ethics needs fixing! I have a lifelong nightmare of witnessing medical doctors, their administor's, including their hospital CEO "hanging" out together on a regular basis as a girlfriend of one of these physcians of immoral character. Publically drinking, showing off their latest handheld breathalizers, discussing the undesirable physical features of their nurses and patients. Lamenting about their ex-wives, ex and present girlfriends in obnoxious detail. I am not saying all doctors are like this, but this was my unfortunate experience dating a medical doctor for the first time. I thought their computer and cell phones (belonging to the hospital) but they sure were not worried about it from the kind of texts & emails I witnesses. I had the notion that doctors were very important busy people but not the creep I used to go out with. He spent all day on several websites and blogging long conversations on several sites he had interests in, all during the work day. I don't know how he had time for patients! Then there was their ridiculous egos and in my experience highly controlling with several texts all day long that demanded an answer immediately. Listen jerk, I have to work for a living! I don't have someone cleaning my house and underwear and don't have time to go out every night of the week to hobnob. When explaining my "boyfriend situation" to a co-worker who exclaimed how lucky I was to be dating a doctor, I told her exactly how NOT fun it was. She didn't believe me. So I went to the back of the store where we worked, took my cell out of my purse and showed her my texts from the last 2 hours. 17 texts in less than two hours, one more angry than the other. She was incredulous. Finally after a short time I just could not take the texts, emails and evenings of drunken bad behavior and broke it off. After much begging and promises of over a week I slowly started seeing him again. He seemed to be a lot better with his drinking and temper. Then I got the shock of my life. To make a even longer story short early in our intimate part of our relationship he had secretly brought a small video recorder into my apt and secretly taped us having sex. It was just a freak accident that I found it by his own carelessness. I broke it off immediatly and currently am being threatened and harassed to give it back or prove I destroyed it. During this time I started using search engines and can't believe all the smut on him. He had just got his licence reinstated after losing it for two years for having sex with a patient. The hospital knew about that one but decided to hire him anyway. I went to a high-profile attorney but all he cares about is a cival action and getting his 40 percent and all costs. After paying taxes, big deal. All the therapy and money in the world is not going to help me. Having him exposed so no other women have to go through this would help more. He is enbolden I believe because these guys all stick together.

Posted by: Pamx1121 | July 20, 2010 8:19 PM | Report abuse

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