Physician Substance Abuse Policies Insufficient in Hospitals

An online commentary published in the May 22/May 29 edition of the Journal of the American Medical Association asserts that all hospitals should randomly test physicians for drug and alcohol abuse to increase patient safety.

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The commentary cited surveys that suggest physicians may have a higher rate of alcohol and drug abuse than the general public, and workers in high-risk industries including airlines, railroads, and nuclear power plants are already being tested for alcohol and drugs following critical events.

In their commentary, Julius Cuong Pham, MD, PhD, an emergency medicine physician at Johns Hopkins Hospital, Peter J. Pronovost, MD, PhD, director of the Johns Hopkins Armstrong Institute for Patient Safety and Quality, and Gregory E. Skipper, MD, an addiction psychiatrist for Promises Treatment Centers, said there should be routine drug and alcohol testing for all physicians involved in critical events that lead to patient deaths, and they called for the creation of a national hospital regulatory body to conduct adverse event analysis and drug testing to help eliminate quality of care issues and problems related to employee substance abuse.

With such programs in place, physicians and employers may experience reductions in absenteeism, unintentional adverse events, injuries, and turnover, and they may be able to identify debilitating problems early, the authors said.