nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Friday, July 16, 2010

Some Doctors Don't Report Other Doctors Who Are Impaired

 
I've had several experiences of handling impaired physicians.  This is just a selection.

[I wasn't going to write about this, but after the misrepresentation in the press, I felt compelled.  ]

Case 1:  Inappropriate touching.  I was called to conduct a credentials review.  Result:  revoked privileges and reported to the state medical board. License revoked. Law enforcement was handled separately.
Case 2:  Reckless disregard for patient safety.  Internist did a treadmill on an allegedly unstable patient.  Result:  privilieges restricted while investigation was done.  Facts didn't support the reckless disregard, and records of care showed appropriate management of risk.  Privileges restored.
Case 3:  Drunkenness while on call.  Came to hospital intoxicated.  Result:  Rehab, reported to state board.
Case 4:  Arrest for unlawful carrying of a firearm.  Result:  Review of patient cases showed clinical competence.  Physician voluntarily underwent psychiatric evaluation.  Insufficient criteria for a diagnosis.  Returned to patient care without incident.

In addition to these, there have been many instances of doing a focused review of the care a physician was rendering and many peer reviews of patient records.  In a number of cases, I've required a physician to justify their clinical management in writing.

Not a one of these was easy, and only some of them turned out to be real.  The system works when you make it work.

That a study in JAMA (July 14) finds that some doctors don't report incompetence or impairment is not a surprise.  The fear of retaliation is real, and the distaste for getting into a messy fight is also a factor.  Anonymous reporting is a joke; everybody knows you made the report.

Nonetheless, it's a disgraceful performance.  There's a special trust in medicine that goes above most professional ethics requirements: as patients, we are at our most vulnerable when sick or injured.

I recommend you do the following:  most state medical boards maintain a page where you can look up your doctor and find out whether there have been complaints, disciplinary actions, criminal history, license restrictions, etc.  In my state the website is here:  Texas Medical Board.  Click on the "Check your doctor" link and follow the instructions.  Lots of info.

I just checked myself, and I'm still clean (whew!).  They even have where I was a couple of months late paying for my license renewal 24 years ago  (So? I was deployed to Egypt...I blew it).

Doc D
 

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