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.
See here for more discussion.

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

No comments:

Post a Comment


What I'm Reading - Updated 3 May

Blog Archive