If pilots and commercial truck drivers are subject to federally mandated drug and alcohol testing, why aren’t doctors?  According to an article recently published in The Journal of the American Medical Association, they should be.

At least one in ten doctors will suffer from drug or alcohol addiction at some point during their career.  Despite these statistics, however, the American Medical Association has never required doctors to undergo drug or alcohol testing, either before beginning employment or following an unexpected patient death or injury.  And, unlike other high-risk industries, no federal agency or other regulatory body has ever mandated profession-wide testing.

In their April 29 article, Drs. Julius Cuong Pham and Peter J. Pronovost, patient safety experts at Johns Hopkins University in Baltimore, Maryland (with Dr. Gregory E. Skipper of Promises Treatment Center in Santa Monica, California contributing),  argue that drug testing could have a wide variety of positive effects on the profession.  “Patients might be better protected from preventable harm.  Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem.”  While Johns Hopkins is among a small number of hospitals that requires doctors undergo drug testing as a condition of employment, it is not an industry-wide practice.  Drs. Cuong, Pronovost and Skipper believe that should change.   

The article recommends a number of steps, the first of which includes implementing an AMA-created and accredited testing body.  The testing body could then oversee a variety of testing standards for all AMA accredited hospitals, which would include requiring: mandatory physical examinations and drug screening before medical staff are appointed to a hospital; random drug and alcohol testing; and, testing all physicians involved in a patient’s unexpected death or injury.

In cases where a doctor is found to be impaired, the article recommends the hospital suspending or revoking his privileges and, in some cases, reporting positive drug and alcohol tests to the state licensure board.  Any doctor found to be practicing while under the influence would be required to undergo treatment and routine monitoring as a condition for returning to practice.