Featured Research

from universities, journals, and other organizations

Many physicians do not accept responsibility to report incompetent, impaired colleagues

Date:
July 14, 2010
Source:
Massachusetts General Hospital
Summary:
More than one-third of US physicians responding to a survey did not agree that physicians should always report colleagues who are incompetent or impaired by conditions such as substance abuse or mental health disorders. The survey also found that substantial numbers of physicians feel unprepared to report or otherwise deal with impaired or incompetent colleagues.

More than one-third of U.S. physicians responding to a survey did not agree that physicians should always report colleagues who are incompetent or impaired by conditions such as substance abuse or mental health disorders.

Related Articles


The report from the Mongan Institute for Health Policy at Massachusetts General Hospital (MGH), published in the July 14 Journal of the American Medical Association, also finds that substantial numbers of physicians feel unprepared to report or otherwise deal with impaired or incompetent colleagues.

"Our findings cast serious doubt on the ability of medicine to self-regulate with regard to impaired or incompetent physicians," says Catherine DesRoches, DrPh, of the Mongan Institute, who led the study. "Since physicians themselves are the primary mechanism for detecting such colleagues, understanding their beliefs and experiences surrounding this issue is essential. This is clearly an area where the profession of medicine needs to be concerned."

Many states and professional organizations -- including the American Medical Association -- require physicians and other health professionals to report colleagues whose ability to practice medicine is impaired. In spite of increased attention to and concern about medical errors in professional circles and in the media, studies have shown that fewer impaired physicians are being reported than would be expected. The current study was designed to examine physicians' beliefs about the obligation to report, their preparedness to report, and their experiences with and actions taken when confronted with impaired or incompetent colleagues.

A larger survey of medical professionalism taken in 2009 included a group of questions focused on beliefs and behaviors regarding impaired or incompetent colleagues. The survey was sent to 3,500 physicians -- 500 each in internal medicine, family practice, pediatrics, cardiology, general surgery, psychiatry and anesthesia. Participants were asked to rate their agreement that "physicians should report all instances of significantly impaired or incompetent colleagues." They also were asked how prepared they felt to deal with such a colleague and whether they had direct knowledge of an impaired or incompetent colleague in the past three years. Those with such knowledge were asked whether they had reported the most recent incident and also if, within that three-year period, particular reasons were associated with a failure to report.

Almost 1,900 surveys were returned, and only 64 percent of the respondents agreed that physicians should always report impaired or incompetent colleagues. About 70 percent of respondents indicated feeling prepared to deal with an impaired colleague, and 64 percent felt prepared to deal with an incompetent colleague in their practice. Pediatricians were the least likely to report feeling prepared to deal with impaired or incompetent colleagues, while psychiatrists and anesthesiologists felt most prepared. Direct, personal knowledge of an impaired or incompetent physician during the past three years was indicated by 17 percent of respondents, but only 67 percent of those with such knowledge actually had reported the colleague.

"This study underscores the need for the medical profession to educate its members on their reporting obligations to ensure safe and competent care to patients," says John A. Fromson, MD, associate director of Postgraduate Medical Education, MGH Psychiatry, and a co-author of the report. "Those obligations include referring colleagues to physician health programs that can guide and monitor their recovery from substance use and mental disorders."

The most frequently cited reason for not reporting was the expectation that someone else would report, indicated by 19 percent, followed by the belief that nothing would happen because of the report, cited by 15 percent, and a fear of retribution, 12 percent. Among factors associated with not reporting were belonging to one- or two-person practices and being a member of an underrepresented minority or a graduate of a foreign medical school. Whether respondents came from a state with high, medium or low rate of malpractice claims was not associated with failure to report.

"Our results imply that the current system of reporting is functionally inadequate; many physicians are afraid to access it or believe that reporting will not be effective," says Eric G. Campbell, PhD, research director for the Mongan Institute and senior author of the JAMA report. "Improvements to the system need to include helping physicians understand their professional responsibility to report impaired and incompetent colleagues, enhancing protections for reporting physicians and providing confidential feedback about outcomes." Campbell is an associate professor of Medicine, DesRoches an assistant professor, and Fromson an assistant clinical professor at Harvard Medical School.

Additional co-authors of the study -- supported by a grant from the Institute on Medicine as a Profession -- are Sowmya Rao, PhD, Lisa Iezzoni, MD, MSc, and Christine Vogeli, PhD, Mongan Institute for Health Policy at MGH; and Robert J. Birnbaum, MD, PhD, MGH Psychiatry.


Story Source:

The above story is based on materials provided by Massachusetts General Hospital. Note: Materials may be edited for content and length.


Journal References:

  1. Catherine M. DesRoches; Sowmya R. Rao; John A. Fromson; Robert J. Birnbaum; Lisa Iezzoni; Christine Vogeli; Eric G. Campbell. Physicians' Perceptions, Preparedness for Reporting, and Experiences Related to Impaired and Incompetent Colleagues. JAMA, 2010; 304 (2): 187-193 [link]
  2. Matthew K. Wynia. The Role of Professionalism and Self-regulation in Detecting Impaired or Incompetent Physicians. JAMA, 2010; 304 (2): 210-212 [link]

Cite This Page:

Massachusetts General Hospital. "Many physicians do not accept responsibility to report incompetent, impaired colleagues." ScienceDaily. ScienceDaily, 14 July 2010. <www.sciencedaily.com/releases/2010/07/100713165001.htm>.
Massachusetts General Hospital. (2010, July 14). Many physicians do not accept responsibility to report incompetent, impaired colleagues. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2010/07/100713165001.htm
Massachusetts General Hospital. "Many physicians do not accept responsibility to report incompetent, impaired colleagues." ScienceDaily. www.sciencedaily.com/releases/2010/07/100713165001.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins