Friday, June 25, 2010

Drug Testing Docs?

I got this link from Sermo. Lucian Leape MD, a public health professor at Harvard, wants to subject doctors in America to strict random and periodic drug testing to help identify those physicians who are impaired. All in the name of patient safety, of course:
"I'm very much in favor of random testing," Dr. Leape says. "We have a responsibility to identify problem doctors and bring them into treatment." And to protect patients in the process.

Ok, I get it. Impaired physicians are bad. We don't want strung out cokeheads and stumbling alcoholics roaming the halls of our hospitals. But random drug testing? Listen, it's hard to argue with someone like Dr. Leape without appearing to be some uber-lefty, bleary eyed, tie-dye wearing hippy freak. But consider:

1) A doctor who is on vacation with extended family in the Outer Banks. After a day of surfing and tanning and several cold frosty beers, one her cousins busts out a joint late night on the back deck while the ocean rolls into shore. And let's say she partakes in such activities 3 of the next 4 nights in similar fashion. That THC will be floating around in her system for the next 30 days, potentially. What if she is called to give urine a week after the trip?

2) Let's say an internist goes to a Super Bowl party with friends. The day turns into an all night fiesta as they celebrate the Browns' first ever world title. Many beers are consumed. Knowing that it was going to be a long night of carousing, the doctor had cancelled his office hours for the following Monday morning, planning to just drop by the office in the afternoon to do some charting. The next morning, his office manager calls at 8 AM sharp and tells him he has to have his urine/blood sample in by 10AM. He stumbles out of bed, still hung over, and rushes into the hospital. The result shows his blood alcohol is 0.09 (enough to get you a DUI). What do you do with him?

What are the consequences? Do you lose your license? Are you reported to the medical board? Are your privileges at hospitals suspended? Does your name wind up on the police blotter section of your local Sunday paper?

To be clear-- I am strictly against the idea of physicians practicing medicine while impaired. But this totalitarian encroachment on what a man or a woman chooses to do in his/her free time is rather disturbing. As a professional class I think it is our own responsibility to identify and report those doctors who have a problem. An impaired physician cannot hide for very long. We just need to stop being such timid cowards and do a better job of self-policing ourselves.


Anonymous said...

OMG! Physicans subjected to the same testing millions of Cops/Firemen/Truck Drivers/Pilots/Military/Fast Food Workers/My Kids/Practically any job where someone else is paying you/ submit to daily...
Whats this world comin to????

as for your hypotheticals(What is this? the Oral Boards?)

1: Marriage-Wana's illegal, shes screwed, serves her right, thats why Jehovah made THC stick around forever instead of like LSD which only requires mere micrograms for effect, not that I know anything about LSD.

2: Alcohols legal, he's cool, unless he gets arrested for DUI.

Self Policing doesn't work, even with the Police...

Frank "Dont' bogart the Acid" Drackman

Wayne Conrad said...

As long people have someone "bad" to be afraid of, no would-be tyrant need infringe their human rights or political liberties. The people will give them up voluntarily, and be glad to do so.

Anonymous said...

Well? I suspect things might get a little interesting.


Anonymous said...

Is there a random or anonymous way to check alertness, manual dexterity, or whatever is deemed appropriate by both doctors and patients, without these chemical tests?

If so, is it appropriate to check everyone in society randomly when they perform work which affects others, or place others at risk such as by driving?

Eventually cars may be equipped with instruments to check alertness, etc.

Another Anonymous said...

In my job I know that on any given day that I may be called to give a sample of urine, blood, hair or nails to prove that I have not illegally used certain substances. I must be able to prove within 48 hours that anything in my body has been prescribed by a physician for me.

What vital job do I do? Data entry in insurance while I attend school.

Do I think that doctors should be held to this standard also? Doctors who often have inflated egos and tendencies to think they can handle things like that- (I know my husband getting his doctorate went a bit to my head, his as well). Damn straight they should!

I'm all for legalizing drugs to reduce the costs related to prohibition and the so called war on drugs, but whole heartedly agree with the societal sanctions against drug use. The exact reason that I believe drugs could be legalized with fewer catastrophic problems and far less crime.

Anonymous said...

If Jerry Garcia got drug tested he might still be alive, making horrible music, instead of just another Ben & Jerrys Ice Cream Flavor..

Anonymous said...

Frank please bogart the acid all you want. It's pretty obvious you are not stupid enough to drop acid but you have made me wonder considering your SEC football bias.
We are talking about marijuana which will be fully legal in California for recreational use after this November's vote. Marijuana is also on the ballot in Nevada in 2011 which I fully expect it will pass in that state as well. If you are getting paid by a private company, management should be able to test you for drug use any time they want.
Whose bringing all these drugs into the United States? Google Bill Clinton, Mena Arkansas, Iran Contra, or Air America and Frank Lucas. Illegal drugs keep the price high and the prisions full.

Anonymous said...

AMEN AMEN AMEN. This sort of thing just breeds resentment. Next up, DNA samples, just to make sure we're all in the system? Or better yet, those funny little ankle bracelets that monitor alcohol content in the blood in real time. That would REALLY be a winner (sarcasm alert).

Most people know their limit. Most doctors are responsible. Most physicians will stop their colleagues from self destructing. I feel the profession is pretty good at policing itself.

And for the record, I've never given a pee sample to the government... even though I worked in one of its units for a while. Fast food worker provide pee samples? Seriously? Where? ANY job where someone else is paying you???? Really? I'm not sure what planet Frank Drackman is living on.

Anonymous said...

Damn right SEC Football is the Best, last 4 National Champs, and the SEC Title Games become the De-facto BCS Championship.
ACC? dont make me laugh
Big 10(11?,12?) can't even count
PAC 10? 12? USC forfieted there dirty 04' BCS Title, which should have gone to Auburn if it wasn't for the Marxist Stream Media Bias.
OK, the Big 12(10?) has 2 or 3 decent teams that wish they were in the SEC.

Ohio State would finish 5th in the SEC West.


DoctorMama said...

Here's my solution: drug tests that are announced in advance. Because if you can't pass a drug test that you know is coming, you really have a problem. Otherwise, only if someone seems impaired.

(And I mean this for everyone, not just physicians.)