A physician smells alcohol on the breath of one of her physician colleagues. The concerned physician confronts her colleague, but he adamantly denies consuming any alcohol. Nonetheless, the concerned physician insists that the colleague go home for the day. The colleague initially protests saying, "I just had a couple of beers last night!" However, he eventually leaves for the day voluntarily. The concerned physician plans to discuss the issue further with her colleague the next day and encourage him to get help.
The colleague comes to work the next day again smelling of alcohol. Which of the following is the most appropriate course of action?

Question

A physician smells alcohol on the breath of one of her physician colleagues.  The concerned physician confronts her colleague, but he adamantly denies consuming any alcohol.  Nonetheless, the concerned physician insists that the colleague go home for the day.  The colleague initially protests saying, "I just had a couple of beers last night!"  However, he eventually leaves for the day voluntarily.  The concerned physician plans to discuss the issue further with her colleague the next day and encourage him to get help.
The colleague comes to work the next day again smelling of alcohol.  Which of the following is the most appropriate course of action?

Quizplus · Accepted Answer

Although physicians may detect impairment in their colleagues, they are often reluctant to report an impaired physician due to concerns regarding potential professional and personal consequences. However, patient safety must always take priority. When there are concerns that a physician may be too impaired to practice medicine safely due to a substance use disorder, psychiatric illness, or medical condition (eg, neurodegenerative disease) physicians are ethically obligated to report suspected physician impairment to the appropriate state regulatory body. In most states, a physician health program (PHP) would be the appropriate regulatory body, but in the few states without a PHP, physicians would file a report directly with the state medical board. (Choice A) It would be inappropriate for a concerned colleague to intervene in the medical care of a potentially impaired physician. The PHP can assist the impaired physician in obtaining necessary evaluation and/or treatment. (Choice B) The physician's alcohol abuse is a risk to patient care and safety. Reporting a physician to the PHP does not require evidence of malpractice. (Choice C) Although it may be appropriate to notify the potentially impaired physician's supervisor, this action alone would not discharge the concerned physician's ethical duty to report the impaired physician to the state PHP. (Choice E) Efforts to discuss concerns directly with the physician have already been met with denial and there is continued evidence of impairment that places his patients at risk. It would be inappropriate to postpone notifying the state PHP. Educational objective: Physicians have an ethical responsibility to report an impaired colleague to the appropriate state regulatory body (ie, a physician health program or state medical board). __________ References: The prevalence of substance use disorders in American physicians. (http://www.ncbi.nlm.nih.gov/pubmed/25823633) Service provision to physicians with mental health and addiction problems. (http://www.ncbi.nlm.nih.gov/pubmed/26001924)

A Physician Smells Alcohol on the Breath of One of Her