An intern attends a local dinner party and recognizes a colleague who works at the same hospital in another department. During the course of the evening, she observes her colleague responding to a number of routine medical calls from the hospital and consuming several alcoholic drinks. Later that evening, the physician notices that her colleague is giving medication orders over the phone and appears grossly intoxicated with slurred speech. The physician confronts her colleague, asking him to transfer on-call responsibilities for the sake of patient care. He insists that he is fine, is not drunk, and that his duties end in 30 minutes anyway. Which of the following is the most appropriate course of action?

Question

An intern attends a local dinner party and recognizes a colleague who works at the same hospital in another department.  During the course of the evening, she observes her colleague responding to a number of routine medical calls from the hospital and consuming several alcoholic drinks.  Later that evening, the physician notices that her colleague is giving medication orders over the phone and appears grossly intoxicated with slurred speech.  The physician confronts her colleague, asking him to transfer on-call responsibilities for the sake of patient care.  He insists that he is fine, is not drunk, and that his duties end in 30 minutes anyway.  Which of the following is the most appropriate course of action?

Quizplus · Accepted Answer

Physicians are ethically and legally obligated to report impaired colleagues in a timely manner. This physician is in the uncomfortable position of knowing that a colleague is intoxicated while on duty. Although it is unclear whether this is a one-time occurrence or part of a pattern of more extensive impairment, the physician is obligated to intervene immediately because patient safety is at risk. The colleague's immediate supervisor should be informed so that the situation can be dealt with as quickly as possible. Risks of not intervening include harm to patients and failure to obtain necessary evaluation and treatment for the physician, which can negatively impact his health, career, and family. Most hospitals and state medical boards have regulations requiring physicians to report impaired colleagues. This can usually be done anonymously. In a non-emergency situation, a person should contact the designated hospital committee, commonly called a physician health program (Choice E). If this is not possible or such a body does not exist, then the state licensing board should be contacted (Choice F). It is the committee or board's responsibility to systematically gather all the facts and arrange for a comprehensive assessment and intervention if necessary. (Choice B) The physician confronted the colleague with no response, and harm can still be done to a patient in 30 minutes. A claim of confronting a colleague is not a substitute for reporting the incident. (Choices C and D) Witnessing the physician's on-duty intoxicated behavior is sufficient reason to intervene as patient care may be in jeopardy. Whether there is direct evidence of harm or the physician has an established pattern of problem behavior is irrelevant. Educational objective: Physicians are ethically and legally obligated to report impaired colleagues in a timely manner. Reporting protects patient safety and can assist the impaired physician in receiving appropriate evaluation and treatment. __________ References: Impaired physicians. (http://www.ncbi.nlm.nih.gov/pubmed/24873127) Physicians' willingness to report impaired colleagues. (http://www.ncbi.nlm.nih.gov/pubmed/15882920)

An Intern Attends a Local Dinner Party and Recognizes a Colleague