Alcohol, Drugs, Addiction and Bad Doctoring
Thursday December 20, 2007
One estimate tells us that as many as 8,000 physicians may be
undergoing rehab for drug or alcohol addictions at any given time. If
that's true, then that means there are 400 doctors on average in each
state in the US who are practicing while under the influence. One of
them may be your doctor. The number represents one percent of all
licensed doctors in the US.
This comes to light from an MSNBC expose about addicted doctors and
the fact that while they undergo rehab, they are still allowed to
practice medicine. Further, the rehab programs are secret. They are
intentionally confidential so patients won't know which doctors have
addiction problems so those doctors won't lose their practices.
Should they remain confidential?
There are opinions on all sides of this argument. The article states
that addiction specialists (although it doesn't say who they are) and
the AMA (American Medical Association) think these programs should
remain confidential. They contend that if the programs aren't
confidential then doctors won't go into rehab. They'll just keep
practicing.
And that's the problem. Doctors whose capabilities are altered by
drugs or alcohol are dangerous. The MSNBC article cites myriad
examples of botched surgeries, and delayed treatments, even for
cancer.
It's another one of those conundrums: should these programs remain
confidential so these talented doctors can work to overcome addictions
and continue to help patients? Or should they be made public so
patients can learn about them and make informed choices?
But I think they are asking the wrong question.
Consider: Doctors and providers are in a class of careers that affect
life and death -- like pilots. If a pilot is found to be drunk, or
discovered to have a problem with alcohol or drugs, he is yanked from
his plane. He's not allowed to fly.
Doctors are responsible for life and death, too. Surgery is an obvious
problem. But other doctors may diagnose incorrectly, prescribe
medicine incorrectly, send patients for the wrong kinds of procedures
-- there are many things that a doctor, no matter what type s/he is
may do that put patients in danger every day.
So why are they allowed to practice at all? Rehab or no rehab -- why
aren't they just pulled from practice?
The article doesn't talk about how the rehab system works. I would
have more confidence in the confidentiality side if I knew that
doctors were pulled from practice for, say, the first six weeks, then
stayed in the rehab system for the next six months or a year. If
that's how these systems work, then yes -- I'm all for dignity and
getting someone back on his feet. Confidentiality is fine as long as
doctors are not allowed to treat patients during those early
withdrawal days and initial counseling.
But if not, if doctors continue their practices (and stress levels)
with no interim period of practice-absent rehab -- then I say -- take
them out of the practice and any situation where they can possibly
harm a patient.
And a word to patients: part of the responsibility for identification
is up to us. We must recognize that doctors are human beings, too --
and just as we wouldn't get into a car with a drunk driver, we don't
need to spend time being cared for by a drunk, or otherwise under-the-
influence doctor or other provider. Yes, I recognize that some addicts/
drunks are able to hide their problems, but many aren't. If you ever
suspect your provider is under the influence, then RUN, don't walk, to
the exit.
How s/he handles his/her addition is up to him/her -- but you don't
have to be a party to it.
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