Physician Drug Testing

The New York Times reported last week on a ballot initiative in California that would mandate random routine drug and alcohol testing of physicians, and targeted testing after major adverse patient events. The full text of the proposal is available here.

Proponents of the measure (Proposition 46) highlight the danger posed by impaired physicians and the ubiquity of drug testing for other professionals such as airline pilots and public safety officers. They also endorse the other “patient safety measures” included in the proposition, including mandating that providers check a controlled substance database similar to the New York State I-STOP database before prescribing. Their arguments are summarized here.

Predictably, the California Medical Association opposes the measure, mostly – they say – because it would also raise the current cap on “pain and suffering” payments in malpractice suits, and lead to higher malpractice insurance costs. Interestingly, the CMA website opposing the proposition doesn’t mention the drug testing provision.

My first reaction when I read about the drug testing initiative was one of sadness. What a shame that we have failed to maintain the public trust in our profession. But I was also reminded of a case I was involved in years ago in which a physician’s careless act led to a patient’s death. I have long regretted that I failed to insist that the physician be tested for drugs or alcohol at the time. If the death had been caused by a plane crash or a bus accident, we would all expect such testing to take place, and its omission would never be tolerated by the National Transportation Safety Board.

The mission statement of the CMA is: “Promoting the science and art of medicine, the care and well-being of patients, the protection of the public health and the betterment of the medical profession.” Seems to me that if they really mean it, they ought to be in favor of drug testing.

What do you think??

2 thoughts on “Physician Drug Testing

  1. The patient is helpless in the medical system. I had a PCP where I often wondered if he was on drugs or ill-like cancer or something. Odd things set him off, and then he often seemed to be in a fog. I’m in an HMO that makes it arduous to change doctors.

    I have RSD from a botched breast biopsy. I don’t suspect drugs-just exhaustion and not that much skill. The patients need all the protection we can get. Drugs impair judgments about prescribing meds, plans of treatment.

    We need some protection and assurance. I can’t really say that I trust the American medical profession.

  2. It is very sad that it has to come to this. I appreciate your understanding of the patients’ points. Some of us got the brunt of small mistakes that have now been magnified due to problems on the part of the physician. If they had been helped that would have been great, rather than messing up the people here.

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