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Wednesday, October 1, 2014Lift License or Rehab?
California's Proposition 46, which includes testing of
physicians for impairment randomly and after adverse events, addresses an
important problem, but in a dangerously flawed manner, say authors of 2
commentaries published online September 30 in the Annals of Internal Medicine.
On November 4, Californians will vote on the
Medical Malpractice Lawsuits Cap and Drug Testing of Doctors Initiative
(Proposition 46), which would mandate random drug and alcohol testing of
physicians and quadruple the cap on malpractice awards to $1.1 million. If it
passes, it would be the first such law in the nation.
Proponents promote it as a patient safety measure, but authors of both commentaries say it will have the opposite effect.
Proposition 46 calls for the immediate suspension of
physicians who test positive, but the authors note that it never defines a
legitimate process for confirming test results. False-positives are inevitable,
and innocent physicians could be tied up in lengthy and costly court battles.
One flaw of the current proposition, they
say, is that results of the drug testing could be used in criminal and civil
litigation. When programs are designed to punish, rather than rehabilitate,
they say, healthcare providers are less likely to seek help or report an
impaired colleague, which could jeopardize patient safety. "Thus, under this new law, physicians
might seek to avoid detection as long as possible, might not be reported as
early, and might come to attention only after egregious patient harm," Dr.
Pham and Dr. Pronovost write.
