"The most dangerous physician is one that's not come to the attention of the organization, because over the course of their lifetime, 1 out of 10 doctors will have some significant problem with drugs or alcohol. So the percentage who are impaired at any one time is a smaller percentage, but even if it is three or 4 percent, that's scary," says William Norcross, MD, family medicine specialist and professor of clinical family medicine at UC San Diego Health System.
Norcross has served on the UCSD physician Well-Being Committee for eight years.
The Joint Commission requires healthcare organizations to have a system in place to manage practitioners with health concerns. These committees may operate under different names, but their ultimate job is to protect patients by being a confidential resource for staff members to turn when a colleague is in trouble.
"People hope when they go to a hospital or to a large medical group that there is a wellbeing committee somewhere and that they're doing this kind of work to make sure that the care that patients receive is safe. But I don't think that anyone can tell you, because it is so confidential, that across the board that it is happening in the same way and in the same quality from hospital to hospital," says Norcross.
For addicted clinicians, a large issue is that there is no transparency in the system, says Ethan O. Bryson, MD, an associate professor in the Departments of Anesthesiology and Psychiatry at Mount Sinai School of Medicine. Bryson recently spoke on the topic at the Association for Health Care Journalists conference in Boston. Bryson is the author of the book, Addicted Healers.
"Sometimes these physicians are pushed out the door because the hospital leadership doesn't want to deal with them, but nothing is reported to the state medical boards, and even [if it were], there is little communication [among] the state medical boards," says Bryson.