Mandatory drug screenings may not be a novelty in the workplace, even in the hospital setting, but they are for medical staff members. If hospitals screen employees for controlled substances, it's to ensure healthcare providers are fit to care for the public.
Physicians are often excluded from those tests because of their non-employed status and because culturally they are often seen as above suspicion because of their position in society. However, hospitals must keep in mind that physicians experience the same human weaknesses as everyone else.
Should hospitals begin testing their physicians for controlled substances and make those tests an appointment requirement?
Directors of physician health programs (PHP) are split on the matter of mandatory drug tests for practitioners. PHPs are state-run health programs that help physicians recover from substance abuse and provide other support services.
"I think it would be a good idea [to make tests mandatory], but not everybody thinks it would be a good idea," says Peter Mansky, MD, executive medical director at Nevada Health Professionals Assistance Foundation in Las Vegas. "It's controversial."
Some of the controversy lies with the invasion of privacy inherent in these tests. Additionally, not all drug screenings are accurate—some substances may be missed, and other legal, prescriptive substances may be detected.
"I think it should only be done in the context of a drug-free workplace, like any other businesses might do," says Gary Carr, MD, FAAFP, Diplomate ABAM, medical director at Hattiesburg, MS-based Professional Health Network (www.professionalshealthnetwork.com). To keep the screenings fair, Carr says everyone in the hospital—from housekeeping to administration—should undergo the tests.
Even if everyone in the organization is screened, it may still be difficult to adopt such a policy.
"If there's no reason to believe there's a substance issue, how do you justify testing for it?" says Luis Sanchez, MD, director of Physician Health Services, Inc., a Massachusetts Medical Society corporation in Waltham.
It may be difficult to justify if the medical staff strongly believes it's an invasion of privacy. "There are very few hospitals that I'm aware of that will screen randomly or will screen everybody," he says.
However, Sanchez adds that some industries, such as the airline industry, have justified screenings because the industry frames it as a matter of public safety.
In the end, hospitals should weigh the issue from all sides before making their decision. Listening to public opinion and the concerns of medical staff members and employees will contribute to balanced policies and avoid the element of surprise if the hospital decides to begin testing everyone.
Emily Berry is an associate editor for Briefings on Credentialing and Credentialing Resource Center Connection, and manages the Credentialing Resource Center. You can reach her at eberry@hcpro.com.