Medical News Today

More than one third of US doctors who responded to a survey did not agree it was their responsibility to report colleagues who were incompetent or impaired, for instance due to substance abuse or a mental health disorder.

The findings were published on July 14th in JAMA, Journal of the American Medical Association. 

Lead study investigator, Dr Catherine DesRoches, of the Mongan Institute for Health Policy at Massachusetts General Hospital (MGH) in Boston, told the press that their findings question the ability of medical profession to regulate itself when it comes to dealing with incompetent or impaired doctors:

"Since physicians themselves are the primary mechanism for detecting such colleagues, understanding their beliefs and experiences surrounding this issue is essential. This is clearly an area where the profession of medicine needs to be concerned," she urged.

The survey covered doctors in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. From 2,938 eligible US doctors invited to complete the survey, 1,891 responded (64.4 percent). 

The survey asked respondents to rate the extent to which they agreed or disagreed with the statement:

"Physicians should report all instances of significantly impaired or incompetent colleagues."

It also asked them to say how prepared they felt to deal with such a situation, and whether they had had direct knowledge of an impaired or incompetent colleague in the past three years.

If they answered yes to having direct knowledge of such a case or cases, the survey then asked them to say whether they had reported the most recent case, and if they had failed to report any cases within the last three years, what reasons did they have.

The results showed that: 

• 64 percent (1,120 respondents) agreed that doctors should always report impaired or incompetent colleagues.

• 69 percent (1,208) said they felt prepared to deal effectively with impaired colleagues in their medical practice.

• 17 percent (309) had direct personal knowledge of a colleague who was incompetent to practise medicine in their hospital, group, or practice.

• Of these, 67 percent (204) reported the colleague.

Psychiatrists and anesthesiologists were the most likely to say they felt prepared to deal with impaired or incompetent colleagues, while pediatricians were the least likely.

Underrepresented minorities and graduates of non-US medical schools were less likely than their counterparts to say they would report impaired or incompetent colleagues, while doctors working in hospitals or medical schools were the most likely.

The most frequently stated reason for taking no action was the belief that someone else was alreading dealing with it (19 percent of respondents, 58), followed by the belief that nothing would happen (15 percent, 46) and fear of retribution (12 percent, 36).