Patient safety requires doctors report incompetent physicians

Recently, JAMA published a study concluding that doctors are hesitant to report incompetent physicians or those who were impaired.

According to the article,

more than a third of docs don’t think they’re responsible for reporting those who aren’t fit to practice, according to the results just published in JAMA. And only 69 percent of the docs who knew about an impaired or incompetent colleague reported them.

To those who advocate that the medical profession self-police, the numbers aren’t encouraging.

Who’s the blame? Here are some reasons:

The most common reason — given 19 percent of the time by doctors who said they were aware of a problem doctor — is that they thought someone else was on top of it. After that 15 percent of the respondents figured nothing would happen anyway. Fear of retribution was also a factor, cited by 12 percent of these doctors.

According to the study’s lead author, smaller specialty practices are dependent on referrals, so angering colleagues can jeopardize that. I’d imagine this is less of a problem in larger, integrative practices where doctors are paid on salary.

Having a formalized system of reporting, along with ensuring the anonymity of whisteblowers can help.

I recently wrote that medical residents aren’t formally taught something as simple as filling out an incident report.  A culture of patient safety requires teaching doctors — especially those early in training — to know when and how to report their impaired or incompetent colleagues.  Only then can we improve the integrity of how the medical profession polices itself.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of, also on FacebookTwitterGoogle+, and LinkedIn.

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