QUESTION:        Is suspicion of alcohol or drug use while on hospital premises reason enough for Administration or medical staff leadership to act?

ANSWER:            First, you need a game plan.  By that, we mean a physician health/wellness policy.  Many hospitals and medical staffs have a separate policy dealing with such issues, including substance abuse.  These policies routinely provide for drug or alcohol screens when there is a suspicion of impairment, who may request them and the consequences if the physician declines.

Suspicion is reason enough to act.  In accordance with the policy, anyone should be able to report a concern – any practitioner, employee, patient, family member, or any other individual.  The concern should be reported to the Chief of Staff, Chief Medical Officer (“CMO”), or another medical staff leader, who will then refer it to the committee handling the matter (e.g., either a “Leadership Council” of experienced leaders or a physician health committee), which will assume primary responsibility for an issue.

Individuals filing a report do not need to have “proof,” but should describe the facts that form the basis for their suspicion, such as an odor of alcohol, problems with judgment or speech, diminished motor skills, behavior changes and mood swings, and unexplained drowsiness or inattentiveness, among other things.

If the physician is providing services at the hospital, or is expected to provide services in the very near future (e.g., a few hours) such that the committee would not have time to meet prior to the physician’s provision of services, the Chief of Staff, CMO, or other medical staff leader should be required to immediately and personally assess the physician, who may be required to submit to a blood, hair, or urine test, or other appropriate evaluation, to determine his or her ability to safely practice.  If the physician refuses, that should result in the automatic relinquishment of the physician’s clinical privileges pending review of the matter by the committee.

Another option is to ask the physician to voluntarily refrain from exercising his or her clinical privileges or agree to conditions on his or her practice while the matter is being reviewed.  If the physician agrees to voluntarily refrain from exercising his or her privileges, his or her patients may be assigned to another individual with appropriate clinical privileges.  If the physician does not agree, a precautionary suspension may be considered in accordance with the Credentials or Health/Wellness Policy.

For more on practitioner health and wellness, join Linda Haddad and Phil Zarone for

“Something Smells Fishy Around Here…”
January 9, 2018

– the first of our Grand Rounds 2018 series – “Crisis!!!  Now What?”