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Drug-Test Physicians? Docs Say ‘No Way’

http://www.medscape.com/viewarticle/830211?nlid=64226_1521&src=wnl_edit_medp_wir&uac=174964FT&spon=17

From airline pilots to Walmart greeters, many American workers are required to submit to drug testing as a condition of employment. In a recent discussion on Medscape Physician Connect (MPC), an all-physician discussion group, doctors discussed whether they should be subjected to testing. It did not take long for an answer to emerge: an emphatic “no.”

What ever happened to probable cause? [If] a doc comes in smelling of alcohol, marijuana, or is acting erratically, perhaps making irrational [statements], those are flags that should prompt an investigation. Screening for substance use should be based upon reasonable suspicion and not kneejerk across an entire population. There are legitimate reasons that employers may wish to screen potential employees but I see no legitimate reason to continually mandate employees (including healthcare employees) who do not exhibit any evidence of impairment.

The ethical question is whether the risk of patient injury by those 10 or so physician merits that the other 90 or so physicians out of 100 should be subjected to scrutiny . . . The question which still should be answered about those 10-12 physicians out of 100 is what absolute risk do they pose to patients’ diagnoses, treatment, and lives and how many patients together are at absolute risk for serious consequences?

Random drug testing is an invasion of privacy. What is at issue is the problem of sample error and being falsely accused. I personally have witnessed errors in chain of custody of both hair samples and drug tests. I don’t see why a company, instead of random drug tests, can’t have policies and procedures that state a test may be required in cases of unexplained excessive absences, changes in behavior, deterioration in performance, accidents on the job, etc.

 

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