Do doctors rat out their own? That's an interesting question. A reader sent me this picture of newspaper text with a similar title. I did a little search and found the source study for this story was a JAMA article that studied the ratting out habits of almost 2000 physicians. What did they find? Almost 2/3 agreed they had a professional obligation to report incompetent physicians or physicians under the influence of drugs or alcohol.
Only 17% (about 400) physicians reported having direct knowledge of an incompetent or intoxicated physician and of those 17%, 2/3 (or about 250) of these physicians reported them to appropriate authorities. That leaves only about 150 out of 5000 physicians, or 6% of physicians who have not reported their colleagues when they should have.
Why did this 6% of physicians not report incompetent or intoxicated physicians? The most common reasons reported were
- Fear of retribution
- It was being handled by someone else
- Nothing would happen anyway
- The physician would be excessively punished
- It wasn't their responsibility
All the Google headlines seem to say no, physicians would not rat out their own. The power is in perspective. What if the headline said "94% of physicians acted appropriately" instead of "Physicians don't rat out their own"
I look at the data and find physicians as a whole carry the highest degree professionalism, compassion and competency. How many Wall street executives were reporting their colleagues while the country was looted? How many friends and colleagues turn in their mother, son or neighbor falsifying their disability claims or their mortgage applications? How many Obama officials are failing to tell the public the truth as they recapitalize banks with record profits at the expense of fixed income elderly. How many SEC executives were looking the other way when their colleagues were surfing porn eight hours a day. How many Congressmen and women ignore their colleagues' flagrant dishonesty by buying votes from special interests. How many cops let one slide for their brother in the badge.
Every where you look, you are going to have people who lack the courage to do the right thing. If you believe that physicians are somehow super human and will always turn their colleagues in you might as well write a letter to the tooth fairy.
What you have here is a tiny part of a tiny problem. Physicians as a whole are highly competent. They have passed the test. They have paid thousands of dollars to certify with their governing boards to declare their competency with certification. If we are now to believe that physicians are incompetent despite their certification by their specialty board, we then must abandon the model of board certification and find an alternative means to measure the competency of physicians.
And when I am forced to pay money and reapply for state licensure every few years, my colleagues are forced to attest (in uncompensated time) as to the competency of my skills and the lack of my addiction to drugs and alcohol. If physicians are practicing drunk, and the state licensure process is meant to prevent it, then the government process is flawed, not the physicians. The process relies on physicians providing truthful answers and physicians as a whole, 94% of them, are truthful. If the concern is missing 6% of the problem then the government process should be changed. Just like you can't change your spouse, you're not going to change the moral fabric of the physician.
I'll take a 94% success rate any day of the week. The other 6% will eventually be found, one way or another. Besides, there's always a good med mal lawyer or two or three waiting for an opportunity to protect the patient.
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