Would you turn in an incompetent colleague?

A recent report published in the Journal of the American Medical Association (JAMA) revealed that many medical doctors have direct, personal knowledge of an impaired or incompetent physician in their workplaces but won’t report them.

Doctor thinkingThe researchers, led by Catherine DesRoches of Harvard Medical School, surveyed 1,891 practicing US doctors in order to “understand physicians’ beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine.”

A majority of the doctors surveyed (64%) said they agreed that it was important to report other MDs who were “significantly impaired or otherwise incompetent to practice.” But just 69% said they were prepared to really do anything about the situation if it came up in their practice.

More shocking was the revelation that 17% of the doctors had direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. But of those, a full one third (33%) had not reported the colleague to the relevant authority.

The reasons they gave for their silence were the belief that someone else would take care of the problem (19%), the belief that nothing would happen as a result of the report (15%) and fear of retribution (12%).

The actual numbers might be even higher since, of the 2,938 physicians contacted, only 1,891 agreed to take the survey — the other 36% might have decided the questions were a bit too delicate to answer.

As bad as this sounds, I wonder how it differs from the chiropractic profession (or any health care profession). Granted, an incompetent chiropractor is far less of a threat to a patient’s well being than an incompetent MD, but what do we do when we realize a fellow DC is significantly impaired? If we know a colleague is drinking or using drugs during work, or is otherwise unfit to care for patients, do we report him or her to the board?

I realize that there have been many (far too many) cases where chiropractors have “tattled” on their competition for the most trivial infractions of the rules, but that’s a far cry from accusing another practitioner of being incompetent.

This is one of those grey areas that require soul searching and total honesty. If we truly believe that a colleague might do any harm to patients or to the profession as a whole, we owe it to those patients and chiropractic to take a courageous stand. We might try approaching the doctor and discussing the situation with him or her, offering to assist in getting the person proper help overcoming the problem. If that doesn’t work, we may have no choice but to file a complaint with the state board.

SOURCE: “Physicians’ Perceptions, Preparedness for Reporting, and Experiences Related to Impaired and Incompetent Colleagues,” JAMA. 2010;304(2):187-193. doi:10.1001/jama.2010.921