The Need for Better Self-Policing

Two news stories this week raise serious concerns about the effectiveness of systems intended to act upon physicians and nurses who don’t meet adequate standards for providing patient care.

•       A Massachusetts General Hospital survey of more than 3,000 physicians across multiple specialties found that one of every three doctors rejected the idea that they should report colleagues who are incompetent or impaired by substance abuse or mental health problems.  The survey found that 17 percent of doctors had encountered a physician who was either incompetent or impaired, but only two-thirds of those doctors turned in their colleague.

•       In today’s USA Today, it was reported that nurses who have committed acts of misconduct in some states can easily get jobs in other states that are part of a multi-state compact aimed at getting nurses into regions that need them the most.  The news article cited a nurse in Wisconsin who was fired for stealing narcotics, but still maintained a clean record in the eyes of the multi-state compact and was able to easily get another nursing job in North Carolina.

I don’t want to oversimplify these issues.  Certainly, it is difficult for physicians, in order to maintain open lines of communication and collaboration, to “snitch” on a colleague who has an addiction problem or who may even be suffering early signs of dementia.  And, for nurses, the idea of multi-state cooperation is a good one because innovative steps need to be taken to address the nursing shortages that exist in so many parts of the country.

In the end, though, the patient has to come first, and patients can’t be put at risk by any lessening of standards when it comes to the quality of physicians and nurses.  There is a need here for associations representing both professions to be proactive in ensuring that all members in their ranks meet the highest standards.