Alcohol and Drug Testing of Health Professionals Following Preventable Adverse Events: A Bad Idea

Abstract

Various kinds of alcohol and drug testing, such as preemployment, routine, and for-cause testing, are commonly performed by employers. While healthcare organizations usually require preemployment drug testing, they vary on whether personnel will be subjected to further testing. Recently, a call has gone out for postincident testing among physicians who are involved in serious, preventable events, especially ones leading to a patient's death. This article will offer a number of counterarguments to that proposal and discuss an alternate approach: that health institutions can better improve patient safety and employees' well-being by implementing an organizational policy of "speaking up" when system operators notice work behaviors or environmental factors that threaten harm or peril. The article will conclude with a description of various strategies that facilitate speaking up, and why the practice constitutes a superior alternative to mandatory alcohol and drug testing in the wake of serious, harm-causing medical error.

Addicted Health Care Professionals: Missing the Wood for the Trees?

“…For a long time, identifying best practice through benchmarking has been essential for improvement in quality and security (Braillon et al 2007). In contrast, focusing on rare and tragic events, such as a Stevens Johnson syndrome or a case settled for $15.5 million (Banja 2014), may not be the best method to improve quality of care (West, Weeks, and Bagian 2008). For too long, health care professional organizations and the Surgeon General have failed to raise the bar.…”

“…Alain Braillon, University Hospital, Amiens Banja (2014) is rightly concerned with addicted health care professionals, a security issue too rarely raised as even the magnitude of this problem remains poorly investigated, but his title is unduly provocative and he may have missed the most damaging addiction. First, is testing of school bus drivers a bad idea?…”

“…Professor Banja (2014) has eloquently articulated that it is not clear that any demonstrable harm can be attributed to impaired physicians:…”

On Speaking Up and Alcohol and Drug Testing for Health Care Professionals

“…On Speaking Up and Alcohol and Drug Testing for Health Care Professionals David Trafimow, New Mexico State University In the target article, Banja (2014) argues against alcohol and drug testing for health care professionals and provides several reasons. Most important, there is not much evidence that alcohol or drug abuse has large effects on the performance of health care professionals, and Banja cited evidence that the effects are small.…”

Unintended Effects on Morale of Mandatory Postincident Testing

“…In the target article, Banja (2014) argues against alcohol and drug testing for health care professionals and provides several reasons. Most important, there is not much evidence that alcohol or drug abuse has large effects on the performance of health care professionals, and Banja cited evidence that the effects are small.…”