While drug and alcohol testing as a condition of employment is common among physicians applying for hospital-based positions, there are increasing calls for expanding hospital quality-control programs to include screening for substance abuse impairment through random testing and following sentinel events leading to a patient’s death. Expanding substance abuse testing of physicians will bring the medical profession better in line with other high-risk industries like the airlines, railways, and nuclear power, according to an article published online ahead of print April 29 in the Journal of the American Medical Association (JAMA). Data do not exist showing impaired physicians are actually harming patients. But there is recognition that alcohol, narcotic, and sedative addiction is as common among physicians as the general population and that medical errors are common in hospitals. “In states without proactive [physician health] programs, it seems, by default, that patient harm has to occur before a review process occurs,” write the authors, led by Julius Pham, M.D., Ph.D., from Johns Hopkins University in Baltimore. Self-monitoring, rather than external regulation, has been the norm in ensuring physician professionalism. But the authors of the JAMA article say that expansion of physician health program oversight coupled with hospital-level implementation might provide […]