JAMA Viewpoint: Proactive medical staff monitoring could bolster peer review

Peer review is the accepted modality to identify physicians with impaired performance, but a robust physician health program could further protect patients, wrote Julius C. Pham, MD, PhD, of the Johns Hopkins University School of Medicine, in an April 29 Journal of the American Medical Association online Viewpoint. Such a program could include a physical examination, drug testing, or both before a medical staff appointment, with random alcohol/drug testing thereafter, as well as mandatory drug/alcohol testing for all physicians involved with a sentinel event leading to patient death. Physicians found to be impaired would be required to attend a treatment program and be subject routine monitoring as a condition of licensure/hospital privileges.

“Patients and their family members have a right to be protected from impaired physicians. In other high-risk industries, this right is supported by regulations and surveillance. Shouldn't medicine be the same? A robust system to identify impaired physicians may enhance the professionalism that peer review seeks to protect,” Pham concluded.