Physicians and bloodborne pathogens occupational exposure

Dear Medical Staff Leader:

According to Robert Ball, MD, MPH of the South Carolina State Department of Health and Environmental Control, "Many physicians [especially surgeons] experience occupational exposure to bloodborne pathogens, which are often unreported. Even if reported, these exposures are often poorly managed in various unstructured manners that ultimately provide suboptimal and inappropriate care for the exposed physician. This has led to a number of deaths and considerable stress among those physicians experiencing sharps injuries." According to Ball, "Often [such] physicians use the hospital's employee health/infection control nurse and protocols, at considerable time and expense to all involved."

Ball also notes that 95 percent of all physician sharps injuries require only testing of the patient to determine that no further action is necessary, and in almost all of the remaining 5 percent, testing the physician eliminates the need for concern. A very small percentage results in the need for drug therapy. Unfortunately, and perhaps because most physicians are not hospital employees, many are not offered access to the organized and well-managed occupational exposure management program available to hospital employees.

As a medical staff leader, you might seize the opportunity to request that such exposure management protocols and resources be made available to all physicians reporting sharps injuries. In many instances, hospitals will agree to cover all costs associated with physician testing and drug therapy in cases when such testing demonstrates conversion. It is highly likely that a medical staff leader could convince hospital management to extend participation in these programs to all physician members of the medical staff.

Part of this protocol, of course, must be maximizing not only physician safety but physician privacy as well.

"Hospitals and medical staffs, desirous of good mutual relations, as well as improved infection control interventions and reduced nosocomial infection rates, must develop innovative strategies to further improve professional partnerships and ensure healthier patients, providers, and hospital environments," Ball says.

As a leader, this is one area in which you can make a difference for physicians and our patients.

That's all for this week.

All the best,

Rick Sheff, MD