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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4222.0: Tuesday, December 13, 2005 - 2:48 PM

Abstract #116088

Urine trouble: Health policy and ethical issues surrounding mandatory, pre-employment and not-for-cause drug testing of physicians

Martin T. Donohoe, MD, FACP, Portland State University, Old Town Clinic, 3718 Rivers Edge Drive, Lake Oswego, OR 97034, 503-819-6979, martin.donohoe@verizon.net

Health care organizations have increasingly adopted mandatory pre-employment and random, not-for-cause drug testing programs for physicians. This has occurred in the wake of federally-mandated and burgeoning industry-based drug testing programs; in response to concerns about medical errors, lawsuits, public image, and popular misconceptions surrounding substance use and abuse, and to recommendations of the American Hospital Association; and with the encouragement of business interests directly invested in the increasing use of drug tests. In this talk I will discuss the prevalence of substance use and abuse among physicians, the recommendations of policy-making bodies, and data on the costs and benefits of drug testing programs. For-cause drug testing and random testing of physicians who have been rehabilitated of a substance use disorder, when used appropriately, have been successful in maintaining abstinence and preserving doctors' careers. However, mandatory pre-employment and random, not-for-cause testing programs represent an unwarranted invasion of privacy and are based on poor science, are financially wasteful, and are unlikely to meet their implicit goals of creating a safer clinical environment and diminishing errors while improving the quality of patient care. More effective methods to diagnose and assist impaired physicians and to protect patients from incompetent and impaired doctors and enhance quality of patient care will be described.

Learning Objectives:

  • At the conclusion of this session, the participant should be able to

    Keywords: Drug Test, Quality of Care

    Presenting author's disclosure statement:

    I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

    [ Recorded presentation ] Recorded presentation

    Civil Rights, Ethics and Public Health

    The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA