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Many Physicians Would Avoid Reporting Professional Misconduct

A survey shows a surprisingly high percentage seem to feel it is not their job.

In theory, medicine is a self-regulating profession, which means that most instances of substandard practice are expected to be identified and rectified internally. However, a survey of U.S. physicians now confirms what we all know — that many are not eager to take on the responsibility.

Of almost 1900 respondents in seven specialties, only 64% completely agreed that "physicians should report all instances of significantly impaired or incompetent colleagues to their professional society, hospital, clinic, and/or other relevant authority." Similar percentages stated they felt "very prepared" or "somewhat prepared" to deal with impaired or incompetent colleagues. Physicians in solo or two-person practices were least likely to completely support reporting; physicians in university or medical school settings were most likely to feel prepared to do so. Anesthesiologists and psychiatrists were most likely to feel prepared to deal with impaired colleagues; anesthesiologists and surgeons were most likely to feel prepared to deal with incompetent ones. Women were more likely than men to believe incompetence should be reported but were less likely to be prepared to report it.

Among the 17% of respondents with direct personal knowledge of an impaired or incompetent colleague in the previous 3 years, 33% had not reported that colleague. The most commonly cited reasons were "thought someone else was taking care of the problem," "believed nothing would happen as a result of the report," and "fear of retribution."

Comment: Surveys like this one, which couch difficult issues in generalities, are always difficult to interpret. These authors find it deplorable that a full one third of physicians appear unwilling to shoulder the burden of self-policing. However, their reluctance might stem from the realization that "incompetence" is not always so clear-cut in medicine. Sometimes the shades of gray are such that no survey can capture the case-by-case decision making that is required.

— Abigail Zuger, MD

Published in Journal Watch General Medicine July 22, 2010

Citation(s):

DesRoches CM et al. Physicians' perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues. JAMA 2010 Jul 14; 304:187. (http://dx.doi.org/10.1001/jama.2010.921)

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