Will Doctors Be Able to Escape Random Drug Testing?

Leigh Page, MS

Disclosures

April 22, 2015

In This Article

What Would Random Testing for Physicians Be Like?

The MGH anesthesiology department, which has been randomly testing since 2004, offers a glimpse into what random testing for physicians would be like.

Michael G. Fitzsimons, MD, who oversees the drug-testing program, said he has not encountered significant problems carrying out the policy, and he believes the rights of employees with false-positive results have been protected.

Dr Fitzsimons said the department randomly tests about 200-250 people on staff, including residents and senior physicians, at a total cost of about $50,000 a year. First-year residents, thought to be at highest risk, get at least two tests, whereas others get an average of one test a year.

As with all random testing, subjects are not told when they will be tested, and when they are notified, they must put aside their work and proceed to the testing lab. But they are permitted to provide their sample without observation, which many workplaces don't allow.

In more than 12 years of random testing, the department has had only one confirmed positive result. Dr Fitzsimons thinks the test has functioned as a deterrent. Medical students inquiring about the residency program are told that they will be tested, and he believes that those who want to abuse drugs don't apply.

In addition, the program has had two false-positives, which occur when the initial screening shows a positive result but a confirmation test does not. When this happens, the case is dropped.

Dr Fitzsimons discussed one of these cases. It took 10 days to get the confirmation result, and during that time, the employee had to immediately stop working and go on a leave of absence. But once the finding was determined to be false-positive, he went back to work, and any mention of the test was expunged from his record.

Dr Fitzsimons said he favors random testing. It's "a patient safety issue," because "patients can be injured by impaired healthcare providers," he said. He added that it can also save the lives of anesthesiologists, who have ready access to powerful drugs. One study[8] of anesthesiology residents found that 28 died of drug overdoses between 1975 and 2012, and their rate of substance abuse has increased since 2003.

But there's hardly been a rush of anesthesia departments to join the MGH program in performing random drug testing. Although a 2002 study[9] found that 61% of anesthesiology department chairs said they were interested in random testing, only the MGH and Cleveland Clinic departments are known to have launched programs.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....