Is Random Drug Testing in Physicians' Future?

Sandra Levy

Disclosures

July 11, 2017

In This Article

Will Doctors Be Required to Undergo Random Drug Testing?

Doctors who practice under the influence of drugs or alcohol risk harming their patients. How widespread is this problem, and should random drug testing be enforced for physicians, as it is for airline pilots?

In 2014, Proposition 46 appeared on the California ballot. It included an initiative that would have required drug and alcohol testing of doctors and the reporting of positive tests to the California Medical Board. The proposition was defeated, but the debate continues.

In Medscape's 2016 Ethics Survey of more than 7500 physicians, 41% of physicians said doctors should be tested, 42% said no, and 18% said it depends. But the practice of random testing of employees is growing in acceptance.

A recent Medscape video hosted by Dr Arthur L. Caplan featured a discussion with Dr Cheryl Karcher, a board-certified dermatologist and expert on aesthetic medicine, and Dr Craig Klugman, a bioethicist and medical anthropologist at DePaul University in Chicago. The debate sparked well over 180 emotional responses from physicians.

"Military medicine has been doing random drug testing of all healthcare workers since the 1980s," said one physician. "Anyone who wants to pursue this issue should just ask the Office of the Surgeon General of any of the three services what the advantages and disadvantages of the program was or is. No need to reinvent the wheel. I personally have no issue with being subject to random drug testing with the proper safeguards in place—for example, a robust chain-of-evidence security program."

Another physician who gave a thumbs-up to mandatory testing said, "I think at the end, this is for the benefit of every party involved, but mostly for our patients. I agree on drug testing 100%."

Random drug testing may save a doctor's life, said one respondent:

During 35 years of practice as an anesthesiologist, I have known two faculty members and two residents who have died of drug overdoses (two from fentanyl, one from sufentanil, and one from sevoflurane). There have been several near-misses. Random test everyone, and worry about the poppy seeds later. These were all good people whose behavioral clues were obvious in hindsight, but were excused or written off as fatigue, stress, et cetera. And if you think, "It could not happen to me," you are delusional.

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