A family physician whom a young patient's mother accused of being impaired at work has won his lawsuit against a Kentucky hospital.
A jury on May 2 awarded John M. Farmer, MD, $3.7 million for emotional distress and contract damages against Baptist Health Madisonville and Baptist Health Medical Group Inc for a series of actions they took against Farmer after the impairment complaint.
"It's been the worst thing that I've ever gone through in my entire life," Farmer said in an interview with Medscape. "My career was disrupted, because I couldn't finish residency on time, and I had difficulty finding full-time employment comparable to what I expected to obtain immediately following residency. It continues to significantly impact my life and my job, because I remain subject to random drug testing at any time and must check in every day to see whether I have to get drug tested."
Farmer was in his third year of residency at the hospital when the mother of two young patients accused the doctor of being "on something" during a visit with her children, said Kathleen DeLaney, an Indianapolis-based attorney who represented Farmer in the case.
According to the lawsuit, the hospital violated its fitness for duty and drug testing policy by not immediately notifying Farmer of the complaint nor immediately testing him to prove whether or not there was a factual basis for the allegation. Repercussions from the unproven complaint damaged Farmer's personal and professional reputation. It severely limited his job prospects and earning potential, the suit alleged.
Baptist Health spokeswoman Rebecca Towles Brown said Baptist Health is exploring its legal options after the jury's decision.
"We strongly disagree with the allegations made against Baptist Health in this case and are disappointed in the jury's verdict. Baptist Health followed its medical staff policies and appropriately responded to concerns raised about Dr Farmer's well-being and behavior on the date in question. We are evaluating our post-verdict options, as we believe the facts as they occurred do not support the verdict. Our primary focus remains providing high-quality care to our patients and families."
What Sparked the Complaint?
On November 4, 2019, Farmer worked a full day in the clinic at Baptist Health, visiting and treating patients and interacting with colleagues, according to court documents. In the late afternoon, he conducted a routine appointment with two children while their mother, her boyfriend, and a medical student were present.
Following the afternoon appointment, the mother issued a complaint to an office manager that Farmer was impaired, noting that he was "touching his nose a lot," according to the lawsuit.
The next morning, hospital administrators met with Farmer and asked whether he was impaired the day before, to which he replied, "Absolutely not," court documents state. Farmer asked to be given a urine drug screen immediately, but administrators allegedly said he needed to be tested at the Kentucky Physicians Health Foundation in Louisville.
Farmer immediately made the 3-hour drive to the facility, and Baptist Health placed him on leave, pending the evaluation. The health foundation sent Farmer to a third-party vendor to complete a urine drug screen, which returned a result of "dilute." (A "dilute" result occurs when the urine concentration is weak because of too much water in the urine and testers are unable to detect whether alcohol or drugs are present.)
He was then instructed to go to a separate alcohol treatment facility for a 96-hour evaluation, where he was ultimately diagnosed with mild alcohol use disorder, according to DeLaney. The facility did not recommend that he receive any inpatient care, she said.
Hospital administrators later sent a letter to the Kentucky Board of Medical Licensure alerting them of the patient's complaint. The board opened an investigation, and Farmer was required to sign an interim order in which he agreeed not to practice medicine until approved by the board, according to court documents. The order was reported to the National Practitioner's Data Bank (NPDB).
To maintain his employment and complete his residency, Farmer was ultimately required to sign a 2-year agreement with Kentucky Physicians Health Foundation, which included regular testing, monitoring, and therapy. The board later extended the agreement to 5 years and made Farmer's compliance a condition of retaining his medical license, according to legal records.
Farmer sued Baptist Health Medical Group and Baptist Heath Madisonville in 2021, alleging breach of contract and tortious interference with prospective business advantage.
At trial, co-workers, including Farmer's attending physicians, testified that Farmer was not impaired on the date in question, DeLaney said. A key fact highlighted at trial is that Farmer has attention-deficit/hyperactivity disorder (ADHD).
"My client has ADHD, so he's normally a twitchy person," she said. "There was lots of testimony about how he moves a lot and that he's fidgety and doesn't stand still. The two attending doctors that were supervising him at clinic that afternoon both said 100% he was not impaired; he was his usual self. They told the residency director that right after the incident. They both testified at trial they thought that would be the end of the matter."
Baptist Health would not comment about whether it followed its fitness for duty and drug testing policy or whether leaders spoke with other medical professionals who worked with Farmer on the day of the complaint.
Farmer said he feels vindicated by the verdict and grateful to the jury.
"I intend to continue practicing as a family medicine doctor and hope to continue to grow and advance in my career," he said.
Have You Been Falsely Accused? Here's What to Do
Farmer is not alone in fighting back against allegations by hospitals regarding conduct associated with impairment.
In 2020, an obstetrician/gynecologist who had been accused of being under the influence while working won $4.75 million in fraud and defamation damages against St. Vincent Carmel Hospital and St. Vincent Carmel Medical Group for its treatment following an impairment complaint by a nurse.
It's unclear how prevalent such scenarios are because frequently, physicians are embarrassed and keep quiet about the situation and how they were treated, said Louise B. Andrew, MD, JD, an emergency physician/internist and attorney who consults on physician health and wellness, litigation stress, and disability discrimination.
"Physicians are unlikely to reveal that it's happened to them unless they happen to have had a good outcome" she said. "All we know is that we're hearing more and more about it, and that might be because people are becoming more open and outraged when it happens. It's quite easy for anyone in a hospital environment or in an office environment, for a competitor, a co-worker, or even a disgruntled patient to allege a physician has 'glazed eyes' or 'alcohol on the breath,' and that's all it takes to start the ball rolling."
If you are falsely accused of being impaired at work or are suddenly confronted with a complaint, the first step is to remain calm, said Kernan Manion, MD, executive director for the Center for Physician Rights, a nonprofit organization that assists physicians who have been subject to unfair medical board, health program, or peer review processes.
"The first thing is to keep your wits about you," he said, "because often, docs get frightened or angry, and they overact. You have to gain your composure and ask for documentation about the nature of the allegation."
Obtain in writing any and all information that supports the allegation, he adds. Physicians who are asked to report to a physician health program should ask the reason they are being referred and whether it is for a medical evaluation or another type of evaluation, he said. If it's a medical reason, the process needs to follow medical parameters in terms of confidentiality.
"The bottom line is that a doctor should not take everything at face value and follow the organization's orders unquestioning," he said. "They have a right to get their concerns addressed."
Physicians who are accused of using substances on duty or being under the influence while working have to right to undergo testing immediately, Andrew said.
"If you're told on the spot, 'You need to submit to testing,' then you should do it, but make sure it's done properly," she said. "Ensure that forensically, you give two samples and that they are sealed and the chain of evidence is maintained. The reason for that is if one of them is a false positive, the second one can be reviewed separately."
If administrators do not allow for prompt testing, get yourself tested immediately on your own, she said.
As far as leaves of absence are concerned, ensure you know what type of leave is being executed, Manion said. Ask the nature of the leave and whether the leave counts as a suspension that will go against your medical license and be reportable to the NPDB, he stresses. In such cases, the only reason to suspend a doctor's privileges is because they are considered a danger to others, or, in other words, there's been an allegation of unsafe care, he said.
"If there is an allegation of unsafe care, the physician should ask for documentation of the patient safety issues in question and why they are being deemed unsafe to practice," he said.
DeLaney recommends that physicians not report to or communicate with any state medical association, physician health foundation, or licensing authority without first getting legal advice.
In addition, doctors will likely be tested for acute and long-term drug and alcohol use, so it's a good idea to avoid any activity or substances that could result in a dilute sample or a positive result on a drug or alcohol test, she said.
As for broader solutions, it's important that more physicians come out of the shadows and tell their stories when these injustices take place, said Andrew.
"Doctors need to be more open about this when it happens, which is not easy," she said. "More need to be suing, which is certainly not cheap. Also, when they do come to settlements, they should not sign nondisclosure agreements so that they can talk about what happened and it can be publicized. This way, more doctors are aware of the types of tactics used against physicians and what other doctors have done that can help."
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Cite this: Doc Accused of Impairment Wins $3.7M for Unproven Complaint - Medscape - May 24, 2023.