Silence When Speaking Is Required

Professional courtesy can go too far. Are we ethically bound to report an impaired or incompetent professional who works with us? Yes, when the workplace is populated by medical professionals responsible for patients’ lives. But a 2009 survey answered by 1,891 physicians reported in the July 14 issue of JAMA found 36 percent would not report all instances to a relevant authority, implying that self-regulation by this profession is not effective.

The authors (from Boston's Mongan Institute for Health Policy and Massachusetts General Hospital) said their survey is nationally representative and involved 2,938 eligible professionals in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Why do some say they wouldn't report? Their most-cited reasons -- believing someone else would handle the problem, nothing would happen despite the report, or there would be some kind of reprisal -- sound familiar to me because I've blown the whistle myself at times but seen nothing done.

"Overall, physicians support the professional commitment to report all instances of impaired or incompetent colleagues in their medical practice to a relevant authority; however, when faced with these situations, many do not report,” they observed. Only 64 percent (1,120) of the surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or incompetent to practice.

Scientific American on Tuesday posted a report describing the study and an editorial concerning it in the same JAMA issue.

How many workplace casualties result and how much productivity is lost from turning a blind eye to impairment, incompetence, or simply failure to follow necessary safety rules? What are the policy and the actual practice at your place of work when you encounter a co-worker who’s under the influence, unsafe, or unsatisfactory in the job?

Posted by Jerry Laws on Jul 14, 2010


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