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Drug Screening of Physicians: Violations of Personal Privacy vs "Peace of Mind"

Yesterday, I received the following e-mail from Ed:

“Dr Bernstein, as a retired USAF pilot and current airline pilot who has been subjected to random drug screening for my entire professional career, why aren’t medical providers who have easy access to legal drugs as well as the same to access to illegal drugs as the rest of society, subject to random drug screening? The public literally places their lives in our respective hands and it seems both professions have a ethical, moral, and legal obligation to ensure reasonable efforts are made to identify those who abuse drugs. I think this would make a great topic for your blog.”
It was.. and here it is.

I wrote Ed back “Good topic for consideration. The question is not the moral, ethical or legal aspects of testing but in the physician population alone, what are the studies and statistics which confirm that such testing would make a significant difference in overall patient safety vs the validity and the economics of a test result?  An airline pilot, in daily work, may have hundreds of lives beyond his/her own at immediate highly significant risk whereas a physician’s risk pool is limited to his one patient with less significant risk. ..Maurice. “

We must find the statistics to compare physicians to airline pilots with regard to drug intoxication, frequency of incidence and outcome in terms of risks to lives and health in their daily professions. In reality, the testing of physicians for drug use is already occurring in U.S. hospitals both on staff admission and also randomly. If the statistics show that drug use by physicians is minute and the consequences of such addiction is also minute, then the questions are whether such testing is simply a way to provide society and the patients some “peace of mind” and whether that benefit is sufficient to ethically permit violation of a physician’s personal privacy and its professional consequences  for that patient comfort.

If statistics will show that there is a difference between the risks to patients vs passengers, would you agree that there should be a difference between physicians and airline pilots in the way society handles the drug-use issue for safety and “peace of mind”?  ..Maurice.  

Graphic: From Google Images modified by me with ArtRage 3.

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