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The “Acute Perspective” about “doctors with drink problems” is not only tautologous but also a cul-de-sac.(1)
First, why the subtitle they “deserve help”? Who would pledge to acting differently and why should a doctor be treated better or worse than anyone else?
Secondly, the issue is first about patient care. Can a doctor experiencing troubles provide adequate care? Even for less complex problems than alcohol, the consequences may be devastating for patients: when compared with non-smoking physicians, physicians who smoke are less likely to identify the smoking status of their patients, provide advice on quitting and thorough cessation counseling coverage, and initiate cessation interventions.(2)
Why is there no assessment of doctors' fitness to practice while there are enduring pledges to implement in the healthcare system the most sophisticated risk management framework, the one from the aviation model?(3,4) Doctors can practise without assessment though: a) there are numerous factors putting health-care professionals at a higher risk of substance abuse; b) knowledge is continuously changing. To put it simply, bus drivers have been regularly assessed for “know-how” and “know it to be” for a long time while healthcare professionals have been enduringly postponing the issue.(5)
The solution will not come from doctors and the first stage must be simple. Could the NHS and the General Medical Council of the United Kingdom begin by implementing the toolkit for employers designed by the workplace campaigns at Business in the Community, the Prince’s responsible business network, in association with Public Health England? (https://wellbeing.bitc.org.uk/all-resources/toolkits/drugs-alcohol-and-t...)
1 Oliver D. David Oliver: Doctors with drink problems deserve help. BMJ 2019;365:l4057.
2 Huang C, Guo C, Yu S et al.,. Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model. Tob. Control 2013;Suppl 2;ii27–ii33.
3 Rodger J. Lessons health care can learn from aviation. BMJ 2008;337:a1777.
4 Kar P. Partha Kar: Applying aviation safety to healthcare-are we missing the fundamental? BMJ 2019;364:l735
5 Bashook PG, Parboosingh J. Recertification and the maintenance of competence. BMJ 1998;316:545-8.
Do patients deserve doctors with problems?
The “Acute Perspective” about “doctors with drink problems” is not only tautologous but also a cul-de-sac.(1)
First, why the subtitle they “deserve help”? Who would pledge to acting differently and why should a doctor be treated better or worse than anyone else?
Secondly, the issue is first about patient care. Can a doctor experiencing troubles provide adequate care? Even for less complex problems than alcohol, the consequences may be devastating for patients: when compared with non-smoking physicians, physicians who smoke are less likely to identify the smoking status of their patients, provide advice on quitting and thorough cessation counseling coverage, and initiate cessation interventions.(2)
Why is there no assessment of doctors' fitness to practice while there are enduring pledges to implement in the healthcare system the most sophisticated risk management framework, the one from the aviation model?(3,4) Doctors can practise without assessment though: a) there are numerous factors putting health-care professionals at a higher risk of substance abuse; b) knowledge is continuously changing. To put it simply, bus drivers have been regularly assessed for “know-how” and “know it to be” for a long time while healthcare professionals have been enduringly postponing the issue.(5)
The solution will not come from doctors and the first stage must be simple. Could the NHS and the General Medical Council of the United Kingdom begin by implementing the toolkit for employers designed by the workplace campaigns at Business in the Community, the Prince’s responsible business network, in association with Public Health England? (https://wellbeing.bitc.org.uk/all-resources/toolkits/drugs-alcohol-and-t...)
1 Oliver D. David Oliver: Doctors with drink problems deserve help. BMJ 2019;365:l4057.
2 Huang C, Guo C, Yu S et al.,. Smoking behaviours and cessation services among male physicians in China: evidence from a structural equation model. Tob. Control 2013;Suppl 2;ii27–ii33.
3 Rodger J. Lessons health care can learn from aviation. BMJ 2008;337:a1777.
4 Kar P. Partha Kar: Applying aviation safety to healthcare-are we missing the fundamental? BMJ 2019;364:l735
5 Bashook PG, Parboosingh J. Recertification and the maintenance of competence. BMJ 1998;316:545-8.
Competing interests: No competing interests