The 130th Annual Meeting of APHA

Abstract #43162

Martin T Donohoe, MD, FACP, Clinical Assistant Professor of Medicine and Senior Scholar, Center for Ethics in Health Care, Oregon Health and Science University, 3718 Rivers Edge Drive, Lake Oswego, OR 97034, 503/819-6979, martin.donohoe@verizon.net

Health care organizations have increasingly adopted mandatory pre-employment and random, not-for-cause drug testing programs for health care providers. This has occurred in the wake of federally-mandated and burgeoning industry-based drug testing programs; in response to concerns about medical errors, lawsuits, public image, and popular misconceptions surrounding substance use and abuse; upon recommendations of the American Hospital Association; and with the encouragement of business interests directly invested in the increasing use of drug tests.

For-cause drug testing and random testing of health care providers who have been rehabilitated of a substance use disorder, when used appropriately, have been successful in maintaining abstinence and preserving providers’ careers. However, I will argue that mandatory pre-employment and random, not-for-cause testing programs are based on poor science, are financially wasteful, and are unlikely to meet their implicit goals of creating a safer clinical environment and diminishing errors while improving the quality of patient care. The invasion of privacy posed by these programs could potentially lead to other types of unwarranted testing and dissemination of providers' health data beyond the confines of their institutions. More effective methods to protect patients from incompetent and impaired providers, which are not subject to such serious financial and ethical problems, will be described (e.g., performance-based testing).

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