Blog | Friday, September 12, 2014

Testing doctors for drugs and alcohol


I read recently that the left coast state of California is contemplating requiring physicians to submit to alcohol and drug testing. Citizens there will be voting on this proposal this November. I do think that the public is entitled to be treated by physicians who are unimpaired. Physicians, as members of the human species, have the same vices and frailties as the rest of us.

I have no objection to this new requirement, if it passes. This will not be a stand-alone proposal on the ballot, but is a part of the ballot initiative. Why would trial lawyers in the Golden State want to include it? The meat of their ballot effort is to reverse effective tort reform that had been in place there for several years. Click on the Legal Quality category on this blog for a fuller explanation of why the medical malpractice system has been screaming for reform, and is slowing getting it. Sure, there are always two or more sides to every issue. But, when the different points of view here are fairly weighed, trial lawyers’ self-serving positions are overtaken. They offer a different spin, of course. While I acknowledge the validity of some of their arguments, I believe that the system they advocate helps very few at the expense of many more innocents.

The California ballot initiative aims to increase the financial cap for a medical malpractice award from $250,000 to $1.1 million. Trial lawyers and other supporters were concerned that the public may reject raising the cap as they have been enjoying the benefits of tort reform. Focus groups supported the notion that the public would find the drug and alcohol testing proposal appealing, which would raise the probability of passage of the bill.

There’s nothing evil about any of this. Every player in every issue uses polling and focus groups to create and tailor their message. (Ever notice how politicians claim they never read polls whenever poll results are against them or their positions?) I’m sure that the insurance companies who champion tort reform are using the same techniques to manage their message.

But, voters there and the rest of us should recognize why the drug and alcohol provision is included. It was just a spoonful of sugar to make the legal medicine go down. Why not just include the medical malpractice vote on the ballot by itself,? We’ve seen our politicians use this same technique over and over again. Add a popular poison-pill provision to an unpopular piece of legislation. When it’s properly voted down, criticize those who voted against it by pointing out their opposition to the popular add-on provision. Follow this example.

Legislator A: I am adding an amendment to the Quadruple the Minimum Wage Bill that would give all veterans and their families free First Class seating on all domestic flights.

Legislator B: I am voting against the bill because I think that quadrupling the minimum wage is bad economic policy

Legislator A: Shame on Legislator A for trashing our veterans who have sacrificed so much for this country.

Should other professions be subjected to random drug and alcohol testing? Which would you suggest?

Will Californians see through the smoke here? We’ll find out this November.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.