Blog | Monday, May 4, 2015

Should hospitals ban workers from smoking at home?


I practice gastroenterology in Cleveland in the dark shadow of a large medical institution whose name contains the name of our city. They are a world class medical institution whose reputation is largely derived from its cardiovascular department. Presumably, these practitioners, like all doctors, advise patients who smoke that cigarettes have deleterious health effects. The entire campus is smoke-free, as are all hospitals today. This is a relatively new development. A few years ago, nurses and other hospital staff would huddle at the entrance puffing away. No more. Now, there is no smoking anywhere on the hospital property. Hospital puffers now have to wait until quitting time, when they are behind the wheel and leaving the grounds before they light up.

I'm okay with all this. The hospital should set an example to promote better health. Patients and families who enter the hospital who must pass through a smoky fog might wonder about the hospital's commitment to health and healing. Of course, one could make the same argument about overweight nurses and physicians, but obesity apparently cannot be legally outlawed on hospital wards.

The mega-medical-mall here in Cleveland has put in place a no smoking policy on steroids. Not only can't you smoke on the job, but you can't smoke anywhere on this planet or any other extraterrestrial location. In fact, workers there will be tested periodically for nicotine to verify compliance with the edict.

I'm not okay with this policy. If medical personnel smoke on their own time, but refrain from doing so on the job, I do not believe this should disqualify them from their jobs. Folks are entitled to smoke, drink, curse, watch adult movies, gain weight, eat deep fried onion rings and forego aerobic exercise when they are on their own time. Of course, the hospital should encourage personnel to quit and offer treatment programs to assist them in doing so. But, mandating this as a job requirement is wrong.

We have staff in our office who smoke. I wish they didn't, and they know it. But, we're not about to fire them for this addiction which does not impact on their job performance.

While our office is smoke-free, we do permit staff smokers to take a break outside when they feel they need inhalation therapy. These sessions occur out of view of our patients. Some of our non-smoking staff have muttered that this is unfair as the puffers are in effect rewarded with a breaks during the day that they do not receive. While this argument is valid, we have left the status quo in effect. I'm not sure the greater good in our small practice would be served by enforcing a no smoking policy, although admittedly, this is arguable.

Outlawing Camels and Marlboros at both work and play is beyond Big Brother. It's an intrusive violation of personal freedom that should be extinguished.

To those who support it, why stop with cigarettes? What other activities and behaviors should be prohibited off the job? I have a personal interest here. If sarcasm were on the list, then I'd be fired.

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.