title: Physicians' perceptions, preparedness for reporting, and experiences related to impaired and incompetent colleagues.
abstract: BACKGROUND
  Peer monitoring and reporting are the primary mechanisms for identifying physicians who are impaired or otherwise incompetent to practice, but data suggest that the rate of such reporting is lower than it should be.
  
  
  OBJECTIVE
  To understand physicians' beliefs, preparedness, and actual experiences related to colleagues who are impaired or incompetent to practice medicine.
  
  
  METHODS
  Nationally representative survey of 2938 eligible physicians practicing in the United States in 2009 in anesthesiology, cardiology, family practice, general surgery, internal medicine, pediatrics, and psychiatry. Overall, 1891 physicians (64.4%) responded.
  
  
  METHODS
  Beliefs about and preparedness for reporting and experiences with colleagues who practice medicine while impaired or who are incompetent in their medical practice.
  
  
  RESULTS
  Sixty-four percent (n = 1120) of surveyed physicians agreed with the professional commitment to report physicians who are significantly impaired or otherwise incompetent to practice. Nonetheless, only 69% (n = 1208) of physicians reported being prepared to effectively deal with impaired colleagues in their medical practice, and 64% (n = 1126) reported being so prepared to deal with incompetent colleagues. Seventeen percent (n = 309) of physicians had direct personal knowledge of a physician colleague who was incompetent to practice medicine in their hospital, group, or practice. Of those with this knowledge, 67% (n = 204) reported this colleague to the relevant authority. Underrepresented minorities and graduates of non-US medical schools were less likely than their counterparts to report, and physicians working in hospitals or medical schools were most likely to report. The most frequently cited reason for taking no action was the belief that someone else was taking care of the problem (19% [n = 58]), followed by the belief that nothing would happen as a result of the report (15% [n = 46]) and fear of retribution (12% [n = 36]).
  
  
  CONCLUSIONS
  Overall, physicians support the professional commitment to report all instances of impaired or incompetent colleagues in their medical practice to a relevant authority; however, when faced with these situations, many do not report.
authors.affiliation: Mongan Institute for Health Policy, Massachusetts General Hospital, 50 Staniford St, Ste 900, Boston, MA 02114, USA. cdesroches@partners.org
authors.forename: Catherine M
authors.initials: CM
authors.lastname: DesRoches
authors.forename: Sowmya R
authors.initials: SR
authors.lastname: Rao
authors.forename: John A
authors.initials: JA
authors.lastname: Fromson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Birnbaum
authors.forename: Lisa
authors.initials: L
authors.lastname: Iezzoni
authors.forename: Christine
authors.initials: C
authors.lastname: Vogeli
authors.forename: Eric G
authors.initials: EG
authors.lastname: Campbell
mesh_terms: D001291:Attitude of Health Personnel; D003625:Data Collection; D005260:Female; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D010379:Peer Group; D010815:Physician Impairment; D010820:Physicians / Q000592:standards; D017009:Professional Autonomy; D014481:United States