An emergency medicine attending physician is working a busy weekend shift. A triage nurse approaches the attending and expresses concern about another staff physician, who has just arrived for their shift. The nurse reports that the arriving physician is slurring their words and stumbling. The attending physician approaches their colleague and immediately notes a strong odor of alcohol. The impaired physician is currently logging into a computer to pick up the first patient's chart. Which of the following is the most appropriate next step for the attending physician?
- Intervene to prevent the colleague from seeing patients and notify the clinical directorAnswer
- BConfront the colleague privately and advise them to go sleep in the call room
- CAssume care of the colleague's assigned patients without taking further action
- DWait until the end of the shift to report the observation to the state medical board
- EContact local law enforcement to administer a breathalyzer test
Answer
Intervene to prevent the colleague from seeing patients and notify the clinical director.
The correct action is to immediately intervene to prevent patient contact and report to clinical leadership. The AMA Code of Medical Ethics states that physicians have a duty to report impaired colleagues to protect patient safety. In an acute setting where a physician is intoxicated, the immediate priority is stopping patient care. Following this, the event must be reported to the departmental supervisor or clinical director so that institutional policies (and potential Physician Health Program involvement) can be activated.
Step-by-Step Solution
Key Concept
When a physician is acutely impaired (e.g., intoxicated), the most immediate step is to prevent them from participating in patient care, followed by reporting the incident to institutional clinical leadership.