Examkin

Question

Difficulty: MediumPhysician Impairment and Peer Reporting

A 34-year-old hospitalist is receiving morning sign-out from the night-shift intensive care unit (ICU) physician. During the transition, the hospitalist notices that the ICU physician has a staggering gait, slurred speech, and a strong odor of alcohol on their breath. The ICU physician states they are about to leave the hospital but plan to quickly place a central venous catheter in a newly admitted hypotensive patient before departing. Which of the following is the most appropriate next step for the hospitalist?

  1. Directly prevent the colleague from performing the procedure and immediately notify hospital clinical leadership.Answer
  2. B
    Advise the colleague to go home immediately and independently perform the procedure to protect the colleague's career.
  3. C
    Permit the colleague to perform the procedure but remain in the room to closely supervise their technique.
  4. D
    Notify local law enforcement to report the colleague for being intoxicated in a healthcare facility.
  5. E
    Submit a formal complaint to the state licensing board before taking over the patient's care.

Answer

Directly prevent the colleague from performing the procedure and immediately notify hospital clinical leadership.
When encountering an acutely impaired physician, the paramount ethical duty is to protect patients from immediate harm. In this scenario, the ICU physician is exhibiting clear signs of acute alcohol intoxication just before intending to place a central venous catheter. The observer must intervene immediately to stop the impaired physician from providing care. Once the patient is safe, the observer is obligated to report the colleague to the appropriate institutional authority, such as the chief medical officer or a physician health program, to ensure formal evaluation and prevent future harm.

Step-by-Step Solution

1
Identify the immediate threat to patient safety.
The ICU physician shows clear signs of acute alcohol intoxication and intends to perform an invasive procedure.
Recognizing acute impairment is critical to preventing patient harm during high-risk interventions.
2
Determine the priority of action based on ethical guidelines.
Patient safety supersedes all other concerns, requiring immediate intervention to stop the procedure.
The American Medical Association (AMA) ethical guidelines mandate that protecting patients from imminent harm is the primary responsibility of any physician.
3
Select the appropriate reporting pathway.
Escalate the concern to clinical leadership or the hospital's physician health program.
Institutional protocols require formal notification to ensure the impaired physician is safely removed from duty, evaluated, and prevented from harming future patients.

Key Concept

Management of Acute Physician Impairment and Peer Reporting
Rate this question

Topics

Physician Impairment and Peer Reporting

More questions from this topic