Doctors in the U.S. slow to report an incompetent or unethical colleague

The results of a new survey of doctors in the States suggests that the majority of them, regardless of what they may say, are reluctant to report incompetent or unethical colleagues.

The survey conducted by researchers from Massachusetts General Hospital and Harvard Medical School, has found that almost half of all U.S. doctors fail to report incompetent or unethical colleagues, even though they agree that they should be reported.

Of the physicians surveyed 46 percent admitted they knew of a serious medical error that had been made but did not tell authorities about it.

Eric Campbell who led the survey says there is a measurable 'disconnect' between what physicians say they think is the right thing to do and what they actually do.

It also appears that doctors are also surprisingly eager to order unnecessary and often expensive tests such as magnetic resonance imaging or MRI scans.

However only 25 percent consciously try to ensure they did not unintentionally treat someone differently because of their sex or race.

A U.S. Institute of Medicine report in 2000 found that up to 98,000 people die needlessly every year because of medical errors in hospitals.

The survey by Campbell and his colleagues of a national random sample of 3,504 practicing doctors was conducted between November 2003 and June 2004.

They received responses from 1,662 doctors and found that though almost 96 percent said they should report all instances of significant incompetence or medical errors to the hospital clinic or to authorities, this did not translate into practice.

The exception was among cardiologists and surgeons, with just about 45 percent agreeing.

Cardiologists say they are more likely to deal with such problems inside their practices.

Eighty five percent of most doctors said they should tell patients or relatives about significant errors but even though 40 percent admitted that they knew of a serious medical error in their hospital group or practice, 31 percent admitted they had done nothing about it on at least one occasion.

The survey has revealed that doctors in fact do not always practice what they preach ethically; while 93 percent of doctors said they should provide care regardless of a patient's ability to pay, only 69 percent actually accepted uninsured patients who cannot pay.

Also revealed was that while most agreed they needed to keep up with changes in the profession and have their competence reviewed, only 31 percent had undergone a competency review in the past three years.

Dr. James Thompson, chief executive officer of the Federation of State Medical Boards, says there is not much that can be done to help doctors who are struggling to be competent and doctors know this.

Thompson says there are very few places where they can send them for remediation, and medical boards often do not have the resources to punish errant doctors.

State medical boards, says Thompson, are underfunded, understaffed and do not have their own teams of investigators, which inhibits their ability to go deal aggressively with doctors and they also cannot act unless someone reports a problem doctor.

Senior author David Blumenthal says human beings always fall short of their aspirations but the intent of the paper was not to criticize but to highlight the areas for improvement and was encouraged that virtually all respondents supported professional standards.

The report is published in the Annals of Internal Medicine.