Only 39% of physicians are familiar with guidelines on when to report an impaired colleague, according to the Can J Anesth study.
It listed the following sings of substance abuse:
- Deteriorating quality of work, sloppy charting, increased surgical complication rate
- Mood swings, irritability, anger, euphoria or depression
- Lateness, forgetting to show up, rescheduling surgeries
- Withdrawal from family, friends and leisure activities
- Weight loss
According to the American Academy of Ophthalmology, physicians should withdraw from any aspect of practice affected by physical, mental or emotional impairment, and when impaired physicians don't withdraw, it is the duty of other ophthalmologists who know of the impairment to take action.
While this includes physical issues, substance abuse, abusive behavior and sexual harassment, it also extends to a colleague's reluctance to learn new techniques in the face of overwhelming evidence.
Dr. Pickering quoted a newspaper report about an ophthalmologist who was credited with helping to invent optical coherence tomography and served as dean of the medical school at the University of Southern California. The administration reappointed this ophthalmologist despite years of complaints of his "hair-trigger temper, public humiliation of colleagues and perceived drinking problem," and did not report his behavior to the California Medical Board, according to a Nov. 14, 2017 article in the Los Angeles Times.