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Comment & Response |

Protection of Patients From Physician Substance Misuse—Reply

Julius Cuong Pham, MD, PhD1; Peter J. Pronovost, MD, PhD1; Gregory E. Skipper, MD2
[+] Author Affiliations
1Johns Hopkins University School of Medicine, Baltimore, Maryland
2Professional Health Services, Promises Treatment Centers, Santa Monica, California
JAMA. 2013;310(13):1403-1404. doi:10.1001/jama.2013.277978.
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In Reply We agree with Dr Stolbach and colleagues that there is currently insufficient evidence that random drug testing of physicians effectively improves patient safety. Until evidence is generated by actually drug testing physicians, at least on a limited scale, its effectiveness will never be known. Fitzsimons et al1 have demonstrated the feasibility of random drug testing among anesthesia residents, though their single institution study lacked the size and power to show effectiveness. Moreover, we are aware of several private anesthesiology groups that currently have such an active program. Across other industries in the United States, drug use is less common among employees when drug testing occurs.2 Because physicians have the same rate of substance abuse problems as the general population, one might expect similar benefits.

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October 2, 2013
Andrew Stolbach, MD; Lewis S. Nelson, MD; Robert S. Hoffman, MD
1Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Division of Medical Toxicology, New York University School of Medicine, New York, New York
JAMA. 2013;310(13):1402-1403. doi:10.1001/jama.2013.277948.
October 2, 2013
Jeffrey Selzer, MD
1New York State Committee for Physician Health, Albany
JAMA. 2013;310(13):1403. doi:10.1001/jama.2013.277963.
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