Reporting a Breach of Ethics

Ethical behavior is one of the cornerstones upon which the medical profession is built, and it is something that is expected of all physicians at all times, by each other as well as by patients. When a physician witnesses a colleague commit a violation of ethics, the decision to report him or her can be a difficult one. To not do so, however, may cause more harm for all involved.

Nothing is more sacrosanct in the medical world than professional ethics, but that principle doesn’t stop violations from occurring. Ultimately, it’s up to physicians to preserve the integrity of their profession by reporting colleagues who exhibit unethical behavior to state medical boards, state physician health programs or hospital leaders. The prospect of doing so may raise its own set of ethical dilemmas for physicians, especially if they’re worried about damaging a colleague’s reputation or career.

The American Medical Association makes clear, however, that physicians are ethically obligated to report fellow physicians who display unethical behavior, with the decision about what body to report the behavior to determined by the nature of the offense. If, for example, a behavior violates the provisions of a state licensing board, that body should be notified. Behavior that could be classified as criminal should be reported to law enforcement authorities. If a physician’s unethical behavior persists after the first report, the reporting 
physician should notify a more senior body or official.

Tips for Navigating the Reporting Process

The first step in resolving an issue of unethical behavior in a fellow physician is determining whether or not such behavior has occurred. Identifying unethical or inappropriate behavior may sound like a clear-cut proposition, but it is not always so. Some unethical behaviors, such as failing to attend staff meetings, can be subtle. One of the most crucial clues to look for is change in a colleague’s personality that could lead to unethical behavior. Sometimes the behavior may be caused by a psychiatric disorder or substance abuse, which — if reported through the proper channels and treated with the appropriate professional help — can sometimes be resolved while keeping the physician’s career intact.

If you witness unethical behavior by a colleague, spend time carefully considering the next step, but don’t be afraid to ask for the perspective of a trustworthy friend or colleague. Do not confront the physician yourself, as he or she may react in an unpredictable way. Before you report the physician to a state entity or hospital leader, gather evidence of several instances of unethical behavior to bolster your report.

Reporting procedures vary from state to state. Many physicians prefer to make a first report anonymously, often by turning initially to the state physician health program — a step that may possibly avert discipline for the offending physician. Many states allow physicians to report cases of unethical behavior by colleagues to the state physician health program rather than the medical board.

Perhaps the most important issue to consider when weighing whether or not to report a colleague’s unethical behavior is not the potential effect such a report could have on his or her career, but how your own career could suffer by failing to do so. You may face discipline if it is discovered that you knew of a colleague’s indiscretions and did nothing, which is why many states provide immunity to reporting physicians as a further incentive to physicians to police their profession.

MD News March 2011



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