Health-Care Workers Should Undergo Drug Testing

Why aren’t doctors — and other health-care workers — drug tested?

It’s a good question, and the title of a recent commentary published in the New York Times. The authors, Daniel R. Levinson and Erika T. Broadhurst, inspector general and special agent, respectively, for the U.S. Department of Health and Human Services (HHS), argue for the routine testing of medical caregivers to ensure they aren’t compromised by addiction issues, and therefore more likely to harm the patients they treat.

The authors recount the tale of David Kwiatkowski, a medical technician/drug addict who worked in more than a dozen hospitals in eight states before he was caught stealing fentanyl intended for cardiac patients. Fentanyl is a painkiller the technician would inject into himself, then refill the same syringe to replace the patient’s dose with saline. Kwiatkowski had hepatitis C, a potentially fatal and contagious virus.

We wrote about this scary episode too, and the scores of people he was suspected of infecting, thanks to his need for drugs and the system’s inability or unwillingness to stop him.

He was caught, and sentenced to 39 years in prison, but among his victims are a man who had to have a leg amputated, and another who suffered liver failure.

The authors, as HHS employees, were involved in investigating that case. In their commentary, they wrote, “We believe that this case, and others like it, show that our hospitals are not protecting patients from drug tampering.”

Even if Kwiatkowski hadn’t concealed his job history, the writers say, regulations and procedures are so different among the states, and even between health-care facilities, that they enabled the technician to continuing sowing deadly havoc. Most of the hospitals where he worked didn’t call the police after they found out what he was doing. They didn’t tell job agencies or other institutions. They didn’t have to.

Kwiatkowski isn’t the only grim reaper the authors cite in making their case. We also wrote about Kristen Diane Parker, a former surgical technician who got 30 years in prison for doing the same thing as Kwiatkowski, and with the same drug. She infected more than a dozen patients with hepatitis C. In Florida, Steven Beumel also got a 30-year sentence for similar behavior with similar consequences – at least five people got hepatitis C; one underwent a liver transplant and later died.

“Hospitals can do more to protect patients,” say Levinson and Broadhurst. “Improved security, such as surveillance of drug storage areas, tighter chain of custody on drugs and better tracking of controlled substances are obvious areas to target.

“But we should go further. We believe hospitals should be required to perform random drug tests on all health-care workers with access to drugs. The tests should be comprehensive enough to screen for fentanyl and other commonly abused drugs and must keep up with evolving drug abuse patterns.”

We agree. Last year, our blog “Doctors Advocate for Doctor Drug and Alcohol Testing,” was about a study published in the Journal of the American Medical Association (JAMA). Its authors enumerated five ways to address the problem. It’s common sense, isn’t it?

The Times writers want to require medical centers to contact law enforcement agencies if they suspect a health-care worker of stealing drugs. They also want to help the addicts. “We should also treat addiction as the chronic disease that it is, and get addicted health care workers help,” they say.

One model they suggest is the Federation of State Physician Health Programs (FSPHP), a nonprofit corporation dedicated to developing common objectives and standards, and enhancing awareness of issues related to physician health and impairment. These programs work with state agencies to recommend treatment and monitor recovery while helping physicians avoid professional and criminal penalties, and has been shown to be effective.

But all health-care workers, not just physicians, can put patients at risk, and they all should be subject to mandatory drug testing.

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