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.
Pham JC, Pronovost PJ, Skipper GE. Protection of Patients From Physician Substance Misuse—Reply. JAMA. 2013;310(13):1403-1404. doi:10.1001/jama.2013.277978