Author Affiliations: Departments of Emergency Medicine (Dr Pham) and Anesthesiology & Critical Care Medicine (Drs Pham and Pronovost), Surgery, and Health Policy & Management (Dr Pronovost), Johns Hopkins University, Baltimore, Maryland; Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland (Drs Pham and Pronovost); and Professional Health Services, Promises Treatment Centers, Santa Monica, California (Dr Skipper).
When a critical event occurs in most high-risk industries (such as airlines, nuclear power, or railways), a detailed investigation examines a variety of system and individual factors (such as fatigue and substance abuse) that caused or contributed to the event. Directly involved individuals are commonly tested for alcohol and other drugs. Airplane pilots and truck drivers are tested following crashes and near misses.1 Some law enforcement officers are tested following fatal shooting incidents.
Pham JC, Pronovost PJ, Skipper GE. Identification of Physician Impairment. JAMA. 2013;309(20):2101–2102. doi:10.1001/jama.2013.4635
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