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Comment & Response
October 2, 2013

Protection of Patients From Physician Substance Misuse

Author Affiliations
  • 1New York State Committee for Physician Health, Albany
JAMA. 2013;310(13):1403. doi:10.1001/jama.2013.277963

To the Editor Dr Pham and colleagues1 proposed preemployment, random, and postincident drug testing as important measures to identify physician impairment and possibly reduce patient harm. The evidence that drug testing improves workplace functioning is weak,2 and its failure to deliver promised benefits may account for its declining use by US companies.3 Furthermore, urine toxicology testing typically measures metabolites present for an average of 48 hours or longer. The results may therefore be uninformative at best and misinformative at worst about whether a physician is impaired or even affected by a drug at the time when the sample is collected.