Reporting Unethical or Incompetent Physicians

Liability Issues

Both reporting and not reporting come with risks, depending on what constitutes misconduct. “A physician may grossly deviate from the standard of care or practice guidelines, making the misconduct objectively discernible, but a lot of suspected physician misconduct is subjective in nature,” Dr. McHale said.

Several states, such as Minnesota, Oregon, and Delaware, have statues that recognize the subjective nature of misconduct and stipulate that a physician make a report if they reasonably believe that misconduct occurred. Some states use a tiered approach to misconduct, whereby only certain acts of misconduct rise to the level of mandatory reporting, said Dr. McHale. This guidance can help address whether a physician is required to report based simply on a patient complaint or whether there must be adequate facts to justify the report.

Physicians need to be aware of their duty to report as an ethical issue and a legal requirement. Physicians and institutions also need to better use available tools to identify and prevent adverse events before they become actionable. In part, it’s incumbent upon institutions to promote a culture of safety and best practices, Dr. McHale noted. But part of it also rests upon individuals and specialty societies to promote evidence-based practices and best data use.

In addition, Dr. Shapiro believes that all physicians should be taught how to have difficult conversations and provide feedback. “It should be part of residency training and required faculty development training,” she said. “At the very least, leaders should be taught how to do it. Providing critical feedback is what moves us forward.”

Karen Appold is a freelance medical writer based in Pennsylvania.