Report to Administration Immediately for Patient Safety
When a healthcare provider shows signs of impairment (drowsiness, slurred speech, minor mistakes), you must report directly to administration immediately—this is the only ethically and professionally acceptable action that prioritizes patient safety. 1
Why Administration Must Be Notified First
Patient safety takes absolute priority over colleague loyalty. The combination of drowsiness, slurred speech, and clinical errors represents an immediate threat to patient welfare that requires urgent intervention to prevent serious harm or death. 1
Administration has the unique authority to:
- Immediately remove the impaired provider from clinical duties while investigation proceeds 1
- Coordinate with regulatory authorities and physician health programs 1
- Ensure appropriate remediation and treatment before the provider returns to practice 1
The Professional Obligation to Report
The American Academy of Pediatrics explicitly states that physicians have an ethical obligation to report colleagues practicing under the influence of drugs or alcohol. 2 This is not optional—it is a core professional duty rooted in the principle of nonmaleficence. 1
Clear evidence of unsafe practice—such as practicing medicine under the influence of drugs or alcohol—must be reported to the hospital's in-house impairment program, the chief of pediatrics, or the chief of hospital staff. 2 Some medical societies or state licensing boards have external impaired-physician programs available for referral. 2
Why Other Options Are Inappropriate
Option C (talking privately and waiting) is dangerous and unethical because:
- It delays protection of patients from immediate harm 1
- Substance use disorders rarely resolve without formal intervention 2
- You lack the authority to monitor or ensure the provider stops working while impaired 1
Option A (ethics committee) and Option D (redirecting patients) are inadequate because:
- Ethics committees lack authority for immediate removal from clinical duties 1
- Telling patients to see another provider does not address the systemic safety issue 1
- Neither option provides the rapid response required for active patient safety threats 1
The Dual Goal: Safety AND Rehabilitation
Reporting should be done with discretion and sensitivity, with clear intention to help the impaired physician progress toward treatment and recovery. 1 The goal is both patient protection AND colleague rehabilitation, not punishment. 1
Substance use disorders are treatable conditions, and early intervention improves outcomes for both the impaired provider and prevents patient harm. 1 Physicians under investigation should be protected from destructive gossip and rumors, with communication governed by confidentiality rules until charges are proven or the physician is exonerated. 2
Critical Pitfall to Avoid
Never delay reporting due to concerns about "being a snitch" or damaging a colleague's career. 1 Your primary professional responsibility is to prioritize patient welfare above all other considerations, including protecting a colleague. 1 The historic reluctance of the medical profession to report colleagues whose performance falls below minimum standards must be overcome when patient safety is at stake. 2
The correct answer is B: Report to administration for patient safety.