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Dealing with staff addicts in the workplace

by Lauren Dubinsky, Senior Reporter | April 17, 2015
Risk Management
A New York-based radiologist was arrested and charged yesterday with allegedly writing 280 illegal prescriptions for controlled substances such as Oxycodone, Percocet and Hydrocodone. Dr. Albert R. Cowie could face up to 20 years in prison, a $1 million fine or both.

Cowie distributed the prescriptions to three individuals who filled the scripts at local pharmacies, keeping some of the substances for themselves and giving the remainder to him, according to the compliant. He also allegedly had a relationship with a prostitute and spent $200 a day to support their heroin addiction.

Alarming? yes. Rare?, no.

Studies have shown that the rate of addiction among practicing physicians is estimated to be between 10 and 12 percent, which is the same as or slightly higher than the rate for the general population.

To ensure that addiction does not become a problem at your health care facility, Michelle Foster Earle, the president of risk-consulting firm Omnisure, told DOTmed News that facilities should have a medication inventory or loss control system in place.

In her opinion, an institution whose approach to the issue sets the standard is Carteret General Hospital in North Carolina.

The hospital uses Pandora and CareFusion software with their Pyxis automated withdrawal system in order to run anomalous usage reports and evaluate the appropriateness of dose, quantity, frequency and waste patterns by patient account numbers. If they spot discrepancies, they gather data and then interview the staff member along with the director of safety and risk management, pharmacy director and clinical/medical director.

Depending on how well the staff member cooperates, the hospital refers them to an assistance program and reports the incident to the licensing board. However, if they fail to cooperate then the hospital gets law enforcement involved.

Earle believes that employees should be screened upon hire and should also undergo random screening as well. Carteret maintains a computer generated database of the staff members’ last four SSN digits and the hospital’s employee health department monitors current staff’s medication lists and reports any considerable opioid prescription regimens to an external medical review officer for therapeutic dosing.

Ultimately, Earle believes that the hospital must “do the right thing for the employee, patient safety, and organizational risk” and part of that involves following through so the staff member with addiction problems is not passed off to other organizations.

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