Johns Hopkins Hospital officials have shelved plans to become the first hospital in the nation to test all its doctors for drug and alcohol abuse, saying they had underestimated the physicians' intense opposition to the proposal.
Instead, the hospital plans to press ahead with a compromise plan to test new applicants to the medical staff. Testing of those doctors for alcohol, barbiturates, opiates, cocaine, marijuana and RTC PCP will begin Jan. 1, officials said.
Dr. Hamilton Moses III, vice president for medical affairs, said yesterday that he still believes the original plan to test all physicians would have demonstrated the hospital's commitment to a drug-free environment, boosting confidence among patients. The hospital had proposed to test doctors when they were first appointed and then at two-year intervals.
Unexpectedly, he said, the administration ran into a tidal wave of opposition among doctors who felt that universal testing was an invasion of privacy that was not warranted by any evidence of widespread drug or alcohol use among staff members.
"We made a mistake -- a colossal misjudgment of the degree of controversy that would develop," Dr. Moses said. "Rather than being seen as a positive step, it was seen as invasive and undesirable."
The plan was approved last February by the hospital's trustees and the medical board, a governing body composed primarily of hospital department chiefs. Although the concept of routine screening has been debated since 1987, Dr. Moses said hospital leaders should have consulted many more physicians before putting it to a vote.
Besides its new plan to test physician applicants, the administration also announced its intention to drug-test residents and nurses applying for jobs at Hopkins. Testing of residents -- young doctors in training -- will not begin, officials said, until the hospital has disclosed its plans to medical students who are applying to work at the hospital.
Original plans to test all 1,500 doctors at Hopkins attracted widespread attention in the lay and medical media. Officials said they did not believe the hospital had a particular problem with drug and alcohol abuse -- but wanted to send an appropriate message at a time of intense national concern about drugs.
Controversy was almost immediate. Votes against the plan came from the governing body of the medical school faculty, the hospital ethics committee and the house staff -- interns and residents.
An article in the Journal of the American Medical Association, written by the AMA's chief counsel, said the policy was well-intentioned but an invasion of privacy. And a recent survey of medical school faculty members revealed "overwhelming opposition" to the plan, according to Dr. Sidney Gottlieb, a cardiologist who is chairman of the faculty council.
"If you're going to step on people's rights and go beyond the rights to privacy, you'd better have an overwhelming reason to do it," he said. "And most people don't think that this fits that category."
Besides concerns over privacy rights, he said, physicians also feared damage to reputations that might follow a false-positive test result. Doctors also felt the testing plan would produce an atmosphere of "chemical McCarthyism" that would strain relationships between doctors and administrators and deter good doctors from coming to Hopkins.
"The decision of the medical board represents flexible leadership and evidence of sensitivity to the concerns of the faculty at large," Dr. Gottlieb said.
Dr. Gottlieb applauded the establishment at Hopkins of a "professional assistance committee" that counsels doctors with drug or alcohol problems and refers them to treatment programs. The program was established last January.
Doctors can consult the committee voluntarily -- or they can be referred by supervisors who suspect a problem. Johns Hopkins also has a long-standing program that gives officials the right to test doctors who have displayed signs of impairment.