When a radiologist’s declining health starts to impact patient care, it can create a troubling scenario that needs to be addressed right away. But how? What’s the best way the radiologist’s colleagues can address this issue?
That’s the very subject of a new analysis published in the Journal of Radiology Nursing.
The authors—Kate Molchan, JD, PhD, and Jessica Ginsberg, JD, MBE, both of Atlanta’s Wellstar Health System—provided a hypothetical example. Dr. X, they said, was a 73-year-old interventional radiologist with nearly four decades of experience. He was a celebrated leader and mentor with a long list of impressive accomplishments. Roughly two years ago, however, Dr. X suffered a stroke. He returned full-time after 8 months of recovery, but he is forgetful at times and doesn’t quite seem himself. In addition, Dr. X developed a tremor in his dominant hand—one that once started bothering him in the middle of a procedure, causing a colleague to step in and finish the job.
“Dr. X’s intervention radiology team is now concerned that Dr. X may no longer be able to keep up with the demand of his rigorous interventional radiology schedule,” the authors wrote. “Moreover, they are worried that his tremors coupled with his forgetfulness and diminishing acuity are negatively impacting patient care and could potentially be dangerous to his patients. They feel the need to address this touchy issue with Dr. X, but, at the same time, they do not want to embarrass or dishonor a physician they highly respect.”
This is an “ethically challenging and potentially uncomfortable position,” Molchan and Ginsberg wrote. However, there are things the IR team must remember as they consider their scenario. For example: Dr. X’s colleagues “have a professional duty to protect patients from harm.”
“Given Dr. X’s age coupled with his recent stroke, is it likely that his psychomotor function will only continue to decline—an unfortunate but unavoidable fate for many aging professionals,” the authors wrote. “Although it is understandable for Dr. X’s colleagues to want to insulate Dr. X from any embarrassment, they are duty-bound to maximize the health and safety of patients.”
Molchan and Ginsberg suggest electing one member of the interventional radiology group to begin the discussion with Dr. X about his situation. This can help “soften the confrontation” and “reduce the likelihood of Dr. X feeling shame or that he is being ambushed.” That one person and Dr. X can then review the evidence together, including any applicable outcomes data or complication rates.
After that review, the authors note, maybe it will be determined that Dr. X can stay involved, but reduce his workload and focus on “diagnostic or less complicated interventional radiology interventions.” Considering his ability to mentor younger specialists, Dr. X could also focus more on teaching and assisting colleagues with less experience.
“Provided that Dr. X responds appropriately, it is ethically supportable for the IR group to attempt to handle this matter internally,” the authors concluded. “If, Dr. X is obstinate and continues to dismiss these important safety concerns, however, the interventional radiology group should follow their established reporting structure to escalate the matter (going as far as involving the medical board, if necessary).”
Click here to read the full analysis.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.