Q. I’m a male para, injured for 12 years, and I recently moved to a large city. At the time I needed to find a good urologist because I was experiencing recurring UTIs. I found a great SCI support group and got the name of a local urologist that many in the group recommended. They liked the doctor because he was friendly, easy to work with and seemed to know about spinal cord injury and neurogenic bladder. Also, he was an experienced surgeon.
On my first visit I explained that I suspected a problem with my urethra was causing the infections and might require surgery. He prescribed a new antibiotic and said he’d do a cystoscopy and inspect my urethra if the infection returned. He seemed nice as well as competent. However, I was shocked to smell alcohol on his breath and suspected he had been drinking.
At the next group meeting, I mentioned this to the others. Most of them defended the doctor. Only one other member said she had suspected him of drinking, noting that she too had smelled alcohol on his breath. After the meeting she also told me that she had seen the doctor visibly intoxicated at a popular local restaurant just two weeks earlier. Because of this, she said she was considering changing urologists.
My infection cleared, but I’m afraid it may return and I still may need surgery. In the meantime, I feel conflicted. I fear my new urologist may be a “maintenance alcoholic.” He may be like my dad, who drank every night but still functioned reasonably well during working hours. But he got worse over time, and his hands started shaking. I’m torn between staying with this doctor and not saying anything, looking for a different urologist, or maybe even reporting him to the state medical licensing board. But if I do this, I fear the rest of the group might feel I am betraying them, especially if they lose him as a favored doctor. Is there something I can do short of reporting him to the licensing board? I feel a responsibility to do something but I’m not sure what to do.
A. I see what you are up against. Let’s start with some factual analysis. Alcoholic behavior that eventually interferes with work is more common than you might think. Statistics vary, but many estimates put the incidence of alcoholism among men — who are more prone to the disease — at about 10%. Not all of these are severe alcoholics, but as you implied, unmanaged alcoholism is a progressive disease. Perhaps one-third of these are maintenance alcoholics, who, as you know, need to keep a certain level of alcohol in their blood throughout the day to feel comfortable. Quite often they will drink heavily in the evening, resulting in a substantial blood-alcohol level the next morning that steadily dissipates. At the end of the day, or sometimes earlier, they will start drinking again to satisfy their dependence. This kind of behavior is most often seen in men who have daytime employment, while steady “nipping” throughout the day is the preference of unemployed men. Over time, both habits can result in disease or nerve damage that causes the “shakes,” which is particularly dangerous in the medical profession, especially with surgeons.
A key factor in your dilemma, however, is the lack of definitive evidence about the drinking habits of the doctor in question. The behavior that the two of you who have witnessed, presumably related to heavy drinking, falls short of proof of alcoholism. But it may be a violation of your state’s medical licensing board’s standards of professional conduct. Each state board has a statute, most commonly known as the medical practice act, that lists examples of unprofessional conduct. Two examples that might apply in your situation are “impaired ability to practice due to addiction” and “dishonesty” (when the doctor hides his addiction or refuses to get treatment). Both examples are important, but the first one is obviously of paramount concern.
The situation you are in requires careful consideration in choosing what to do or not do, as well as ethical consideration of possible outcomes. If you take the position of the majority of the support group and do nothing, you may be avoiding the real problem out of fear of alienating the group and losing their support. Could this be a kind of subconscious enabling behavior that is related to your relationship with your father? On the other hand, if you decide to report what you have witnessed to a licensing board, your action may have consequences for the doctor, his family and all of his patients, including you. It is unlikely that the board would take action based on two anecdotal complaints, but they may inform the doctor of the complaints as a matter of course. If others have complained or complain in the future, the licensing board may revoke his license to practice.
Many licensing boards offer accredited rehabilitation programs if the case meets certain standards. Informing your state’s medical licensing board of a potential problem could possibly result in a positive outcome for everyone concerned. If your complaint turns out to be unwarranted and is dismissed, the doctor will most likely not be told who filed the complaint.
Perhaps a better approach would be to send a letter short of an official complaint to the medical licensing board. Simply tell them the truth of your dilemma and ask that your identity be kept anonymous. You could inform the board that you are uncertain if there is a drinking problem or not, and that you don’t want to cause undue concern since you have no specific complaints based on the doctor’s performance. In doing this, you will be leaving the decision to act with the board. In the meantime, you and your friends can remain watchful. Hopefully, this kind of approach will have beneficial results for everyone.
** This post was originally published on https://www.newmobility.com/2019/12/should-i-report-my-urologist-to-a-licensing-board/