State Drug Testing Proposal Hits Snag
By Bob Stiles
Robert Birnbrauer can’t understand why medical professionals in Pennsylvania hospitals aren’t randomly tested for drug use.
Each year, hundreds of the state’s doctors, nurses and other medical professionals step over the line and become drug abusers, said Birnbrauer, vice president of human resources for the Temple University Health System in Philadelphia.
“There are some professions that really require oversight in some way, and health care is one of them,” Birnbrauer said. “If other groups (such as those involving transportation) in the state require testing, why not here?”
But Birnbrauer recently lost another round in his battle for random testing when the Pennsylvania Labor Relations Board ruled against his health system for the second time, stating that Temple must include possible testing in contract talks before implementing the practice with union workers.
Temple officials have not decided whether to appeal the ruling.
In recent months, six Western Pennsylvania health care workers were charged with drug offenses:
Frank C. Glomb, 33, of Washington Township, Westmoreland County, allegedly diverted morphine, Demerol and other pain prescription drugs from the Mercy Jeannette Hospital pharmacy, according to the state Attorney General’s Office. Investigators allege Glomb cut open boxes of pain medicine, removed some of the drugs, then replaced the missing liquid with saline solution.
Carrie Watkins, 30, of McMurray, Washington County, was charged with taking the pain medications morphine sulfate and Dilaudid from Monongahela Valley Hospital early last year.
Both Glomb and Watkins face trials.
Three care providers in Armstrong County — Stacy Ann Miller of Petrolia, Michelle R. Bonner, formerly of Kittanning, and Lisa Marie Drum, of Dayton — were accused of illegally ordering or obtaining pain-relieving medications and other prescription drugs for themselves and family members’ use.
Drum, a registered nurse, was placed in a rehabilitation program. Bonner, a licensed practical nurse, pleaded guilty and is to be sentenced next month. Miller, a registered nurse, will stand trial later this year.
Dr. Antoine Francis Cawog, 62, of Unity, a physician at Excela Health Westmoreland Hospital in Greensburg, was charged last month with selling prescriptions for pain medications and other drugs to a confidential informant. Investigators said some transactions occurred in the hospital. Cawog was charged by the state Attorney General’s Office with dispensing prescriptions without giving proper examinations.
‘Reasonable suspicion’
Most hospitals do pre-employment drug testing. Many will test employees suspected of having drug problems. But few, if any, do random testing, according to the Pennsylvania Hospital Association.
Officials of Westmoreland County’s Excela Health System require pre-employment testing and will test if an employee displays suspicious behavior, said Laurie English, Excela’s director of human resources and shared services.
“We just haven’t felt a need to do random testing on our work force,” English said. “We just don’t have that many problems.”
The same policy exists at University of Pittsburgh Medical Center facilities.
“It is our system-wide policy to drug screen all UPMC employees, including physicians, prior to employment,” said Frank Raczkiewicz, acting director of media relations.
“Should the situation warrant, employees are also randomly tested. If they test positively and it is not a legitimate issue (such as a valid prescription drug) they are counseled, and they could face disciplinary action, including termination,” he said.
Most hospitals realize that random testing is costlier and less effective than doing testing based upon suspicion, said Bill Cruice, director of the Pennsylvania Association of Staff Nurses and Allied Professionals.
“We’re opposed to random drug testing because it’s not only a potential invasion of privacy, it isn’t really a good use of resources,” said Cruice, whose group is the largest union in Pennsylvania representing nurses, with more than 5,000 registered nurses as members.
“You’d be using a lot of resources at hospitals that could be used for patient care … to find very little,” Cruice said.
But Birnbrauer said random testing can serve as a deterrent to drug abuse.
A review of the nearly 335 disciplinary cases handled by the state Board of Nursing last year showed that drugs were involved in more than half of them.
The statistics reflect society in general, Cruice said.
“Nurses are a slice of life,” he said. “It’s an extremely small number (of nurses abusing drugs).”
Physicians, too
Some physicians who have beaten their drug problems enroll in a Pennsylvania Medical Society-run program called the Physicians’ Health Program, said Dr. Peter Lund, society president and an Erie urologist.
“They have been rehabilitated to the point that they continue their practices,” Lund said.
Doctors in the program must submit to random drug tests or face the possible loss of their licenses. Up to 60 random drugs tests are administered during a physician’s first year on the program, with the number decreasing for each additional year of involvement, said Greg Gable, program director.
Physicians are part of the program for five years, with about 70 percent of them voluntarily continuing involvement for another five years, Gable said.
Lund said the program, established more than 20 years ago, makes others more likely to report a drug-abusing doctor.
Lund said that as a doctor, he hasn’t made up his mind about random drug testing on all medical professionals. The medical society takes no position, he said.
“I’m on the fence. I think there are some civil liberty issues … but at the same time there could be safety problems,” Lund said.
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