EVALUATION, CORRECTIVE ACTION, AND DISCIPLINARY POLICY FOR RESIDENTS

III. Physician Impairment

If, at any time, the Director has reasonable cause to suspect that a resident's behavior is altered because of a physical or mental impairment or the use of drugs, narcotics, or alcohol, the resident shall, at the Director's request, submit to a physical and/or mental examination by a physician(s) acceptable to the Director. The Director shall, prior to making such request, consult with the NYU Office of House Staff Affairs and inform all relevant Hospital Medical Directors (e.g., Bellevue, Hospital for Joint Diseases, and/or New York University Hospitals Center, etc.). The purpose of the examination(s) shall be to determine if the resident is free from health impairments which pose potential risk to patients or personnel or which may interfere with the performance of the resident's clinical duties. The examination shall include, but not be limited to, a breathalyzer, urinalysis, blood, and/or other similar tests to determine if drugs, narcotics, and/or alcohol are in the resident's system.

• Reasonable cause shall include, but not be limited to: unsatisfactory, excessive, or deteriorating attendance record; declining productivity or other unsatisfactory performance or other behavior which may be reasonably attributable to the use of drugs, narcotics, or alcohol; involvement in an on-the-job accident; accosting, striking, or assaulting an employee, patient, or visitor other than in self-defense; returning to work following participation in a drug or alcohol rehabilitation program or leave of absence; or behaving in a manner which suggests that the employee may be unfit for work and/or under the influence of drugs, narcotics, or alcohol, such as: unkempt appearance, poor hygiene; trembling, slurred speech; bloodshot or bleary eyes; complaints by patients and nurses; arguments, bizarre behavior; irritability, depression, mood swings; irresponsibility, poor memory, poor concentration; unexplained accidents or injuries to self; neglect of family, isolation from friends; DWI arrest or DUI violations; financial and/or legal problems; difficult to contact; won't answer phone or return calls; dwindling medical practice; missed appointments, unexplained absences; rounds at irregular times; loss of interest in professional activities, social or community affairs; neglect of patients, incomplete charting, or neglect of other medical staff duties; inappropriate treatment or dangerous orders; excessive prescription writing; unusually high doses or wastage noted in drug logs; noticeable dependency on alcohol or drugs to relieve stress; intoxication at social events or odor of alcohol on breath while on duty.
• Failure to undergo such examination when requested shall be grounds for immediate suspension and/or dismissal from the training program in accordance with the provisions of Section IV.A., Summary Suspension, and Section IV.D.2., Dismissal.

A. Pending and following medical evaluation, the resident may be placed on a medical leave of absence, administratively referred for further evaluation and recommended treatment, and/or subject to disciplinary action up to and including termination of the residency. The Director shall consult with the NYU Office of House Staff Affairs and all relevant Hospital Medical Directors prior to taking any such action. The Hospital Medical Director(s) shall be informed of the outcome of the evaluation. Adverse action taken under this Section III may be appealed upon written notice, in accordance with the provisions of Section V, Appeals.

B. Hospitals are required to report to the New York State Office of Professional Medical Conduct (OPMC) whenever any of the following actions are taken for reasons related in any way to alleged mental or physical impairment: denial, suspension, restriction, termination, or curtailment of, or voluntary or involuntary resignation or withdrawal from, training, employment, association, or professional privileges, or the denial of certification of completion of training. See Section VI, Reporting.

C. Physicians suspected of having problems with alcohol, drugs, or mental illness, but whose ability to practice is not impaired, may be reported to the Committee on Physicians' Health of the Medical Society of the State of New York (CPH). All calls are confidential. CPH identifies, refers to treatment, and monitors impaired physicians. The program is voluntary and participation is confidential. The names of physicians participating in the program are not shared with OPMC without a participant's approval unless there is a failure to comply with treatment recommendations. A physician whose medical performance may be impaired, however, also must be reported to OPMC. The law does not exempt physicians from their duty to report colleagues practicing with a suspected impairment to OPMC because they have reported to CPH.

D. All licensed health professionals, including physicians, are required by state law to report colleagues whom they suspect may be practicing while impaired. Failure to report is, in itself, professional misconduct. For physicians and residents affiliated with a hospital, the report can be made to the hospital's professional practices committee, which must then inform OPMC; in the case of residents, the report should be made to the resident's Director, the Administrative Director for NYU House Staff Affairs, and all relevant Hospital Medical Directors.