AMA meeting: Doctors oppose mandatory drug reporting laws

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Chicago -- Physicians should not be required to report to police information about patients who test positive on drug screens, according to policy adopted at the American Medical Association's June meeting.

"Physicians take an oath to first serve their patients," said AMA Board of Trustees member Steven J. Stack, MD. "We're not in the business of law enforcement. It's a violation of our confidentiality agreement."

Hawaii requires health professionals who treat drivers from a car crash to report results of any medical test that reveals intoxication or drug impairment. Tennessee considered, but did not pass, a similar bill earlier this year.

"A drug screen is an important part of a medical workup," said Stuart Gitlow, MD, MPH, a psychiatrist from New York who was speaking for the American Society of Addiction Medicine. "An obstacle has been placed in our way. The result of that type of regulation is that doctors don't perform drug screens, and the patient doesn't receive the necessary treatment or follow-up."

Physicians said such laws interfere with the patient-physician relationship.

"Mandatory reporting discourages treatment and discourages patients from coming in," said Lynn Parry, MD, a Denver neurologist who represented the Colorado Medical Society. "The law doesn't prohibit you from reporting if you think there's a danger to the public, but it shouldn't mandate it. That's a very important distinction."

Some argued, however, that required reporting of test results may be appropriate in situations such as car crashes in which drugs may have played a role.

"We need to not only look out for our patient, but the patient who could be down the hall who was also injured," said Sandeep Krishnan, a third-year medical student at the University of Missouri, Kansas City, who represented the Missouri State Medical Assn. "There's actually harm that could happen from not reporting."

Opponents noted that other routes can be used to obtain this information and legal mandates were unnecessary. A spokeswoman for the National Council of State Legislatures said there are common ways to gain access to test results if legal action results and this evidence is needed.

The resolution also called for the AMA to promote education of physicians on the importance of referring patients with positive screens for relevant care.

In related action, the AMA voiced support for "The Surgeon General's Call to Action to Prevent and Reduce Underage Drinking" and voted to continue participating in programs to raise awareness and increase screening, diagnosis and treatment of substance use disorders.