An Emergency Physician Recently Began Working at a Local Community

question 59

Multiple Choice

An emergency physician recently began working at a local community hospital.  The emergency department is very busy and is part of a larger training program for emergency medicine residents.  At times the physician works with residents but is not their direct supervisor.  During the third week on the job, the physician meets the emergency medicine chief resident, who comes in infrequently to cover for other residents but is busy primarily with a nonclinical research project.  He has an excellent reputation in the program and is near the end of his final year.  At the end of the shift the physician sees the chief resident in the locker room; although the physician cannot be sure, it appears that the chief resident is snorting a substance behind his locker door.  The following week the physician sees him snorting a white powder in the bathroom.  The physician confronts the chief resident and asks if he is using drugs.  He initially denies drug use but then says, "Please don't tell anyone about this.  They'll kick me out, and I've worked so hard to get here.  I'll do anything you say - stop, get help, sign up for treatment."  The physician is ethically obligated to do which of the following?

• A)Encourage the resident to get help but respect his request for privacy
• B)Ensure that the resident begins substance use treatment
• C)Monitor the resident and intervene if the behavior continues
• D)Report the resident to the physician health program or state licensing board
• E)Set up an intervention with other colleagues to encourage the resident to seek treatment

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