One-third of physicians won't report impaired or incompetent colleagues, according to a survey, even though it's generally required by medical ethics codes and some state laws.

A 2009 survey of nearly 2,000 physicians in a wide range of specialties found only about 64 percent fully believed they had a professional obligation to tell authorities if a colleague were unable to do his or her job.

Furthermore, 17 percent had been aware of an incompetent or impaired colleague over the last 3 years, but one-third chose not to report him or her.

These findings are "troubling" because doctors checking up on each other is the first line of defense for patient safety, the authors wrote in their report, published Wednesday in the Journal of the American Medical Association.

"Self-regulation is the primary mechanism that patients have as protection against physicians who should not be practicing because their judgment is somewhat impaired," Dr. Catherine M. DesRoches, of the Mongan Institute for Health Policy at Massachusetts General Hospital and lead author of the study, told DOTmed News.

The American Medical Association Code of Ethics, the Charter on Medical Professionalism and many states require doctors to report on colleagues they suspect of being incompetent or impaired, especially through drug or alcohol abuse.

In the study, the researchers analyzed mail-in questionnaires answered by 1,891 respondents, from pediatrics, family practice, surgery, anesthesiology, psychiatry, internal medicine and cardiology.

The results found that about 64 percent of physicians said they "completely" agree they should report colleagues unable to do their job properly, with the rest saying they somewhat or don't agree.

And though similar numbers said they were prepared or able to report on colleagues, of the 17 percent who had known someone unfit for the job, only 67 percent reported on the person.

The chief reasons for not reporting were thinking someone else was already taking care of it (19 percent), not believing reporting would make a difference (15 percent) and fear of retaliation (12 percent).

Graduates of U.S. medical schools, whites and Asians and doctors working at universities, medical schools, hospitals and clinics were the most likely to say they completely agreed with reporting. Also, doctors operating in areas with low numbers of malpractice claims were somewhat more likely to say they should report on their colleagues (68 percent) compared with medium and high claim areas (60 to 63 percent), "But [the difference is] pretty marginal," DesRoches said.

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