An independent physician in solo practice who is on the medical staff of a hospital is reported by hospital support staff of continuing to perform procedures with worsening hand tremor and new blindness in one eye. The hospital administration is worried about its liability but the physician has full medical staff privileges and refuses to succumb to testing and an occupational medical evaluation. What authority might the hospital have to enforce fitness for duty testing or functional capacity evaluations? How would that evaluation be performed in the absence of job descriptions? Is there such a thing as specialty-specific job descriptions (neurology, surgery, cardiology) for physicians that must be adhered to? How can we get job descriptions to which to hold the physician accountable?

How might this situation be different for physicians who are employed? Does their employer - a hospital or medical group - have more power to enforce fitness for duty testing or functional capacity evaluations under the threat of termination?

Thanks in advance.

Prerna Khanna, MD