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Am I my brother's keeper? A survey of 10 healthcare professions in the Netherlands about experiences with impaired and incompetent colleagues
  1. Jan Willem Weenink1,
  2. Gert P Westert1,
  3. Lisette Schoonhoven1,2,
  4. Hub Wollersheim1,
  5. Rudolf B Kool1
  1. 1Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
  2. 2Faculty of Health Sciences, University of Southampton, Southampton, UK
  1. Correspondence to Scientific Institute for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Jan-Willem Weenink, P.O. Box 9101, Nijmegen 6500 HB, The Netherlands; janwillemweenink{at}


Background Dealing with poor individual performance of healthcare professionals is essential in patient safety management. The objective of the current study was to explore potential differences regarding experiences with impaired and incompetent colleagues between a broad range of healthcare professions.

Methods A survey of 10 legally regulated professions in the Netherlands on knowledge on dealing with impaired/incompetent colleagues, experiences with such colleagues, action taken upon an impaired and incompetent colleague and reasons for not taking action.

Results We approached 4348 professionals, of whom 1238 responded (28.5%). One-third of the respondents (31.3%) had an experience with an impaired or incompetent colleague in the preceding 12 months, and 84% of these reported cases concerned incompetence. Even under the extreme assumption that all non-respondents had no such experiences, our results indicate that at least 9% of the total sample had dealt with an impaired or incompetent colleague in the previous 12 months. Two-thirds of the professionals (68.6%) who had an experience reported having acted upon it. Respondents significantly less often reported to have acted (49.6% vs 79.1%, p=0.000) when the colleague was working at a different organisation. The primary reason for not taking action was that impairment/incompetence could not be proven.

Conclusions Even using an extreme correction for our low response rate, at least 9% of healthcare professionals reported dealing with impaired or incompetent colleagues in the past year. Creating and clarifying reporting opportunities when confronted with an incompetent or impaired colleague should be a priority for professional organisations, policymakers and regulatory bodies.

  • Safety culture
  • Human error
  • Health services research
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