To improve patient safety, hospitals should randomly test physicians for drug and alcohol use in much the same way other major industries in the U.S. do to protect their customers. The recommendation comes from two Johns Hopkins physicians and patient safety experts in a commentary published in The Journal of the American Medical Association (JAMA). In addition, the experts say medical institutions should take a cue from other high-risk industries, like airlines, railways and nuclear power plants, and mandate that doctors be tested for drug or alcohol impairment immediately following an unexpected patient death or other significant event. “Patients might be better protected from preventable harm”, wrote the authors in the JAMA commentary. “Physicians and employers may experience reduced absenteeism, unintentional adverse events, injuries, and turnover, and early identification of a debilitating problem. In other high-risk industries, this right is supported by regulations and surveillance. Shouldn’t medicine be the same?”