Monday, February 27, 2012

Surgeons and alcohol use

“Prevalence of alcohol use disorders among American surgeons” appeared in the February, 2012 issue of Archives of Surgery.

A survey of 7197 surgeons, all members of the American College of Surgeons [ACS], had a 28.7% response rate and revealed that 15.4% had scores on an alcohol use assessment test that indicated abuse of or dependence on alcohol. This is consistent with the rate of such alcohol problems in the general public.

Factors significantly associated with alcohol abuse or dependence were age [younger surgeons had more problems], being in a relationship, burnout, depression, fewer hours worked, fewer call nights and not having children [I would have thought otherwise]. Women surgeons had twice the incidence of alcohol abuse or dependence than men, which was statistically significant, p = 0.001.

The most distressing result of this survey is that 77.7% of surgeons who had problems with alcohol said they had committed a major medical error within the three previous months. This is three times more often than those who reported no alcohol problems and statistically significant, p = 0.001.

The survey may not be that accurate because it had such a low response rate. In addition, the ACS had 65,844 members at the time of the survey but only 27,457 had provided the organization with e-mail addresses, 25,073 of which were valid. Although the rate of return of those with valid email addresses was 28.7%, the actual percentage of ACS members responding was 10.9% [7197/65,844]. There are also the usual problems of trying to sort out whether those who responded were more or less likely to have alcohol issues.

My opinion: It is not reassuring that surgeons abuse or are dependent on alcohol at the same rate as everyone else, nor is it acceptable. We should be held to a higher standard. Not one surgeon should take the responsibility of operating on a patient while dependent on alcohol. The rate of medical errors is chilling. Now that we have this information, what is going to be done about it?

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