Survey Finds Some Surgeons Report Alcohol Use Disorders



A relatively small proportion of surgeons who responded to an anonymous survey self-reported alcohol use disorders that are consistent with alcohol abuse or dependence, according to a report published in the February issue of Archives of Surgery, one of the JAMA/Archives journals.

Because alcohol abuse disorders can cause clinically significant impairment and distress in other aspects of life, researchers evaluated the prevalence of alcohol use disorders in surgeons and explored the relationship of these disorders to personal and professional characteristics, surgeon distress and self-reported events, such as malpractice lawsuits and medical errors.

Michael R. Oreskovich, M.D., of the American College of Surgeons, Chicago, and the University of Washington, Seattle, and colleagues collected 7,197 (28.7 percent) completed surveys from 25,073 members of the American College of Surgeons for whom they had correct email addresses. Of those who responded, 1,112 (15.4 percent) had a score on the Alcohol Use Disorders Identification Test that was consistent with alcohol abuse or dependence.

Researchers found that age, sex and relationship status had strong associations with alcohol abuse or dependence.

The point prevalence for alcohol abuse or dependence for male surgeons was 13.9 percent and for female surgeons it was 25.6 percent, the study results indicate. Abuse or dependence also was more likely in surgeons who were younger and dissatisfaction with a spouse or partner relationship and not having children were common with abuse or dependence. Surgeons who were burned out and depressed also were more likely to have alcohol abuse and dependence issues.

Researchers note that the prevalence of alcohol abuse or dependence was lowered when surgeons worked longer hours and had more nights on call. Surgeons with alcohol abuse or dependence also accounted for 77.7 percent of surgeons reporting a medical error in the previous three months, researchers suggest.

“Through the present study, the ACS has taken a leadership role in the identification of alcohol abuse and dependence among its members and, in so doing, destigmatization of this disorder with the intent of promoting appropriate intervention and treatment,” the authors comment. “Alcohol abuse and dependence is a treatable and reversible condition with an excellent prognosis when identified early with appropriate intervention, treatment and monitoring.”

“In conclusion, surgeons have alcohol use disorders at the same rate of or slightly higher than their counterparts in the general population,” the researchers conclude. “These findings should also decrease the shame and stigma associated with alcohol abuse or dependence and encourage surgeons to pursue treatment and rehabilitation to promote patient safety and personal well-being.”

In an invited critique, John A. Fromson, M.D., of Massachusetts General Hospital, Harvard Medical School, Boston, writes: “Of particular concern is that the point prevalence for alcohol abuse or dependence in male surgeons was found to be 13.9 percent and for female surgeons almost double at 25.6 percent. This critical finding must serve as a catalyst for future investigation as to the cause, effective treatment and prevention of alcohol use disorders among female and male surgeons.”

In an editorial, Edward H. Livingston, M.D., of the University of Texas Southwestern Medical Center, Dallas, and Joseph S. Wislar, M.S., JAMA, Chicago , write: “The report by Oreskovich et al may not accurately reflect the true incidence of alcoholism among surgeons. The relatively low response rate may give one pause to consider that responding surgeons may not adequately reflect the universe of surgeons, or even the members of the American College of Surgeons, eligible for study participation.”

“Considering the constellation of potential biases that exist in the survey process, the results reported by Oreskovich et al should be interpreted with some caution. Nonresponse bias in particular could drive the rates up or down,” they conclude.

(Arch Surg. 2012;147[2]:168-174; 147[2]:174; 147[2]:110.