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Department of Public Health Sciences University of Toronto Toronto, Ont.
A recent public health item in CMAJ pointed out that although the precise prevalence of problems with alcohol and other drugs among physicians is unknown, it is probably similar to that in the general population.1 Single and colleagues' estimate of 9% was quoted.2 This estimate applies to current drinkers who have experienced any of a list of specific problems at least once in the past year; these individuals do not necessarily need treatment. Single and colleagues broke down the overall estimate by demographic variables: 7.6% of those with university education and 5.8% of those employed in a profession reported any alcohol- related problem in the past year. These latter figures are probably better estimates of the rate of problems among physicians.
More recent data from the 1996–1997 National Population Health Survey showed that, overall, 2.5% of people who drank in the year before the survey drank at "levels associated with clinical dependence on alcohol."3 The rates were 1.1% for those with a university education and 0.8% for those employed in professional or semiprofessional positions. These figures approximate the percentages of physicians ever having received treatment for problems with alcohol and other drugs: 1.2% in Ontario,4 1.8% in Canada5 and 1.3% in the United States.6
Most provincial medical associations have programs for physicians who need treatment for problems with alcohol and other drugs. However, the discrepancy between estimates of those who experience consequences of drinking and those who require and receive treatment points to a large group whose needs are not being addressed. Provincial physician health programs include educational outreach and lectures to medical students and physicians,7 but there is little help for those who feel distress and are beginning to develop problems. Medical schools, hospitals, professional organizations and individual physicians should unite in a health promotion approach to physician health that goes beyond prevention programs, to reduce systemic stresses and involve physicians in building a healthier work environment.
References
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Copyright 1995-2001, Canadian Medical Association. All rights reserved. ISSN 1488-2329
(e) 0820-3946 (p)
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association. |
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