A recent study summarized in General Surgery News, January 2012, reported that one in six surgeons met the criteria for alcohol abuse or dependence. Women, furthermore, had even higher numbers: 25.6% of female surgeons screened positive, while 13.9% of male surgeons were scored positive.
This study, commissioned by the American College of Surgeons, followed previous studies showing that 40% of surgeons met the diagnostic criteria for burnout and up to 20% for depression.
Additional findings were: • Younger surgeons, married surgeons and surgeons without children were more likely to screen positive. • Drinking was more prevalent among surgeons in private practice. • Longer hours of work had a protective factor against dependence. • Surgeons who are isolated, depressed and burned out are more likely to drink heavily. • Surgeons who abused alcohol had twice as much suicidal ideation as others.
One of the authors of the study, Michael Oreskovich, MD, clinical professor of psychiatry at the University of Washington, Seattle, asserts that ‘it may be surgeons turn to alcohol to help deal with the pressure of their careers and the stress of work-life balance....We know that surgeons are perfectionists and when faced with more stress, they just work harder to overpower the stress....If you can’t overpower stress with discipline and focus and the stress is really wearing one down, then a tendency to have a couple of drinks makes sense.” 1
Regarding the differential between men and women, “women surgeons have an extra stressor. That is, they are more inclined to want to try to balance their personal and professional life and have more personal life responsibilities. That puts them at an increased risk.” 2
The study also looked at the effect of having made a major medical error. Those who had made a major error in the past few months had significantly higher rates of problem drinking.
Dr. Oreskovich believes that the survey “likely underestimates the prevalence of alcohol abuse and dependence among surgeons. Surgeons with an alcohol problem are less likely to have answered the questionnaire, he said.” 3
One goal of the authors is to remove the shame and stigma surrounding substance abuse in surgeons and to encourage these physicians to seek help. On the positive side, related research shows that “surgeons have extremely high success rates with rehabilitation programs....81% of surgeons with an admitted substance abuse problem who committed to an intervention went on to complete the program, finish treatment, undergo monitoring and return to practice without a single relapse recorded over five years of monitoring. ‘That is better than anything that’s ever been published previously,’ said Dr. Oreskovich.” 4
Plans are being implemented to establish an online anonymous screening program for surgeons on the American College of Surgeons’ website. Surgeons will receive immediate feedback, and for those at risk, will receive local resource information. Resources will include state physician health programs that provide assistance without medical board involvement.
1 Christina Frangon, “Alcohol Abuse High Among Surgeons”, American Medical News, January 23, 2012 2 3 4 Ibid.