Survey: Quarter of docs drink alcohol while on call

While most doctors are against drinking any alcohol while on call, nearly one-quarter of the 135 doctors surveyed in a recent study from Hamilton County, TN, admitted to drinking alcohol while on call. Sixty-four percent reported having encountered colleagues whom they suspected had used alcohol, and 27% thought they had seen physicians impaired by alcohol while on call.

Jimmy Wallace, a 1999 graduate of The University of the South in Sewanee, TN, who now is a graduate student in public health at The University of North Carolina in Chapel Hill, received a Tonya Foundation grant for the research through Erlanger Medical Center, which is affiliated with the Chattanooga Unit of the Department of Medicine at the University of Tennessee College of Medicine. He joined James Peterman, PhD, professor of philosophy at The University of the South and others to conduct the study (BMJ 2002; 325:579-580).

"I think the subject of this study has not been an issue that’s been discussed previously. That, in itself, is surprising," Peterman says. "There is no standard rule about what is acceptable (for doctors drinking alcohol while on call), so people then make up their own rules, and there are no rules then for medical students on this. There is ambiguity in doctors minds as to whether on-call time is private time or work time. That’s, in a way, the question that needs to be brought out in people’s minds, so a decision can be made on it."

The researchers developed a survey with 10 questions to probe doctors’ perceptions about their own and their colleagues’ use of alcohol while on call. They obtained a list of all doctors in Hamilton County from The American Medical Association, and sent their survey to a 20% random sample from each listed specialty. Of the 206 surveys sent, 135 (65%) responses were returned.

Fourteen percent of the respondents felt that social drinking while on call was acceptable, and one-fourth thought that in their specialty, some alcohol use is safe. Twenty-four percent reported consuming alcohol while on call, but only half of those doctors responded that they report their alcohol use to the patients they treat during that time. In response to asking how many drinks a doctor in their specialty could safely drink while on call, 73% answered zero, 9% answered one, 4% answered two, 5% answered three, and 13% answered four or more. Almost all doctors (98%) believed that patients care whether they use alcohol while on call, but were divided about their obligation to inform patients before seeing them. While sex and specialty were not associated with doctors’ responses, older doctors were more likely to report encountering doctors whom they suspected had used or were impaired by alcohol while on call.

"More data need to be obtained about these issues, and the medical profession and society need to discuss the balance between personal freedom and professional obligation to patients," Peterman says. "Medical societies need to include stronger declarations about drinking alcohol while on call in their ethical codes, before the issue is decided for them. There are clear rules and regulations about alcohol use in the aeronautical industry, so there should be in the medical profession, too."