ヤマアラシのジレンマ

現役外科医の15％がアルコール乱用・依存
http://mtpro.medical-tribune.co.jp/mtpronews/1202/1202062.html
米国外科医学会調査の横断解析
　米国外科医学会（ACS）のMichael R. Oreskovich氏らは，同学会が行った2010年の調査データを横断解析し，現役外科医の15％がアルコール乱用・依存であったと発表した（Arch Surg 2012; 147: 168-174）。過去3カ月の医療ミスの報告者の8割近くがアルコール乱用・依存だった。

Prevalence of Alcohol Use Disorders Among American Surgeons
http://archsurg.ama-assn.org/cgi/content/abstract/147/2/168
Michael R. Oreskovich, MD; Krista L. Kaups, MD; Charles M. Balch, MD; John B. Hanks, MD; Daniel Satele, BA; Jeff Sloan, PhD; Charles Meredith, MD; Amanda Buhl, MPH; Lotte N. Dyrbye, MD, MHPE; Tait D. Shanafelt, MD
Arch Surg. 2012;147(2):168-174. doi:10.1001/archsurg.2011.1481

Objectives  To determine the point prevalence of alcohol abuse and dependence among practicing surgeons.

Design  Cross-sectional study with data gathered through a 2010 survey.

Setting  The United States of America.

Participants  Members of the American College of Surgeons.

Main Outcome Measures  Alcohol abuse and dependence.

Results  Of 25 073 surgeons sampled, 7197 (28.7%) completed the survey. Of these, 1112 (15.4%) had a score on the Alcohol Use Disorders Identification Test, version C, consistent with alcohol abuse or dependence. The point prevalence for alcohol abuse or dependence for male surgeons was 13.9% and for female surgeons was 25.6%. Surgeons reporting a major medical error in the previous 3 months were more likely to have alcohol abuse or dependence (odds ratio, 1.45; P < .001). Surgeons who were burned out (odds ratio, 1.25; P = .01) and depressed (odds ratio, 1.48; P < .001) were more likely to have alcohol abuse or dependence. The emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse or dependence. Male sex, having children, and working for the Department of Veterans Affairs were associated with a lower likelihood of alcohol abuse or dependence.

Conclusions  Alcohol abuse and dependence is a significant problem in US surgeons. Organizational approaches for the early identification of problematic alcohol consumption followed by intervention and treatment where indicated should be strongly supported.

Author Affiliations: American College of Surgeons, Chicago, Illinois (Drs Oreskovich, Kaups, Balch, and Hanks); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Drs Oreskovich and Meredith), and Washington Physicians Health Program (Dr Meredith and Ms Buhl), Seattle; Department of Surgery, University of California, San Francisco, Fresno (Dr Kaups); Department of Surgery, Johns Hopkins University, Baltimore, Maryland (Dr Balch); University of Virginia, Charlottesville (Dr Hanks); and Department of Medicine, Mayo Clinic, Rochester, Minnesota (Mr Satele and Drs Sloan, Dyrbye, and Shanafelt).

> "Oreskovich氏らよると，現役外科医におけるアルコール依存・乱用は一般人口における報告と差はなかったが，その影響はさらに重大である。"