Study finds many M.D.s drink when on call

While most doctors say they're against drinking any alcohol while on call, nearly one-quarter of the 135 doctors surveyed in a recent study from Hamilton County , Tenn. , admitted to drinking alcohol while on call. 64% reported having encountered colleagues they suspected had used alcohol while on call, and 27% reported having encountered colleagues they believed were impaired by alcohol while on call.

The study was conducted by Jimmy Wallace, a graduate student in public health at The University of North Carolina at Chapel Hill . The results were reported in BMJ, a professional journal formerly called the British Medical Journal.

"I think the subject of this study has not been an issue that's been discussed previously. That, in itself, is surprising," said Peterman. "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. Of the 206 surveys sent, 135 (65%) responses were returned.

14% 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. 24%  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% replied two, 5% said three, and 13% answered four or more.

Almost all doctors (98%) believed that patients care whether they use alcohol while on call, but doctors were divided about their obligation to inform patients before seeing them.

"Although almost all doctors think that patients care whether they use alcohol while on call, there is substantial disagreement about the use of alcohol while on call, and the doctors' obligation to inform their patients," stated Peterman.

"More data needs 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. 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."

SOURCE: "Doctors' perceptions of drinking alcohol while on call: questionnaire survey," by Tahir Ahmad, Jimmy Wallace, et al, BMJ, Sept. 14, 2003 .