Emma J. Stokes

Characteristics, diagnosis, and treatment of alcoholism in elderly patients.

The purpose of this study is to examine the ability of physicians to diagnose alcoholism in the elderly patient and to define characteristics specific to the elderly patient with alcoholism. During a 3‐month period, all new admissions to the medical service of The Johns Hopkins Hospital were screened for alcoholism with two screening tests (the CAGE questionnaire and Short Michigan Alcohol Screening Test). The prevalence of screen‐positive alcoholism was 27% in patients under 60 years of age and 21% in patients 60 years and older. Elderly patients with alcoholism were more likely to be black (P < .01), but did not differ significantly in any other way from elderly patients who did not have alcoholism. Although 60% of screen‐positive young patients with alcoholism were identified by their houseofficers, only 37% of elderly patients with screenpositive alcoholism were so identified (P < .05). The elderly patients with alcoholism were significantly less likely to be diagnosed by their houseofficer if they were white, female, or had completed high school (P < .01). Even when diagnosed, elderly patients with alcoholism were less likely than younger patients with alcoholism to have treatment recommended by their houseofficers (P < .05) and, if treatment were recommended, it was less likely to be initiated (P < .05). These data suggest that current medical education is deficient in providing physicians with the skills to detect and treat elderly patients with alcoholism.

Understanding and eradicating bias against women in medicine

No abstract available.

Organizational Change to Support Success of Women

It has been well doeumented that women in academie medicine experience gender-based obstacles to their career success and satisfaction, and that the manifestations of these obstacles are similar to those reported in other disciplines of academia as well as other professions. Nationally, women faeulty in academie medicine experience, to the present, lower salaries than male colleagues at comparable ranks and level of expertise, slower rates of promotion, lesser access to the resources essential to career success such as mentoring, career development information, space and personnel, and lower likelihood of professional recognition for their accomplishments and contributions (Conley 1993; DeAngelis 1995; ACP 1991; Carr 1992 and 1993; Tesch 1995; Etzkowitz 1994; Bickei 1988). Women are imderrepresented in leadership roles and have a profound experience of isolation fi-om colleagues and information. These observations have been reported at every academie medical institution that has evaluated them (Carr 1993, Grosz 1991, Boyer et al. 1988, Dean’s Office 1993, Committee on Work 1989), have been quantified in my own institution (Provost’s Committee 1989), and have been confirmed in national analyses performed by the Association of American Medical Colleges (Bickei 1988, 1994, and 1995).