Jack A. Ginsburg

Undiagnosed hypertension and hypercholesterolemia among uninsured and insured adults in the Third National Health and Nutrition Examination Survey.

Uninsured adults are much less likely than insured adults to receive routine checkups or preventive services, including screening for hypertension and hypercholesterolemia.1 To obtain nationally representative estimates of undiagnosed hypertension and hypercholesterolemia by insurance status, we analyzed the Third National Health and Nutrition Examination Survey (NHANES III).2,3

Alcohol and Other Substance Abuse and Impairment among Physicians in Residency Training

Substance abuse and impairment are serious societal problems. Physicians have historically had high rates of substance abuse, which has been viewed as an occupational hazard. Most authorities agree that the rate of alcoholism among practicing physicians is similar to that among control populations and that the rates of other substance abuse are greater, although some studies have shown no difference. Data about substance abuse among residents in training are limited but suggest that the use of benzodiazopines is greater than that among age-matched peers, whereas the use of alcohol is similar between the two groups. Medical institutions, including those with teaching programs, have legal and ethical responsibilities concerning substance abuse among current and future physicians. Many training programs, however, do not provide educational programs on this subject, do not have faculty trained in substance abuse medicine, and do not have a formal system to address the problem of residents who are suspected or known to be substance abusers. This position paper examines the extent of substance abuse, including alcohol abuse, among physicians in residency training. It outlines approaches to the problem and delineates responsibilities of institutions and residency program directors. Recommendations are made to establish an informational program and a clearly defined, organized process to address the problems of substance abuse among residents. Careful and humane approaches can be used to identify and treat residents with substance abuse problems and thus allowing them to complete their training as competent and drug-free professionals.

Prescription drug abuse: executive summary of a policy position paper from the American College of Physicians.

Prescription drug abuse is a serious public health problem. Physicians and other health professionals with prescribing privileges are entrusted with the authority to use medications in the treatmen...

Achieving a high-performance health care system: policies and positions of the American College of Physicians.

Submitted for publication April 23, 2008 Accepted for publication April 23, 2008 From the 1Department of Medicine, University of Washington School of Medicine, Seattle, Washington, 2Fayetteville Medical Associates, Fayetteville, Tennessee, 3American College of Physicians, Philadelphia, Pennsylvania, and Washington, DC. Address correspondence and reprint requests to Dr. David C. Dale, Department of Medicine, Box 356422, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195. E-mail: dcdale@u.washington.edu.