Objective:
To assess the patient and physician characteristics that influence physicians’ detection of problem drinking in their medical
patients.
Setting:The outpatient medical clinic at an urban university teaching hospital staffed by interns and residents.
Design:Cross-sectional study of a rendomly chosen subsample of consecutive patients.
Measurement:Univariate and multivariate analysis with calculated adjusted odds ratios of factors associated with physician detection of
drinking problems. A problem was diagnosed according to the patient’s results on the alcohol module of the Diagnostic Interview
Schedule (DIS).
Results:Physicians detected 22% of 189 presumably inactive problems and 49% of 92 current problems, i.e., those that have occurred
within the preceding year. Multivariate correlates of detection of active problems included male patient gender, presence
of gastrointestinal complications of excessive drinking, number of concurrent medical disorders, and previous medical record
reference to alcohol (p<0.05). Physician gender and year of training were not associated with detection.
Conclusion:Our physicians appear to rely on specific patient characteristics as well as the patient’s medical record to detect drinking
problems in their ambulatory patients. Their reliance upon these factors may hinder their detection of drinking problems in
women patients and less seriously impaired individuals.
Key words problem drinking - alcohol abuse and dependence - physician detection
Supported in part by Commonwealth Center on Drug Abuse Faculty Grant Program and Bureau of Health Professions, HRSA Grant
for Residency Training in General Internal Medicine.