To the Editor.—
The article by Geller et al1 adds to the increasing literature on the deficiencies in, and differences between, medical students' and housestaffs' knowledge of and attitudes toward alcoholism and screening for this. However, the authors failed to report two important aspects of their study.Were the knowledge and attitude scales and reported practices directed toward ambulatory or hospitalized patients? The prevalence of alcoholism can vary considerably between these two groups of patients. It has been suggested that residents diagnose alcoholism in its late stages, in their hospitalized patients, but do not detect the early symptoms of alcoholism and drug abuse in their ambulatory patients.2What were the exact frequencies of reported screening, referral, and follow-up practices of the students and house staff? The authors presented only the association between perceived responsibility and confidence levels and the reported high or low level of screening and referral.
Wayland MT. The Attitudes of Students and House Staff Toward Alcoholism. JAMA. 1990;263(9):1199. doi:10.1001/jama.1990.03440090028013