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May 23, 1977

Physician Attitudes: Effect on the Treatment of Chemically Dependent Patients

Author Affiliations

From the Department of Psychiatry, School of Medical Sciences, University of Nevada, Reno (Dr Chappel); and the Eagleville Hospital and Rehabilitation Center, Eagleville, Pa (Dr Schnoll).

JAMA. 1977;237(21):2318-2319. doi:10.1001/jama.1977.03270480058021

PHYSICIAN attitudes are recognized as being a crucial factor in determining medical treatment. Studies of diagnostic practice indicate that the pervasive attitude among physicians is that "it is better to suspect illness than not—better safe than sorry." Yet in the case of chemically dependent persons, that traditionally positive attitude is often reversed.

Negative attitudes toward chemically dependent persons are often taught indirectly in the medical school. Pejorative statements made by attending physicians and house staff about "junkies" and "winos" are a familiar part of medical education. Fisher and his colleagues1 have shown that attitudes toward alcoholic patients are more negative in the second year of medical school and continue until they reach a substantially lower level among house staff. The effects of these negative attitudes have been noted at many levels.

Diagnosis  Diagnosis of drug dependence may be delayed or missed. Chafetz2 and others have noted that many