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Invited Critique
Nov 2011

Substance Abuse Among Surgeons: The Perils of Losing Your Credentials: Comment on “Prognosis for the Recovery of Surgeons From Chemical Dependency”

Author Affiliations

Author Affiliations: Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center and the Winchester Surgical Clinic, Dallas, Texas (Drs Balch and Bechamps).

Arch Surg. 2011;146(11):1291-1292. doi:10.1001/archsurg.2011.309

Alcohol and drug abuse are a significant issue among physicians in general and surgeons in particular. A recent 7000-member survey of the American College of Surgeons demonstrated a prevalence for alcohol abuse among male surgeons at 13.8% and for female surgeons at 25.4%.1 Substance abuse, when identified early, treated, and monitored is a reversible condition with an excellent prognosis. But can rehabilitated surgeons reenter the workforce and fully practice their profession again? Unfortunately, the results from this important study showed that the surgeons' rate of reentry is significantly less than their nonsurgeon counterparts.2 Further research needs to be done to determine the cause for this discrepancy. Most of us have encountered a colleague whose medical license or credentials have been encumbered due to violation of his state's medical practice act secondary to substance abuse. The journey back to full licensure and credentialing is difficult and carries the stigma of failure and incompetency, and is subject to prejudicial discrimination. Surgeons come under greater scrutiny because society expects unblemished results from surgical encounters. Retraining is difficult to arrange because of competitiveness for proctored cases with surgical residents and fellows.

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