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Last Updated: Tuesday, 14 June, 2005, 10:36 GMT 11:36 UK
Why do doctors drink so much?
They know the health risks better than any of us, but still doctors are among the worst offenders when it comes to excessive drinking. Why?

There's an old joke in the medical profession that a patient is only an alcoholic if he drinks more than you. The humour, however, belies a disturbing truth about doctors' relationship with alcohol.

Doctors are three times more likely to have cirrhosis of the liver - a sign of alcohol damage - than the population at large. They are second only to publicans and bar staff.

A BBC survey has found that in 10 years, 750 hospital staff - nurses as well as doctors - in England had been disciplined over alcohol and drug-related incidents.

On the face of it, doctors are unlikely alcoholics. They know the dangers better than any of us and, by and large, they are accomplished, intelligent professionals. The average earnings of GPs are almost 100,000.

But, says Dr Alex Freeman, the stress of the job means doctors are at increased risk from all sorts of problems including divorce, suicide and depression.

Workplace uncertainty

"There's a culture of doctors thinking they should be able to sort themselves out because they are doctors. So they don't seek help early, allowing an addiction to take hold," says Dr Freeman, who sat on the British Medical Association's doctors in difficulty panel.

It's a means of self defence - a protective mechanism for being able to cope with the emotion
Dr Guy Ratcliffe

"They want everything to be kept confidential. You wouldn't want to go and sit in a psychiatric outpatients department and run into one of your patients."

Stress, of course, is not confined to those in the medical profession. But Dr Freeman says doctors lack control of their workload and work environment, they stay late to get the job done and, in training, there is the constant uncertainty of having to change jobs frequently.

When it comes to seeking medical treatment, doctors don't always practise what they preach. The temptation is to self-diagnose, says Dr Guy Ratcliffe, head of the Medical Council on Alcohol - a group set up in the 1960s to tackle medics with addiction problems.

"We're less likely to go to see another doctor than most people. It's convenience, if nothing else," says Dr Ratcliffe.

It's also been suggested that since some hospital staff confront death on a daily basis, they tend to be more cavalier about such things than the rest of us. It's perhaps another factor in explaining doctors' reliance on drink and flippancy about the health effects.

Access to drugs

"Doctors develop a fairly thick skin. It's a means of self defence - a protective mechanism for being able to cope with the emotion, and one that is maybe 'assisted' by a couple of gin and tonics after work."

Drug dependency is also a problem. This, says Dr Ratcliffe, is not surprising given the abundance of drugs doctors can easily lay their hands on. Anaesthetists, for example, have "potent access to drugs in the rooms where they work".

Dr Ratcliffe says a lot more work must be done to support medics who fall victim to addiction, and flagging up the help that's already available. Many feel that seeking help will jeopardise their career and everything else that stems from it.

"Doctors as individuals are no different to everyone else. They need to know that if they have a problem, they can get help."

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