The Impaired Dentist: a Challenge to the Profession (Alcohol-Impaired, Peer Assistance).

Abstract

By a r and om sampling process, 500 members of the Michigan Dental Association were chosen to participate in a survey on the alcohol-impaired dentist. Three hundred-seventy (74%) responses were analyzed. The data indicate that a considerable gulf exists between the dentists' evaluations of their own concerns and their perception of the degree of concern throughout the dental community. Sixty-six percent of the respondents felt there was no noticeable or very little concern within the dental community toward the issue of impairment. In contrast, a majority of the dentists (82%) rated their personal concern toward alcohol-impaired colleagues from moderate to a great deal. Forty-eight percent (177) were aware of a colleague with a problem; by hearsay, 39% (144) knew of an impaired dentist in other communities. Eighty percent of the dentists rated themselves from moderate to very high in knowledge about alcoholism; however, knowledge of the intervention process, of publicity designed to address the problem, or of specific intervention programs is severely limited. A majority (60% with another 18% undecided) however favored or highly favored peer intervention as a viable means of addressing the problem. Personal experiences--a close associate with an obvious problem, a family history of alcoholism, an alcohol-related problem in the immediate family--had the most significant effect both on knowledge about alcoholism and concern toward colleagues. The noticeable increase in media and news coverage, the growing concern throughout society in regard to alcoholism and other substance abuse, were also key influences. Stress and drugs at-risk were important vulnerability factors. Eighty-nine percent of the dentists considered dentistry a highly stressful profession. The dem and ing work routine was the major concern; malpractice issues, patient relations and the high expectations of society were a close second. As major drugs at-risk, respondents rated tranquilizers first, stimulants second, nitrous oxide third. The marked difference perceived between high levels of personal concern and the low level of concern attributed to the dental community and the efforts of organized dentistry was striking. Over 90% of the respondents felt ethically obligated to assist impaired colleagues, protect patients' welfare and maintain professional st and ards.