Background
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How do doctors evaluate their own health?
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How balanced is a doctor’s diet and how regularly do they exercise?
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What is the general willingness of doctors to take risks and how often do they participate in preventive examinations? Do predisposed groups exist?
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What is the prevalence of dangerous alcohol use among physicians and how does it affect their counselling behaviour? Which groups are particularly at risk?
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What is the prevalence of substance use, risk taking and obesity in specific comparison between surgical and non-surgical specialties?
Methods
Design and conduction of survey
Questionnaire
Statistics
Results
Return and sample size
Characteristic | Female physicians (n = 417) | Male physicians (n = 503) | All (n = 920) | P-value |
---|---|---|---|---|
Age group | ||||
18–35 | 190/46 | 150/30 | 340/37 | < 0,001 |
36–45 | 101/24 | 135/27 | 236/26 | |
46–55 | 90/22 | 131/26 | 221/24 | |
older than 55 | 36/9 | 87/17 | 123/13 | |
Marital status | ||||
Unmarried | 177/42 | 120/24 | 297/32 | < 0,001 |
Married | 221/53 | 365/73 | 586/64 | |
Divorced/widowed | 19/5 | 18/4 | 37/4 | |
Children (living in the household) | ||||
Yes | 159/38 | 263/52 | 422/46 | < 0,001 |
No | 258/62 | 240/48 | 498/54 | |
Medical speciality | ||||
General practice | 32/8 | 45/9 | 77/8 | < 0,001 |
Anaesthesiology | 66/16 | 85/17 | 151/16 | |
Surgerya | 28/7 | 52/10 | 80/9 | |
Orthopaedic and trauma surgery | 16/4 | 66/13 | 82/9 | |
Internal medicine | 87/21 | 107/21 | 194/21 | |
Paediatrics | 38/9 | 21/4 | 59/6 | |
Psychiatry/child and adolescent | 38/9 | 35/7 | 73/8 | |
Psychiatry | ||||
Other | 112/27 | 92/18 | 204/22 | |
Position/educational level | ||||
Resident | 193/46 | 145/29 | 338/37 | < 0,001 |
Specialist | 117/28 | 130/26 | 247/27 | |
Physician in a leading position | 107/26 | 228/45 | 335/36 | |
Establishment | ||||
University hospital | 184/44 | 192/38 | 376/41 | 0.110 |
For-profit/public/non-profit hospital | 177/42 | 224/45 | 401/44 | |
Phyiscian in private practice | 56/13 | 87/17 | 143/16 | |
Working hours per week | ||||
More than 70 h | 24/6 | 58/12 | 82/9 | < 0,001 |
60 h - less than 70 h | 61/15 | 129/26 | 190/21 | |
50 h - less than 60 h | 132/32 | 164/33 | 296/32 | |
40 h - less than 50 h | 124/30 | 119/24 | 243/26 | |
30 h - less than 40 h | 49/12 | 25/5 | 74/8 | |
Less than 30 h | 27/7 | 8/2 | 35/4 | |
Stresses and strains | ||||
Stress/pressure at work and in the private environment | 157/38 | 173/34 | 330/36 | 0.590 |
Stress/pressure at work or in the private environment | 210/50 | 266/53 | 476/52 | |
None | 50/12 | 64/13 | 114/12 |
Examined variables
Examined variables | Surgical specialitya (n = 241) | Non-surgical specialitya (n = 679) | All (n = 920) | P-Value |
---|---|---|---|---|
Health condition (subjective) | ||||
Satisfactory/good/very good | 217/90 | 610/90 | 827/90 | 1.000 |
Very poor/poor/less healthy | 24/10 | 69/10 | 93/10 | |
Actively taking health risks | ||||
Sometimes/often | 107/44 | 175/26 | 282/31 | < 0,001 |
Rarely/never | 134/56 | 504/74 | 638/69 | |
Preventive check-ups | ||||
Often | 41/17 | 181/27 | 222/24 | 0.003 |
Rarely | 200/83 | 498/73 | 698/76 | |
BMI | ||||
24,5 (3,8) | 24,1 (3,5) | 24,2 (3,6) | 0.160 | |
BMI - categories | ||||
Short/normal weight (BMI < 25) | 159/66 | 444/65 | 603/66 | 0.059 |
Overweight (BMI 25 bis < 30) | 55/23 | 188/28 | 243/26 | |
Obesity (BMI ≥ 30) | 27/11 | 47/7 | 74/8 | |
Nicotineb | ||||
Moderate to high dependence | 15/6 | 29/4 | 44/5 | 0.145 |
Low dependence | 27/11 | 55/8 | 82/9 | |
Non-smoker/otherc | 199/83 | 595/88 | 794/86 | |
Alcohold | ||||
Hazardous alcohol consumption | 70/29 | 142/21 | 212/23 | 0.013 |
Harmless/no alcohol consumption | 171/71 | 537/79 | 708/77 | |
“How often do you drink alcohol in general?” (Scores) | ||||
4 times or more often per week (4) | 38/16 | 99/15 | 137/15 | |
2–3 times per week (3) | 81/34 | 196/29 | 277/30 | |
2–4 times per month (2) | 80/33 | 210/31 | 290/32 | |
Monthly or less (1) | 26/11 | 111/16 | 216/24 | |
Never (0) | 16/7 | 63/9 | ||
“How many unitse of alcohol do you drink on a typical day when you are drinking?” (Scores) | ||||
10 or more (4) | 1/0 | 1/0 | 2/0 | |
7–9 (3) | 6/3 | 9/1 | 15/2 | |
5–6 (2) | 11/5 | 20/3 | 31/3 | |
3–4 (1) | 59/25 | 113/17 | 172/19 | |
1–2 (0) | 148/61 | 473/70 | 621/68 | |
I don’t drink alcohol at all. (0) | 16/7 | 63/9 | 79/9 | |
“How often have you had 6 or more units of alcohol on one day in the last year?” (Scores) | ||||
Daily or almost daily (4) | 3/1 | 1/0 | 4/0 | |
Once a week (3) | 12/5 | 21/3 | 33/4 | |
Once a month (2) | 35/15 | 64/9 | 99/11 | |
Less than monthly (1) | 93/39 | 200/30 | 293/32 | |
Never (0) | 98/41 | 393/58 | 491/53 |
Influencing factors
Potential influencing factors | Harmless/no alcohol consumption (n = 708) | Hazardous alcohol consumption (n = 212) | All n = 920 | P-Value |
---|---|---|---|---|
Age | ||||
≤ 35a | 251/74 | 89/26 | 340 | 0.089 |
> 35a | 457/79 | 123/21 | 580 | |
Gender | ||||
Female | 365/88 | 52/13 | 417 | < 0,001 |
Male | 343/68 | 160/32 | 503 | |
Maritial status | ||||
Unmarried | 215/72 | 82/28 | 297 | 0.075 |
Married | 464/79 | 122/21 | 586 | |
Divorced/widowed | 29/78 | 8/22 | 37 | |
Children (living in the household) | ||||
Yes | 340/81 | 82/19 | 422 | 0.018 |
No | 368/74 | 130/26 | 498 | |
Position/educational level | ||||
Resident | 250/74 | 88/26 | 338 | 0.170 |
Specialist | 199/81 | 48/19 | 247 | |
Physician in a leading position | 259/77 | 76/23 | 335 | |
Establishment | ||||
University hospital | 284/76 | 92/26 | 376 | 0.657 |
For-profit/public/non-profit hospital | 314/78 | 87/22 | 401 | |
Physician in private practice | 110/77 | 33/23 | 143 | |
Working hours per week | ||||
50 h or more | 418/74 | 150/26 | 568 | 0.002 |
Less than 50 h | 290/83 | 62/18 | 352 |
Consultation behaviour
CAGE questionnaire
Self-assessment
Regression analysis
Variables | Odds ratio | 95% confidence interval | P-value |
---|---|---|---|
Hazardous alcohol consumption (AUDIT C test ≥5 points) - all physicians (n = 920) | |||
Female gender | 0.27 | 0,19–0,39 | < 0,001 |
No children in the household | 1.67 | 1,17–2,37 | 0.004 |
Female physicians (n = 417) | |||
No children in the household | 2.16 | 1,01–4,62 | 0.047 |
Surgical speciality | 2.00 | 0,97–4,12 | 0.062 |
Residentsb | 3.10 | 1,02–9,40 | 0.046 |
Specialistsb | 2.61 | 0,92–7,43 | 0.071 |
Male physicians (n = 503) | |||
No children in the household | 1.62 | 1,08 - 2,43 | 0.019 |
Surgical speciality | 1.27 | 0,83 - 1,93 | 0.270 |
Residentsb | 1.19 | 0,62 - 2,27 | 0.605 |
Specialistsb | 0.66 | 0,38 - 1,15 | 0.141 |
Variables | Odds ratio | 95% confidence interval | P-value |
---|---|---|---|
Risky behaviour - all physicians (n = 920) | |||
Female gender | 0.46 | 0,34–0,63 | < 0,001 |
Working hours per week (> 50 h) | 1.56 | 1,12–2,18 | 0.009 |
No children in the household | 1.45 | 1,05–2,00 | 0.023 |
Surgical speciality | 2.03 | 1,47–2,81 | < 0,001 |
Female physicians (n = 417) | |||
Working hours per week (> 50 h) | 1.69 | 0,99–2,88 | 0.055 |
No children in the household | 1.17 | 0,65–2,08 | 0.604 |
Surgical speciality | 2.09 | 1,18–3,69 | 0.011 |
Male physicians (n = 503) | |||
Working hours per week (> 50 h) | 1.53 | 0,99–2,38 | 0.057 |
No children in the household | 1.61 | 1,08–2,38 | 0.018 |
Surgical speciality | 2.00 | 1,34–3,00 | 0.001 |
Variables | Odds ratio | 95% confidence interval | P-value |
---|---|---|---|
Preventive check-ups - all physicians (n = 920) | |||
Female gender | 0.34 | 0,24–0,48 | < 0,001 |
Surgical speciality | 1.57 | 1,05 - 2,35 | 0.029 |
Age < 35a | 0.68 | 0,42 - 1,10 | 0.117 |
Female physicians (n = 417) | |||
Surgical speciality | 1.22 | 0,71 - 2,09 | 0.482 |
Age < 35a | 0.80 | 0,43 - 1,51 | 0.490 |
Male physicians (n = 503) | |||
Surgical speciality | 2.15 | 1,13 - 4,09 | 0.020 |
Age < 35a | 0.49 | 0,22 - 1,10 | 0.083 |
Discussion
Sample and approach
Investigated variables
Conclusion
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Nearly one in four physicians consumed alcohol at hazardous levels.
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Female assistants had a three times higher risk of hazardous alcohol use compared to women in senior positions.
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Surgical professionals tended towards risky health habits twice as often compared to their colleagues in non-surgical disciplines.
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There is a need to improve primary prevention.
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The aim should be the identification of the most vulnerable groups followed by early intervention.