Epidemic of Alcohol Abuse Among Surgeons





A new study indicates that chronic alcohol abuse among surgeons is far more common than among the general population.


 

 

EPIDEMIC OF ALCOHOL ABUSE AMONG SURGEONS

In a previous column (Surgeon Performance and Alcohol), I reviewed a clinical research study that revealed just how significantly alcohol intake degrades surgical skills among surgeons, even well into the day following alcohol intake.  In another recent column, I examined a study that revealed a disturbingly high rate of burnout and depression among American surgeons (Surgeon Burnout and Depression).  This week, I will present a newly published clinical study that, once again, raises serious concerns about the health and wellbeing of many surgeons in the United States.

In a study that appears in the current issue of the Archives of Surgery, more than 7,000 surgeons in the United States agreed to participate in a confidential assessment of alcohol abuse and alcohol dependence among members of the American College of Surgeons.  Validated surveys and tests were administered to these surgeon-volunteers, and the resulting data was analyzed.

Based upon the results of the Alcohol Use Disorders Identification Test, 15 percent of the responding surgeons, overall, were identified as meeting the criteria for either chronic alcohol abuse or alcohol dependence.  Further evaluation of the data collected in this study revealed that 14 percent of the participating male surgeons met the criteria for chronic abuse of alcohol or alcohol dependency, while 26 percent of the corresponding female surgeons met these same worrisome criteria.  Moreover, surgeons who reported having committed a major medical or surgical error within the previous 3 months were 45 percent more likely to abuse alcohol, or to be dependent upon alcohol, when compared to surgeons who did not report any recent errors.  Similarly, surgeons who reported feeling burned out in their professional lives were 25 percent more likely to be problem drinkers when compared to surgeons who did not report professional burnout.  Finally, surgeons who reported symptoms consistent with depression were nearly 50 percent more likely to abuse alcohol than surgeons who did not report feeling depressed.

Interestingly, surgeons were less likely to have alcohol abuse and dependency problems if they were older, male, or had children.  (Approximately 11 percent of adult males in the general population are thought to have chronic alcohol abuse problems, while only about 5 percent of adult females in the general population appear to abuse alcohol on a regular basis.)

The findings of this study, once again, indicate a disturbingly high rate of substance abuse among American surgeons; and this is the first study to show that female surgeons, unlike women in the general population, are twice as likely as their male counterparts to regularly abuse alcohol.  Taken together with previous studies showing very high rates of depression and career burnout among surgeons in the United States, the findings of this latest study are rather worrisome.  (Previous studies have also linked an increased likelihood of medical and surgical errors to surgeons who are depressed, and who abuse alcohol and other drugs.)

I should also note that only 29 percent of the surgeons who were contacted agreed to participate in this confidential study.  Because this participation rate is much lower than what is typically seen in most survey-based research studies, it raises the important question as to whether or not the rate of alcohol abuse and alcohol dependency might actually be considerably higher among surgeons, in general, than what is reflected in this study.  Indeed, most statistics experts believe that a very common reason for nonparticipation in survey-based studies is a reluctance to divulge negative information about oneself.  Moreover, even people who elect to participate in survey-based studies often “fudge” their responses in ways that tend to underestimate their bad habits and other self-perceived shortcomings.  Therefore, it is entirely possible that the incidence of chronic alcohol abuse and alcohol dependency among surgeons may be even higher than what was reported in this study….

 

As I have observed in previous columns, surgeons who abuse alcohol, or other drugs, are more likely to be associated with medical errors and worse patient outcomes.  However, the stigma of reporting oneself as having an alcohol, or other drug, problem is so great in the medical profession that impaired surgeons (as with other physicians) are generally extremely reluctant to admit that they have an alcohol or drug problem.  Most medical boards still require physicians to indicate whether or not they have a history of drug or alcohol abuse on licensure applications, and the medical profession, in general, still seems to be in a state of denial regarding the unusually high incidence of drug and alcohol abuse among physicians when compared to the general public.  It also goes without saying that the potential consequences of being operated upon by an impaired surgeon can be catastrophic to both patients and their loved ones, and, therefore, the still prevailing “head in the sand” approach to identifying, and rehabilitating, impaired physicians would not appear to serve the public interest very well, in my view.

 

While the vast majority of surgeons are passionately devoted to providing the best possible care to their patients, and would therefore not engage in personal behaviors that might potentially endanger their patients, it is becoming increasingly clear that a sizable percentage of surgeons in the United States are seriously impaired by burnout, depression and other mental health illnesses, and by alcohol and drug abuse.  Therefore, a better system of screening out surgical trainees who are predisposed to these serious health problems should be considered, while, at the same time, medical authorities at the state and federal levels should make it easier, and less threatening, for currently impaired physicians and surgeons to reach out for help without fearing that they will be punished or professionally sanctioned as a result.  I, therefore, applaud the American College of Surgeons for sponsoring and publishing this important study as a preliminary step forward in this direction.


 

For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books. Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a lighthearted perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 








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Vitamin D Improves Both HDL Levels and Weight Loss



A new prospective randomized clinical study showed that Vitamin D supplements increased levels of the HDL (“good cholesterol”) and improved weight loss.


 

 

VITAMIN D IMPROVES BOTH HDL LEVELS AND WEIGHT LOSS

Many health claims have been made for Vitamin D, although very few such claims have been well substantiated by high quality research studies.

In my bestselling book, A Cancer Prevention Guide for the Human Race, I exhaustively review and discuss the available scientific data supporting Vitamin D as a potential cancer prevention nutrient.  However, other health claims have also been made for Vitamin D, aside from cancer prevention.  For example, there is some research data available suggesting that low levels of Vitamin D in the blood may be associated with a higher risk of cardiovascular disease.  As with most disease prevention research, though, much of the data supporting this claim for Vitamin D is based upon rather weak methods of clinical research, and there is very little “gold standard” prospective, randomized, placebo-controlled clinical research data available that confirms a role for Vitamin D in cardiovascular disease prevention.  However, a newly published prospective, randomized, placebo-controlled, double-blinded clinical study, which appears in the current issue of the British Journal of Nutrition, adds further support for Vitamin D as a protective factor against cardiovascular disease, particularly among overweight and obese women.

In this new study, 77 otherwise healthy overweight or obese women were secretly randomized to receive either 1,000 International Units (25 micrograms) of Vitamin D per day or a daily placebo (sugar) pill for a period of 12 weeks.  Both groups of patient volunteers were then tested throughout the course of this study, including measurements of their blood pressure, blood cholesterol levels, and weight.  Food intake and physical activity levels were also monitored throughout the course of this clinical research study.

At the end of the study, the blood level of HDL cholesterol (the so-called “good cholesterol”) was found to have significantlyincreased in the group of women who had been secretly randomized to receive daily Vitamin D supplements for 12 weeks.  Similarly, the blood levels of apolipoprotein A-I, which also reduces the risk of cardiovascular disease (and which makes up part of the HDL molecule), was also noted to be significantly higher in the group of women who had received Vitamin D supplements, when compared to the women in the placebo control group.  (Moreover, the levels of both HDL and apolipoprotein A-I were noted to have actually decreased, over time, in the group of women who received only daily placebo pills.)

Finally, in this group of overweight and obese women, 12 weeks of daily Vitamin D supplementation was also associated with an average weight loss of just over 5 pounds (2.7 kilograms), whereas the women in the placebo control group lost less than one pound (0.4 kilogram) during the 12 week course of this study.  Interestingly, the enhanced weight loss that was observed in the Vitamin D group was not associated with any differences in the level of physical activity between the two groups of women in this study.

The rather dramatic results of this prospective, randomized, doubled-blinded, placebo-controlled clinical study, therefore, showed that, at least among overweight and obese women, daily Vitamin D supplementation for 12 weeks was associated with heart-healthy improvements in HDL and apolipoprotein A-I levels, as well as significant weight loss.  Although this study included a rather small group of patient volunteers, and should therefore be repeated with a larger cohort of patients, the fact that this study was conducted according to “gold standard” methods of clinical research further adds to the credibility of its findings.  (Whether or not similar improvements in HDL and apolipoprotein A-I levels can be achieved by Vitamin D supplements in non-overweight or non-obese women, or in men, was not addressed by this clinical study.  However, other human and animal studies have suggested that Vitamin D deficiency may, indeed, be associated with lower HDL and apolipoprotein A-I levels in both males and females.)

As excessive levels of Vitamin D can lead to significant health problems, including nausea, vomiting, dehydration, kidney stones, kidney failure, and ulcers of the GI tract, I strongly recommend that you see your physician first if you choose to start taking Vitamin D supplements.

For more information regarding the potential cancer prevention effects of Vitamin D, order your copy of my evidence-based book, A Cancer Prevention Guide for the Human Race, today!



For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my bestselling book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

Within one week of publication, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books.  Within three months of publication, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a lighthearted perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 






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Heart Disease May Also Increase Prostate Cancer Risk

Welcome to Weekly Health Update




New research strongly suggests that coronary artery disease may significantly increase prostate cancer risk.


 

HEART DISEASE MAY ALSO INCREASE PROSTATE CANCER RISK

As I discuss in my recent bestselling book, A Cancer Prevention Guide for the Human Race, many of the same lifestyle and dietary habits that increase our risk of developing cardiovascular disease (including coronary artery disease, heart attacks, peripheral vascular disease, and stroke) also increase our risk of developing certain types of cancer.  However, the data linking lifestyle and dietary factors with prostate cancer risk has, so far, been both weak and contradictory.  Now, a newly published study has found an apparent link between coronary artery disease and prostate cancer risk.  These findings appear in a new update of the ongoing REDUCE (REduction by DUtasteride of prostate Cancer Events) clinical trial, which I previously reported on in 2010 (), and these updated findings appear in the current online issue of the journal Cancer Epidemiology, Biomarkers & Prevention.

Among the 6,390 men enrolled in this prospective, randomized prostate cancer prevention trial, 547 men were known to have coronary artery disease at the time that they entered into this research study.  Not surprisingly, this group of men with heart disease had a greater number of risk factors for cardiovascular disease when compared to the men without coronary artery disease, including obesity, high blood pressure (hypertension), diabetes, and elevated cholesterol.    What was surprising, however, is that over the 4 year course of this clinical study, the risk of prostate cancer in this group of men with coronary artery disease was significantly higher than what was observed among the men without heart disease.  Two years into the REDUCE study, the men with a history of coronary artery disease were 24 percent more likely to be diagnosed with prostate cancer when compared to the men with healthy hearts.  After four years of participation in this clinical study, the men with known coronary artery disease were 74 percent more likely to be diagnosed with prostate cancer!

While this particular research study was not designed to determine which risk factors for cardiovascular disease were specifically involved with prostate cancer risk, as I discuss in A Cancer Prevention Guide for the Human Race, both obesity and smoking have previously been linked to an increased risk of death due to prostate cancer, and these two lifestyle factors are also strongly linked to cardiovascular disease risk.

 

Prostate cancer is the second most common cause of death due to cancer (following lung cancer) in men, and is associated with nearly 35,000 deaths each year in the United States alone.  In many ways, prostate cancer is the male counterpart of breast cancer (which is also the second most common cause of cancer-associated death in women), although prostate cancer has yet to receive the same level of attention and research funding as has breast cancer.  In my view, we men have a lot to learn from our female counterparts about raising cancer awareness, and advocating for increased research funding, when it comes to prostate cancer. Therefore, I urge all men to explore opportunities to actively support prostate cancer awareness, and improved research funding, in their local communities.


For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 







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Frying With Olive Oil Does Not Increase Cardiovascular Disease Risk

Welcome to Weekly Health Update



New research from Spain shows that frying foods in olive oil and sunflower oil does not increase cardiovascular disease risk.


 

 

 

FRYING WITH OLIVE OIL DOES NOT INCREASE CARDIOVASCULAR DISEASE RISK

As I mention in my recent bestselling book, A Cancer Prevention Guide for the Human Race, many of the very same lifestyle and dietary habits that increase our risk of developing cancer also increase our risk of developing cardiovascular disease, including coronary artery disease, heart attacks (myocardial infarction), peripheral vascular disease, and stroke.  Likewise, adopting an evidence-based cancer prevention lifestyle can not only cut your cancer risk in half, but can also significantly reduce your risk of developing life-threatening cardiovascular disease as well.  For example, one evidence-based strategy that has been shown to reduce both the risk of cancer and cardiovascular disease, and which I extensively discuss in A Cancer Prevention Guide for the Human Race, is following a Mediterranean diet.  Among other features, a Mediterranean diet includes the sparing use of unsaturated cooking oils, including olive oil and sunflower oil, instead of the artery-clogging saturated fats favored as cooking oils in the United States and other western countries.

There are multiple prior research studies that have linked the consumption of foods fried in saturated fats (which are still used in most fried fast foods in the United States) with cardiovascular disease and premature death due to cardiovascular disease.  However, a newly published public health study from Spain, which appears in the current issue of the British Medical Journal, reveals that eating foods fried in olive oil and sunflower oil, which are unsaturated cooking oils, does not appear to increase the risk of developing cardiovascular disease.  This large prospective health study has followed 40,757 Spanish adult volunteers for an average of 11 years, and all of these research volunteers were free from cardiovascular disease at the beginning of this study.

When comparing study volunteers who ate the most fried foods with those who ate the least fried foods, this important research study found no difference in the incidence of death due to cardiovascular disease or, indeed, in the incidence of premature death due to any other causes including cancer.  The differences in cardiovascular disease incidence and premature death found in this Spanish study and those found in similar studies conducted in the United States appear to be due to the different types of cooking oils used to fry foods in Spain (and other Mediterranean countries) and the United States.  Namely, as I have already mentioned, we Americans still favor the use of saturated cooking fats in many of our fried foods, whereas unsaturated fats are favored in Spain and other Mediterranean countries.

The findings of this large Spanish study, which is part of the ongoing enormous prospective European Prospective Investigation into Cancer and Nutrition (EPIC) study, add weight to the similar previous studies that I discuss in A Cancer Prevention Guide for the Human Race.  This new study adds additional evidence to previous observations that a Mediterranean diet can indeed lead to a significant reduction in both cancer risk and cardiovascular disease risk.  In our home, we exclusively use olive oil and canola oil, and in small amounts, to fry our food.  Based upon the findings of this important new study, I recommend the same for you and your family.  (Remember, though, that eating large amounts of deep-fried food, even with the use of unsaturated cooking oils, can lead to significant weight gain due to the high caloric content of fried foods!)



For a groundbreaking overview of cancer risks, and evidence-based strategies to reduce your risk of developing cancer, order your copy of my new book, “A Cancer Prevention Guide for the Human Race,” from AmazonBarnes & NobleBooks-A-MillionVroman’s Bookstore, and other fine bookstores!

On Thanksgiving Day, 2010, A Cancer Prevention Guide for the Human Race was ranked #6 among all cancer-related books on the Amazon.com “Top 100 Bestseller’s List” for Kindle e-books! On Christmas Day, 2010, A Cancer Prevention Guide for the Human Race was the #1 book on the Amazon.comTop 100 New Book Releases in Cancer” list!


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


For a different perspective on Dr. Wascher, please click on the following YouTube link:

Texas Blues Jam


I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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