Journal of General Internal Medicine

, Volume 17, Issue 5, pp 373–376 | Cite as

Professional satisfaction experienced when caring for substance-abusing patients

Faculty and resident physician perspectives
  • Richard Saitz
  • Peter D. Friedmann
  • Lisa M. Sullivan
  • Michael R. Winter
  • Christine Lloyd-Travaglini
  • Mark A. Moskowitz
  • Jeffrey H. Samet
Brief Reports


This survey aimed to describe and compare resident and faculty physician satisfaction, attitudes, and practices regarding patients with addictions. Of 144 primary care physicians, 40% used formal screening tools; 24% asked patients’ family history. Physicians were less likely (P<.05) to experience at least a moderate amount of professional satisfaction caring for patients with alcohol (32% of residents, 49% of faculty) or drug (residents 30%, faculty 31%) problems than when managing hypertension (residents 76%, faculty 79%). Interpersonal experience with addictions was common (85% of faculty, 72% of residents) but not associated with attitudes, practices, or satisfaction. Positive attitudes toward addiction treatment (adjusted odds ratio [AOR], 4.60; 95% confidence interval [95% CI], 1.59 to 13.29), confidence in assessment and intervention (AOR, 2.49; 95% CI, 1.09 to 5.69), and perceived responsibility for addressing substance problems (AOR, 5.59; CI, 2.07 to 15.12) were associated with greater satisfaction. Professional satisfaction caring for patients with substance problems is lower than that for other illnesses. Addressing physician satisfaction may improve care for patients with addictions.

Key Words

physician satisfaction substance abuse resident physicians faculty physicians attitudes screening 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Harwood HJ, Fountain D, Livermore D. The Economic Costs of Alcohol and Drug Abuse in the U.S.-1992. Washington, DC: National Institute on Drug Abuse; 1998. NIH Publication Number 98-4327.Google Scholar
  2. 2.
    Cleary PD, Miller M, Bush BT, Warbury MM, Delbanco TL, Aronson MD. Prevalence and recognition of alcohol abuse in a primary care population. Am J Med. 1988;85:466–71.PubMedCrossRefGoogle Scholar
  3. 3.
    Institute of Medicine. Broadening the Base of Treatment for Alcohol Problems: Report of a Study by a Committee of the Institute of Medicine, Division of Mental Health and Behavioral Medicine. Washington, DC: National Academy Press; 1990.Google Scholar
  4. 4.
    Council on Scientific Affairs AMA (American Medical Association). AMA Guidelines for Physician Involvement in the Care of Substance Abusing Patients. Chicago, Ill: American Medical Association; 1979.Google Scholar
  5. 5.
    Friedmann PD, Saitz R, Samet JH. Management of adults recovering from alcohol or other drug problems. JAMA. 1998;279:1227–31.PubMedCrossRefGoogle Scholar
  6. 6.
    U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. Alexandria, Va: International Medical Publishing; 1996.Google Scholar
  7. 7.
    Saitz R, Mulvey KP, Plough A, Samet JH. Physician unawareness of serious substance abuse. Am J Drug Alcohol Abuse. 1997;23:343–54.PubMedCrossRefGoogle Scholar
  8. 8.
    Friedmann PD, McCullough DM, Chin MH, Saitz R. Screening and intervention for alcohol problems: a national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15:84–91.PubMedCrossRefGoogle Scholar
  9. 9.
    Geller G, Levine DM, Mamon JA, Moore RD, Bone LR, Stokes EJ. Knowledge, attitudes, and reported practices of medical students and house staff regarding the diagnosis and treatment of alcoholism. JAMA. 1989;261:3115–20.PubMedCrossRefGoogle Scholar
  10. 10.
    Chappel JN, Schnoll SH. Physician attitudes: effect on the treatment of chemically dependent patients. JAMA. 1977;237:2318–9.PubMedCrossRefGoogle Scholar
  11. 11.
    Roche AM, Parle MD, Stubbs JM, Hall W, Saunders JB. Management and treatment efficacy of drug and alcohol problems: What do doctors believe. Addiction. 1995;90:1357–66.PubMedCrossRefGoogle Scholar
  12. 12.
    Laswell AB, Liepman MR, McQuade WH, Wolfson MA, Levy SM. Comparison of primary care residents’ confidence and clinical behavior in treating hypertension versus treating alcoholism. Acad Med. 1993;68:580–2.CrossRefGoogle Scholar
  13. 13.
    Sansone CH, ed. Intrinsic and Extrinsic Motivation: The Search for Optimal Motivation and Performance. San Diego: Academic Press; 2000.Google Scholar
  14. 14.
    Chappel JN, Veach TL, Krug RS. The substance abuse attitude survey: an instrument for measuring attitudes. J Stud Alcohol. 1985;46:48–52.PubMedGoogle Scholar
  15. 15.
    Rohman ME, Cleary PD, Warburg M, Delbanco TL, Aronson MD. The response of primary care physicians to problem drinkers. Am J Drug Alcohol Abuse. 1987;13:199–209.PubMedGoogle Scholar
  16. 16.
    Cyr MG, Wartman SA. The effectiveness of routine screening questions in the detection of alcoholism. JAMA. 1988;259:51–4.PubMedCrossRefGoogle Scholar
  17. 17.
    Miner AG, Giner J, Lacalle JR, Franco D, Velasco A. The detection of alcohol-related problems in primary health care. Gac Sanit. 1990;19:135–9.Google Scholar
  18. 18.
    Samet JH, Rollnick S, Barnes H. Beyond CAGE: A brief clinical approach after detection of substance abuse. Arch Intern Med. 1996;156:2287–93.PubMedCrossRefGoogle Scholar
  19. 19.
    Saitz R, Sullivan LM, Samet JH. Training community-based clinicians in screening and brief intervention for substance abuse problems: translating evidence into practice. Substance Abuse. 2000;21:21–31.PubMedCrossRefGoogle Scholar
  20. 20.
    Lewis DC, Faggett WL, in Cooperation with the U.S. Department of Health and Human Services Bureau of Health Professions (U.S. Department of Health and Human Services, Public Health Service, Health Resources and Services Administration). Policy Report of the Physicians Consortium on Substance Abuse Education. Rockville, Md: Health Resources and Services Administration; 1998.Google Scholar

Copyright information

© Society of General Internal Medicine 2002

Authors and Affiliations

  • Richard Saitz
    • 1
    • 3
  • Peter D. Friedmann
    • 6
  • Lisa M. Sullivan
    • 2
  • Michael R. Winter
    • 5
  • Christine Lloyd-Travaglini
    • 5
  • Mark A. Moskowitz
    • 1
  • Jeffrey H. Samet
    • 1
    • 4
  1. 1.the Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of MedicineBoston University School of Medicine and Boston Medical CenterBoston
  2. 2.the Department of BiostatisticsBoston University School of Public HealthBoston
  3. 3.the Department of EpidemiologyBoston University School of Public HealthBoston
  4. 4.the Department of Social and Behavioral SciencesBoston University School of Public HealthBoston
  5. 5.the Data Coordinating CenterBoston University School of Public HealthBoston
  6. 6.the Division of General Internal MedicineRhode Island Hospital, Brown University School of MedicineProvidence

Personalised recommendations