Study looks into how family doctors' own drinking habits affect their advice to patients

Doctors who drink more themselves are more liberal in their advice to patients on alcohol consumption. They set higher thresholds for what is harmful, and while men who are heavy drinkers get to continue drinking, women are often advised to stop altogether, reveals a thesis from the Sahlgrenska Academy at the University of Gothenburg, Sweden.

Researchers at the University of Gothenburg's Sahlgrenska Academy have for the first time looked into how family doctors' own drinking habits affect their advice to patients. The study, which took the form of a questionnaire for doctors in the county of Skaraborg, revealed that those who drink larger amounts set significantly higher limits for harmful levels of consumption than those who are teetotalars or drink little.

Gender also plays a role in the advice doctors give. Where men and women present with the same health problem and consume comparable amounts of alcohol, male heavy drinkers are often advised to cut down on their drinking, while female heavy drinkers are urged to stop drinking altogether.

Heavy drinkers are also much less likely to be referred for treatment if they are men than if they are women - especially if the doctor is a man. "Doctors who drink more have a more liberal view of alcohol, but their attitude is also coloured by high consumption among men being the social norm," says Magnus Geirsson, doctoral student at the Unit of Social Medicine at the Sahlgrenska Academy and himself a family doctor in Skaraborg.

Doctors' alcohol training also plays a role, but perhaps not as one might expect. Nine out of ten doctors in the study set the limit for safe alcohol consumption below the Swedish National Institute of Public Health (FHI) recommendations of 14 units for men and nine for women. Interestingly, doctors who had the most alcohol-related training and considered themselves knowledgeable in the area set higher limits, but they were still below the FHI recommendations.

"This may be because doctors feel that the FHI sets the limits too high, but it could also be that doctors who feel less confident in this area prefer to be more cautious", says Geirsson.

His thesis also shows that the training activities carried out as part of the government's five-year Risk Drinking Project, which aimed to make alcohol-related issues a natural part of health care, have porobably not led to the desired effects of increasing the numbers of patients being adviced on alcohol, in spite of a considerable increase in the numbers of GPs and nurses that consider themselves to be more skilled in giving such advice.

The thesis "Alcohol prevention in Swedish primary health care. Staff knowledge about risky drinking and attitudes towards working with brief alcohol intervention. Where do we go from here?" was successfully defended on 7 October.