Docs Miss Alcohol Abuse -- Almost Always
The study could just as easily have come to the same conclusion about all physicians, not just those in primary care, according to Sam Cullison, MD, a Seattle family physician who's also a specialist in addiction medicine. He agrees that more training in addiction and substance abuse is desirable, but he tells WebMD the study's recommendation that doctors be held liable for missing such a diagnosis a "crazy" attempt at punishing physicians.
Cullison, a clinical associate professor of family medicine in a residency program affiliated with the University of Washington School of Medicine, says that if a patient came in for a sore throat, Cullison wouldn't necessarily ask questions about alcohol or drugs unless there were obvious signs -- such as alcohol on one's breath or a deviated septum from cocaine use. However, substance abuse and addiction questions would come up in detail on an annual physical.