Symposium 3, Sunday Sept. 23rd 2 pm–3.30 pm; Room: Lecture Hall 3
Physician health programs in Europe: Chairpersons: Mundle G (Germany), Gottschaldt E (Germany)
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Presentation S3-1
The German Addiction Foundation—Matthias Gottschaldt (GAFMG)
Mundle G, Gottschaldt E (Germany)
The GAFMG is a non profit organization founded in 1998 following the death of Prof. Dr Matthias Gottschaldt. The objective of the foundation is to continue Matthias Gottschaldt's ideas and visions. A distinguishing mark of Matthias Gottschaldt was his personal experience as an alcohol addicted doctor who publicly fought against stigmas and ostracism. Another distinguishing mark was his role as a scientist who advanced the research of addictions. One example of this was through the rewarding of the Wilhelm Feuerlein Research Grant, the first addiction grant in Germany. The composition of the members of the Foundation reflects the scope of current issues. The members are representatives of addiction research in Germany, i.e. Prof. Dr Karl Mann, the first Professor for addiction research in Germany, Prof. Dr Lutz Schmidt, chairman of the German Society for Addiction Research and Additction Medicine (DGSS), as well as public relations representatives, for example Juergen Leinemann, author of ‘Hoehenrausch—die wirklichkeitsleere Welt der Politiker’, former editor of Spiegel magazine and recovering alcoholic for over 20 years.
Expert Advisory Panel—Addiction in the Medical Profession. As a result of the personal history of Prof. Gottschaldt, one main focus of the foundation is the assistance of doctors who have an addiction themselves. More than ten years ago, in collaboration with several medical associations in Germany, a specific curriculum for the treatment of addicted doctors was developed by Prof. Gottschaldt. In 2005, the ‘Expert Advisory Panel—Addiction in the Medical Profession’ was founded in Germany upon initiative of the German Addiction Foundation. A preliminary study promoted by the German Addiction Foundation in collaboration with the Medical Association Hamburg and the Institute for General Medicine Hamburg, examined the frequency of substance use and abuse in young doctors in the region of Hamburg. High rates of hazardous use were seen for cannabis in young male doctors and for benzodiazepine in young female doctors.
Dialogue Series ‘Menschen Am Gendarmenmarkt’. A further focus of the foundation is the implementation of the dialogue series ‘Menschen am Gendarmenmarkt’. The goal of this dialogue series is to discuss and break down taboos and stigmas against addictions through personal examples of famous personalities. In an open dialogue, the personal story of the development of the disease and the resulting rejection and ostracism, which has hurt the individual's dignity and made life and treatment more difficult, is discussed. New ways to deal with stigma, psychological crisis situations, and addiction are shown. Previous guests were, amongst others, Katrin Sass, an actress (‘Good Bye Lenin’), who spoke very sophisticatedly about her own alcohol addiction, and Horst Seehofer, the former health minister and today's Federal Minister for Food, Agriculture and Consumer Protection in Germany, who spoke about ‘Addictions in politics’.
Wilhelm Feuerlein Research Grant. Through the public offer of this grant every two years, the GAFMG supports the scientific research of addictions. The grant is split between fundamental and applied research. Lauereates include i.e. Prof. Dr Andreas Heinz, medical director of the University clinic for Psychiatry and Psychotherapy, Charite, Berlin and Prof. Dr Gunter Schumann, University Heidelberg, who today has a professorship in London for addiction research. In the area of applied clinical research, the last award was given to the work group of Prof. Spies, department of anesthesia, Charite Berlin which applied the internationally approved AUDIT questionnaire in a surgical emergency department in combination with brief intervention.
Presentation S3-2
Substance abuse and depression in german psychiatrists
Braun M, Schoenfeldt-Lecuona C, Mehta T, Freudenmann R, Beschoner P (Germany)
Introduction. Physicians are supposed to suffer more from substance abuse than other professional groups. However, epidemiological data in support of this is lacking in Germany.
Methods. Within a study of the mental health of Psychiatrists and Anethesists questionnaires sampling demographic data, work load, medical history and drug use were distributed in two German nationwide congresses. In addition we used the Beck-Depression-Inventory (BDI) and the Alcohol Use Disorders Identification Test (AUDIT) as standardised instruments.
Results. Up to now only the sample of Psychiatrists was analysed (n = 1093, response rate 52%). 13.3% (cut-off 8 points) had a an elevated risk for hazardous drinking corresponding approximatly to the general population. 20% had BDI scores above 11 points refering to Depression. 41% reported having had former depression according to ICD-10 criteria. 15% were recently taking psychotropic or analgetic medication.
Conclusions. This is the first study to investigate the prevalence of substance abuse and depression in a large sample of German physicians. Compared to the general population our sample didn't show higher rates of alcohol abuse, but higher rates of depression and use of psychotropic medication. The sample shall be compared to the sample of Anesthesists.
Presentation S3-3
Physician health programs in Germany
Mundle G, Gottschaldt E (Germany)
Aims. Addictions in health care professions are today still denied and show therefore often prolonged courses of the disease, although the treatment results are positive. Differences in the treatment of addicted physicians are mainly in the capability to take over the roll of a patient and to let go of the professional attitude. Medical competence as a doctor does not mean a competent dealing with the own disease, especially in the emotional acceptance.
The programs offered through the Doctors Council of Hamburg, the Oberbergkliniken, Germany and the Physician Health Care Program through the College of Physicians and Surgeons of Ontario, Canada are examples for specified treatment programs for addicted doctors. The outcome rate ofspecialised treatment programs are over 80%.
Presentation S3-4
When doctors get sick. The Galatea Foundation experience
Arteman A, Padrós J, Lusilla P, Gual A (Spain)
Aims. 1. To explain the experience of the Sick Physician Integral Care Program (PAIMM) and the Galatea Foundation of the Catalan Medical Association (Spain). 2. To present some results of two recent studies of the FG concerning adult and resident doctors drugs consumption.
The Sick Physician Integral Care Program (PAIMM in Catalan capital words) was created in 1998 jointly by the Autonomous Catalan Government and the Catalan Medical Association. The PAIMM aim is to treat sick physicians due to mental diseases and alcohol and other drugs abuse in specific treatment unit and with regulatory body procedures, under large conditions of confidentiality. It was the first program with these characteristics created in Europe. Since its creation, PAIMM treated 1.031 sick doctors.
Galatea Foundation (GF) of The Catalan Medical Association manages the PAIMM and other programs devoted to prevent these illnesses. The ‘Health of Resident Doctors’ and ‘Health, Gender and Medical Practice’ are two of these other preventive programs of GF. In the frame of these two other programs we present preliminary results of two recent studies of the Catalan medical population. One among resident doctors, another among adult doctors, both concerning their drug consumption.
Subjects The first study explores 762 adult physicians and the second study explores 206 resident doctors.
Methods. We have made two studies following two different ways in the data collection. The first study has used postal survey, while the second has used a web based survey. Both studies have included variables in relation to health status in general, as well as psychological distress and work conditions, including substance consumption. Analyses: We have made multivariate analysis.
Results. Our findings show that the highest consume data appears in resident doctors in one tierce of cases. Alcohol abuse data are minimal in both cases. Although auto-prescription of anti-inflammatory is present in both studies, none substance consumed appears associated with psychological distress. Residents study shows that variables with most predictive capacity have no relation with substance abuse.
Conclusions. Although our medical population presents high proportion of psychopharmacology auto-prescription. We cannot find alcohol abuse in this population studied.