Prognosis for the recovery of surgeons from chemical dependency: a 5-year outcome study

Arch Surg. 2011 Nov;146(11):1286-91. doi: 10.1001/archsurg.2011.271.


Hypothesis: Rates of relapse, monitoring contract completion, and return to medical practice may differ between surgeons and nonsurgeons being monitored for diagnosed substance use disorders.

Design: Retrospective 5-year longitudinal cohort study.

Setting: A sample of 16 state physician health programs in the United States.

Participants: Nine hundred four physicians who underwent treatment for a substance use disorder and were consecutively admitted to 1 of 16 state physician health programs between September 1, 1995, and September 1, 2001. The study analyzed a subset of data comparing 144 surgeons with 636 nonsurgeons.

Main outcome measures: Rates of continued drug and alcohol misuse (relapse), monitoring contract completion, and return to medical practice at 5 years.

Results: Surgeons were significantly more likely than nonsurgeons to enroll in a physician health program because of alcohol-related problems (odds ratio, 1.9; 95% CI, 1.3-2.7; P = .001) and were less likely to enroll because of opioid use (odds ratio, 0.5; 95% CI, 0.3-0.8, P = .002). Surgeons were neither more nor less likely than nonsurgeons to have a positive drug test result, complete or fail to complete the monitoring contract, or extend the monitoring period beyond the original 5 years specified in their agreements. Fewer surgeons than nonsurgeons were licensed and practicing medicine at the conclusion of the monitoring period, although this difference was not statistically significant.

Conclusions: Surgeons in this study had positive outcomes similar to those of nonsurgeons. However, further research is necessary to conclude whether surgeons are less likely than their nonsurgeon peers to successfully return to medical practice following chemical dependency treatment.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Health Promotion*
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Physician Impairment*
  • Prognosis
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Specialties, Surgical*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / rehabilitation*
  • Time Factors
  • United States / epidemiology