Unhappy, untrained docs not satisfied with treating obesity, addiction

Some of the most prevalent conditions among U.S. patients, such as substance addiction and obesity, are also the hardest for physicians to treat.

A study published in the August Archives of Internal Medicine, however, found that primary care physicians who felt "called" to practice medicine were more likely to feel good about addressing drug, alcohol and weight issues with patients than their more disillusioned counterparts.

Specifically, among the more than 1,500 PCPs surveyed, those who said they were happy with their medical careers were also more likely to report satisfaction in treating nicotine dependence (62 percent), obesity (57 percent) and alcoholism (50 percent), MedPage Today reported. In contrast, unhappy physicians, especially those who said patients were responsible for such conditions, were less likely to find satisfaction in treating them.

"It may be that physicians shy away from addressing these multifaceted, often obdurate conditions because they find that treating them is unsatisfying," study author Kenneth A. Rasinski said.

Another part of the challenge is that most physicians receive little to no training on how to help patients lose weight or break dangerous habits. In fact, a recent report by the National Center on Addiction and Substance Abuse (CASA) at Columbia University found that most doctors fail to identify or diagnose substance abuse "or know what to do with patients who present with treatable symptoms," The Washington Post reported. Indeed, of the 985,375 practicing physicians in the United States, only about 1,200 are trained in addiction medicine, according to CASA.

A new training program underway at 10 academic medical centers is offering residencies in addiction medicine to physicians who have finished training in another specialty, such as family practice or internal medicine. While the medical treatment of addiction is currently recognized as a subspecialty only for psychiatrists, the American Board of Addiction Medicine (ABAM), a program sponsor, wants that designation to become open to primary care and other specialties.

According to internist Christine Pace, who recently completed Boston University's year-long addiction residency, improving physicians' training in treating substance abuse could help them feel more satisfied, as well. "We're not trained to deal with patients who are addicted," she said. "We end up feeling powerless and frustrated--and doctors don't like to feel frustrated and powerless."

To learn more:
- read the article from MedPage Today
- read the abstract from the Archives of Internal Medicine
- see the story from The Washington Post