Is Drug Abuse Among Docs Rising?; Issues Around a Physician's Professional Persona; and Gender Disparity in Trans Treatments

Patrick Lee

November 21, 2022




Is Drug Abuse Among Doctors Rising?

Some evidence suggests that substance abuse may be rising among physicians since the pandemic. Some 51% of physicians think that substance abuse has "increased" in their profession since the onset of COVID-19, but 48% report it at the same level as in pre-pandemic years, according to Medscape's Substance and Opioid Abuse Report 2022.

Others argue that evidence is mounting that such abuse is increasing, though data remains anecdotal from physician health programs, where statistics on substance use disorder referrals are evaluated and managed. Problem drinking and substance use increased in the general population during the pandemic.

Seeking treatment: "The uptick that we saw [in physicians seeking treatment for addiction] definitely increased in March 2020 and shortly thereafter into the summer, and it has continued," said Michael McCormick, medical director of the Healthcare Professionals Assessment Program at Caron Treatment Centers in Pennsylvania.

More pressure: COVID-19 has put physicians under intense pressure for the past 2.5 years, resulting in overworked and overstressed clinicians.




Issues Around a Physician's Professional Persona

What constitutes an appropriate persona for a medical professional? And who makes that call? Physicians are grappling with such questions as medicine diversifies, and as work and leisure overlap, throwing into doubt assumptions about how doctors manage their clothes, hairstyles, makeup, social media presence, or interactions.

Some standards for professionalism reflect a narrow view of what a physician should be, yet such guidelines are slow to change and may exclude expressions of personality or identity, critics argue.

Bias called out: The hashtag #medbikini captured backlash against a 2020 study in the Journal of Vascular Surgery that called out what it considered unprofessional social media content among young surgeons. The journal eventually retracted the study and issued an apology, acknowledging "conscious and unconscious bias."

Unprofessional or not: Expectations for a conservative appearance may disproportionately affect women, people of color, and LGBTQ+ professionals. "Why is it 'unprofessional' to have a visible tattoo? Why is it 'unprofessional' to wear bright colors and patterns?" asked Blair Peters, a plastic surgeon and assistant professor at Oregon Health & Science University in Portland, Oregon.




Gender Disparity in Trans Treatments

Children who were assigned female at birth and who seek gender-affirming care have far outnumbered those assigned male at birth in recent years. The disparity is a reversal of historical trends and has occurred for reasons that are not well understood, Reuters reports.

The difference has manifested as a growing number of children receiving care at the more than 100 gender clinics in the US opt for medical intervention: puberty-blocking drugs, hormones, or surgery.

Divided opinions: The outsized proportion of adolescents seeking treatment to transition from female to male has sparked concerns. Some gender-care specialists urge caution to ensure that only adolescents deemed well-suited to treatment after thorough evaluation receive it. Others argue that delays in treatment unnecessarily prolong a child's distress and put them at risk for self-harm.

Irreversible side effects: Professionals agree that treatment should be supportive. But some question whether peer groups and online media unduly influence patients to pursue medical transition with potentially irreversible side effects at a time when identities may be in flux.

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