Yoram,

Clearly anyone who drinks so much they are a danger to others is a serious cause for concern and something needs to be done, but the question was more about potentially self-harming health behaviours, I think.

It won't be long before doctors with a BMI over 30 are being frowned on as setting a bad example to patients. I suspect they already are, but I don't think we can demand excessive purity from our doctors. That's the point.

Best,

David (Disclosure: BMI 23.58)

I realise that this forum has digressed slightly from its origional topic of alcohol usage, but I'm sure there are many instances during a doctors average week where we dont fulfill the whole role model of society that the public seem to expect of us.

How many of us manage 5 a day  (fruit and veg)? How many manage to keep their diets to the recommended daily intakes of fat and sugar (especially if you eat snacky food at the hospital rather than home cooked foods.).

How much we drink, providing the effect does not endanger our patients, should not be of concern to our patients. I fully agree that the depended drinker who has the shakes during surgery is downright dangerous, and that the doctor turning up hungover from the doctors mess party the night before will have impaired judgement... but if I want to have 2 bottles of wine at home one evening, and I'm not working the next day, or want to go on a bar crawl on holiday whilst abroad, I should not feel ashamed to do so. The main problem with drinking as a doctor while off duty is the requirement for us to come forward in the event of an emergency (as discussed in the discussion forum "is there a doctor on board".). If you've been out for a night out (had 6-8 units and are quite clearly drunk) and someone collapses - should you still come forward? My understanding of the GMC guidance is that whatever the circumstances we have to! This has happened several times to me in several states of drunkenness - usually the night club bouncers simply push you away and thats fine -I've offered my services. On one occasion it was a person we found collasped between night clubs - I tell you theres nothing that sobers you up quite so fast!

Going back to us being role models for communities. If you compile the guidelines most agree that you need 8 hours sleep minimum in 24 hours (especially if you want us to be safe). And I fully agree with the government campaign of "dont drive tired". You should eat 3 good meals a day. When I'm on-call I do a week of 13 hour shifts (9-10 (either way round depending if its days or nights)). I live 20 minutes from work (if theres no traffic) - but its more like an hour's drive at the times I travel for my shift patterns. - So here we go. Get up at 6.30 - breakfast, shower, set out to work at 7.30, Park at work at 8.30 leaving 1/2 hour to get from the car park to the ward. Work 13 hours - probably managing to get in one meal break around 2pm. Finish at 10, back at the car 10.30, hour drive home takes us to 11.30, eat dinner (even if its a frozen microwave meal that takes upto 30 minutes to cook and eat it without giving myself indigestion) so its now midnight. Unpack bag, make lunch for the next day so I have something to eat at work, go to bed around 12.30 - get up at 6.30, repeat day. Anyone seeing the problem here ?!

Sarah

Disclosure: BMI 22.5, average alcohol / week 6 units, if a night out can manage 20 units in one night! :) average hours sleep 7/24 hrs, calorie intake per day (approx 3000)