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Steven W. Greer, MD; Howard Bauchner, MD; Barry Zuckerman, MD

Am J Dis Child. 1990;144(11):1234-1237.

Abstract
• Problems with alcohol are common in the United States but are too frequently ignored by physicians, particularly those working with children. We explored pediatricians' knowledge and practices regarding parental use of alcohol and compared these attributes with those of family practitioners. Child health care providers attending three continuing medical education courses in general pediatrics were surveyed using a closed-item questionnaire. One hundred ninety (69%) of the participants responded, including 90 pediatricians and 39 family practitioners. Forty-six percent of responding pediatricians, compared with 90% of family practitioners, stated that they ask about problems with alcohol in taking a routine family history. Thirty-eight percent of pediatricians who knew the frequency of alcoholism, compared with 47% of those who did not, indicated that they include it in taking a routine family history. Forty-six percent of pediatricians who have experienced a problem with alcohol in their own family, compared with 20% of pediatricians without such personal experience, routinely address the issue of alcohol use with parents and children. Similar analyses among the family practitioners revealed no significant differences. We conclude that fewer than half of pediatricians ask about problems with alcohol in taking a family history. The likelihood of asking about such problems was not influenced by the health care provider's knowledge of alcoholism, but it was influenced by the provider's personal family history of problems with alcohol. Because of the important morbidity associated with alcohol use in families, and because intervention can improve functioning and adaptation of the child, training and Continuing Medical Education courses should address this issue.

(AJDC. 1990;144:1234-1237)

Author Affiliations
From the Divisions of General Pediatrics (Drs Greer and Bauchner) and Developmental and Behavioral Pediatrics (Drs Bauchner and Zuckerman), the Department of Pediatrics, Boston (Mass) City Hospital and the Boston University School of Medicine; and the School of Public Health, Boston University (Drs Bauchner and Zuckerman).

Footnotes
Accepted for publication April 25, 1990.

Presented in part at the "Mental Health Services for Children and Adolescents in Primary Care Settings: A Research Conference," New Haven, Conn, June 12, 1989.

Reprint requests to the Department of Pediatrics, Boston City Hospital, 818 Harrison Ave, Boston, MA 02118 (Dr Greer).

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