Interaction of Physicians with Emergency Ward Alcoholic Patients

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Abstract
The attitudes and interaction of medical personnel who treat alcoholics in the emergency ward of a large metropolitan hospital were discussed. Medical personnel often have a stereotyped approach to the alcoholic. They frequently see him as a derelict beyond help and a person whom they cannot treat except for his physical ailments. His social and psychological problems seem overwhelming and beyond the scope of medical practice. A special technique of "doing" for the alcoholic, understanding his psychological and social needs, and offering him a continuity of relationship offers promise as an effective way of establishing therapeutic contact. This technique consists of the psychiatrist of a treatment team, and at times also the social worker, seeing the alcoholic as soon as he is admitted to the emergency ward, administering to his psychological and physical needs, and often admitting him to the general hospital for further care and evaluation. After discharge from the hospital he is followed in treatment by the same psychiatrist and social worker. It became obvious that psychiatrists using this technique are subject to attitudes similar to those of other personnel caring for the alcoholic. Interaction between the emergency ward alcoholic and the physician often involves a conflict with regard to what the physician expects of the alcoholic and what the alcoholic expects of the physician. The physician expects the alcoholic to conform to certain traditional attitudes of patients, whereas the alcoholic is looking for relief from his distress, which he often expresses in a fashion which elicits in the physician feelings of hostility and morality. Other factors, such as enthusiasm, competitiveness, awareness of the psychological and social problems, and financial backing, help the psychiatrist to make effective contact with the alcoholic, thereby ensuring that he will return for outpatient treatment.

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