Trauma surgeon seeks change in law that discourages counseling of problem drinkers

BOSTON -- Larry Gentilello, MD, believes we have an excellent system for trauma care in the US. Yet, injuries many of them alcohol-related are the leading cause of death for Americans under 44 years of age. "Now, it's time to move forward to prevent injuries," he says. "And to change archaic laws that discourage effective alcohol counseling that has been demonstrated to dramatically reduce injuries and readmissions to trauma centers."

Gentilello, Chief of the Division of Trauma and Critical Care at Beth Israel Deaconess Medical Center and Associate Professor in Harvard Medical School's Department of Surgery, plans to do just that. With the help of an Innovators Combating Substance Abuse award from The Robert Wood Johnson Foundation, Gentilello is leading an initiative to change laws that penalize patients and health professionals by denying insurance coverage for treatment of injuries if it is discovered that the patient is under the influence of alcohol or other substances.

Gentilello and four other trailblazers in the field of substance abuse prevention, treatment and policy development were recently named Innovators, as part of a program that recognizes leaders in the field, brings attention to their groundbreaking work, and provides an opportunity for them to undertake projects they might be unable to complete otherwise.

The laws discourage the use of effective substance abuse counseling techniques in trauma centers, Gentilello says. "I've learned that many trauma surgeons don't test for alcohol because they know that if it is found in a patient's system, their insurance company may refuse to pay the medical bill. I was shocked to discover that this is due to a law that has been on the books more than 50 years."

Yet, Gentilello has found that a simple, half-hour counseling session in the trauma center can reduce the number of alcohol-related readmissions by nearly half. "Patients are highly motivated to change their behavior a

Contact: Jerry Berger
Beth Israel Deaconess Medical Center

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