Dent Lecture: Where to start: Where to go?

Benno Pollak was born in Czechoslovakia in 1912. He began studying medicine in Berlin, before moving to Prague, and then France in 1938, and subsequently serving in the Czech and British armies. He qualified in Medicine in Leeds in 1949 (MRCS, LRCP). He retired from general practice in 1989. He served also as Clinical Tutor in the Department of General Practice, St Thomas’s Hospital, London, and Clinical Assistant, and Emeritus Clinical Assistant at the Maudsley Hospital.

The development of community services for problem drinkers is briefly traced over the last 40 years. The numbers of drinkers in need of advice and treatment far exceeds the available resources. Family practice would be an ideal place in which to further primary care and prevention but lack of time, knowledge and motivation for probing into patients’ drinking habits detract from the potential. A pilot study of opportunistic screening in general practice is described whereby a yellow label affixed to a patient’s medical record card registers the average weekly alcohol intake. In a sample of 400 patients, 16% were high or intermediate risk drinkers. Each high risk drinker presented with a medical condition which could, in either aetiology or management, be related to high consumption. By discussing this, patients were often motivated to drink less or abstain. Various suggestions are made how better medical training and education could improve the diagnosis and treatment of drinking problems.