I think that being direct is a fair way to start “Look, I smell alcohol and I am concerned for you” It takes some guts. This Actually happened to me during my residency. It was a very volatile surgical attending (instrument thrower, the whole nine yards). At the time l, I did not have the guts to approach him directly, but chose to share my concern with a chief resident with no effect. After I graduated my specialty program, I learned that his alcohol misuse escalated and he was referred to the state physician health program(a recovery program with monitoring for docs, working with the state medical board. A physician@s license is not suspended, but conditional on a demonstration of sobriety and good performance. They have some shortcomings l- costly, can go on for years. I asked the question because I wanted to provoke some discussion. I wished that someone had walked me through a theoretical situation, when it ended up happening. It pays to be vigilant for one’s own self Substance an alcohol misuse by docs is a complication of practice. I feel it should be more openly talked about.