Join us for this spirited discussion surrounding issues with Physician Health Programs (PHPs). Drs. Pamela Wible and Dominic Corrigan discuss how they have been impacted by physician struggles, and their views on proposed solutions. The three of us share a strong desire to offer hope and help to doctors! As Dom says, we need to make it safe and easy for physicians to seek support. Pamela adds that it is heartening to see all the doctors, and resources, emerging. We’ve heard many stories of physicians who didn’t want anyone to know that they were struggling. We continue to amplify the message to doctors that you are never alone; please do not suffer in silence! Doctors are repeatedly sharing that they wish they had sought help sooner, and that they wasted too much time putting on a solid front, while actually feeling miserable and trapped. There are MANY physicians who have emerged stronger on the other side, including Pamela and Dom. Do not wait until you hit rock bottom to ask for help; so many people care about you and are ready to support you, no matter what! Dom’s support website: https://physiciansanonymous.org/ Pamela’s website: https://www.idealmedicalcare.org/Â Thank you Kim Downey, a vocal patient standing up for doctors! đź’•
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Interesting if superficial discussion. Would be very enlightening to know which PHPs “reached out” to Dom.It is only to be expected thatthey would present themselves as being purely supportive. Most of the principals and staff fervently believe that they ARE a physician’s best friend. Whereas, in fact it is their conviction of the essential goodness and righteousness of their endeavor that makes them so dangerous. Dom seemed genuinely surprised that the leader of one of them was “even” a “recovering”.
He evidently does not know that this is in fact the norm, and certainly NOT the exception. PHP s came about when addicted physicians reinvented themselves to be the profession’s answer tophysician addiction, in part as a means to retain their own licenses after discipline for substance use. This fact is presumably the reason that so many PHPs and their “preferred evaluation and treatment (ETA) programs” (essentially all of which are owned/run by “recoverings”, some of them former PHP directors who have lost these PHP positions having suffered too many relapses) can ONLY any troubled physician through “substance use” tinted lenses. Which may be somewhat appropriate iffy one indeed HAS substance use, diagnosed according to MEDICALLY ACCEPTED CRITERIA rather than surmised from a single DUI or positive drug screen, or inferred from an anonymous allegation of “alcohol on breath”.
But even in legitimately diagnosed SUDs, these systems almost universally demand abstinence-only treatment, which is NOT the standard of care at least for OUD, and there are many standard treatments for alcohol use disorders other than faith based abstinence 12 step. Failure to provide individualized assessment and treatment options is one of the many ways in which PHPs, abetted by their contractually affiliated Medical Licensure Boards (MLB)s openly violate the ADA.
Further, those who have been incarcerated in ETA programs report that they are denied treatment for previously diagnosed (sometimes longstanding) illnesses made by their own established treatment team, in favor of cheap 12 step recovery programs led by Jr. college level educated staff whose only qualification is that they themselves are recovering. Some of the medical direction of these facilities is provided by physicians who have been found guilty of boundary violations or other issues and may have suffered licensure suspension or removal.
Deaths have occurred in such inpatient programs through neglect of medical problems by untrained staff, and also suicides both in and following such mandatory involuntary treatment. Such “treatment” in many instances has been reported to be punitive and degrading in the model of the “SEED” and “STRAIGHT’ programs in the 80s in which children were abused by other inmates and former inmates turned jr. staff, before these were abolished after numerous lawsuits as well as suicides resulted. Not coincidentally, some of the very same individuals who desianed those proarams were also the founders of the current PHP model (“Blueprint/New Paradigm for’Recovery'”) that underpins the formation of ASAM and PHPs.
He also does not realize how rife with conflict of interest, biased and misleading the ostensible “evidence base” (all based on a single cohort that was diagnosed as having SUD without any criteria specified, without controls and with woefully inadequate statistical justification), written by individuals intimately involved in the lucrative drug testing industry a n d which was serially rejected by several journals and editors before finally being accepted for publication); and then the exact same 904 person data set churned many times over to tout the purported superior effectiveness of PHPs in substance use. One of the coauthors, RL DuPont, was Richard Nixon’s “Drug Czar”, who amassed a fortune from drug testing. He was a principal supporter of STRAIGHT, Inc. The other author has been indicted for insurance fraud in c/w his own rehab program, and has a son who was imprisoned for same.
Although Pamela is wary of Employee Assistance Programs for physicians, they at least are bound by very strict laws governing privacy and confidentiality, their records must be sequestered and they cannot even be revealed to the employer or anyone else unless there is a reasonable
likelihood of immediate actual harm to self or others.
Physician Health Programs recognize no such bounds, and seem to flaunt or be ignorant of almost all laws protecting confidentiality especially of sensitive mental health and substance related conditions. On contract, PHPs demand consent to share your entire medical records with any consultants they choose and with your medical board, on pain of reporting you to the MLB with very possible resultant loss of license.
And they even deny clients access to their own records, claiming that these are “business” and not medical records. They do this sometimes with legislative imprimatur, on the allegation that they are protecting such records from discovery in legal cases.
Dom also seems to be incredibly naive about the medical malpractice system in the US. I must wonder whether he is even a US physician?
There is no doubt that PHPs and their “blueprint” system have been helpful, even life saving for some physicians who have the disease for which PHPs were formed, namely Substance Use Disorders (and according to PA site, Dom is a “recovering” 12 stepper). But there is no way to determine how many have been harmed or killed by this system when it is improperly applied to those who do not have this disease, or who might have survived a more flexible approach to treatment.
For anyone reading this who wants to understand the origin story of PHPs please see the Netflix docuseries: “The Program: Cons, Cults, and Kidnapping” about the same tactics used in the troubled teen industry.