Fifty Years Ago and Physicians Assistance Programs Today

Fifty years ago, my commercial salmon fishing partner Turak J. Newman and I were drifting back from our nets 18 miles upriver from our homes in the nearly abandoned gold rush town of Rampart on Alaska’s Yukon River. An Inuit from Beaver, Alaska, he had, as a young man, found himself broke and stranded in San Francisco.

Desperate, he came up with a plan. He would volunteer for the U. S. Navy, stay in until he’d been paid enough to buy a ticket back to Alaska then he’d quit and fly home.

You can imagine how that actually played out – but it’s hardly surprising that a young man who grew up in an orphanage in Seward, Alaska would not be versed in what “volunteering” for the military entailed.

Turak had ample excuses for his mistaken belief that he was just taking a job and that being a volunteer stopped once he’d signed up and that he could resign at any time.

As usual, what’s the point of this seemingly irrelevant tale from long, long ago?

As is widely reported across the world, physicians, nurses and other front line professionals in the Covid crisis are increasing their consumption of alcohol. So are a lot of the rest of us but not usually to the degree that exhausted front-line workers are.

That might be of less concern if these professionals had some respite other than the short term relief alcohol undoubtedly provides. And when the alcohol begins to impinge, it would be good if they actually had some real help.

Truth is, they don’t.

Across the U.S. and Canada there are scams with various names, usually lumped together as “Physicians Assistance Programs,” with similar organizations for nurses, fire fighters, and other first responders and Covid front liners.

Still waiting for the point?

All of these “organizations” describe themselves as VOLUNTARY programs to help professionals cope and divert.

But as Turak discovered, once you volunteer – nothing is voluntary ever again. At least in this case he was discharged after completing his 2 year tour of duty. Inb the case of these “assistance” programs, you will never be released until your career is over or, as many do, you escape via suicide – Just like the Coast Guard officers I previously wrote about did.

Physicians, nurses, first responders and others who sign up are immediately ordered to “rehab” programs that have no efficacy or a negative efficacy rate. The referring “program” receives a kickback with the amount determined by how long and how often the professional remains in the Kafka-esque labyrinth of “treatment,” AA meetings, so-called denial, and other abuses including license revocation without any due process, extortion, blackmail, and it never ends.

Two examples will suffice.

Dr. P. called us to talk about his concerns with his somewhat increased use of alcohol as retirement neared and his practice slowed. A couple of phone calls sufficed to solve the problem with no further concern.

A year later, at his own annual physical, his doctor asked if he had any concerns to which he replied, “No. A year ago I thought perhaps my drinking was increasing a hit but I handled that with a couple of sessions with a private counselor.”

He thought nothing more about it until a few days later when he received a call from the state medical board director ordering him to Florida for 30 days of rehab, 60 days if he argued, and his license was on hold until he complied.

After all was said and done, there was no escape from the AA/12Step extortion and Dr. P. would be working, if at all, under a provisional license subject to revocation at any time under any whim. The cost of complying? With lost income, fees, costs, etc., minimally, $500,000. Happily for him, he was in a position to retire, which he did.

Case #2, from Canada, Dr. B. received two pieces of news in two days: his wife was considering filing for divorce, and he also received a preliminary diagnosis of ALS. Two days later he had a conference scheduled in the U.S. which allowed for a follow-up evaluation at a major U.S. medical center. He went, received the news he did not have ALS, had a reconciliatory talk with his wife, and proceeded to celebrate a bit too much one evening at the conference.

A jealous colleague reported him to his provincial PAP and the predictable nightmare ensued.

This case was successfully concluded because: 1) there was no previous record of problems; 2) he found a lawyer willing to represent him (not possible in the U.S. where attorneys who go up against AA/12 Step/rehab are crushed along with those they represent); 3) the physicians services were needed by a number of his colleagues; and 4) his attorney was able to trace the kickbacks from the rehab program to the PAP’s director and uncover a history of such payments.

I could add several dozen variations on these case histories, but I’m sure you get the point.

Health care workers and first responders have nowhere to turn for the short term assistance they need and deserve to cope with these unprecedented circumstances. There are fewer than a dozen programs in the U.S. – fewer in Canada – where confidential, effective, and affordable help is available without career ending consequences.

If you doubt this, merely watch a few episodes of Station 19 and/or Grey’s Anatomy which actively push the AA rehab agenda as though these programs were “the standard of care,” “actually work,” and are appropriate. It’s tragic that influential programs which do portray the Covid crisis reasonably accurately turn around and irresponsibly promote programs rooted in failure and extortion as the “solution.”