What to know about what you don’t know you know. #1: Intuition is very efficient—if you don't overthink it.
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This will be hard for some readers to believe. After all, aren't doctors mostly intelligent, well-heeled, and capable of defending themselves against such a blatant racket? And surely this only affects a very small number, right? Well, probably. And some of them really ARE abusers in denial, aren't they? Again, no doubt some are. The point is that some (perhaps many) are not. I hear from plenty of those who are caught in the scheme. And once they become targets of hospital administration, competitors, or disgruntled ex spouses or patients who complain to the medical board or PHP, or if they should foolishly self refer, believing that they can get help from these well organized (and capitalized) programs for very common conditions like burnout or low level depression, they can easily be sucked down a rabbit hole that leads to immediate removal from practice, home, family supports and community...and into a VERY expensive, out of state, artificially supported system of "preferred" providers of for-profit inordinately long inpatient "care", almost purely focused on substance use, utilizing polygraph testing (for example in Kansas) and denying them even the most basic standard of care treatment in favor of faith based abstinence (when substance use is diagnosed). Often their real (non substance related) problems are ignored by staff at such facilities, whose only professional "qualification" for diagnosis or treatment is their own experience in recovery---so it's all that they "know" how to do.
Such is unfortunately the power held over doctors by medical boards, who have abdicated their responsibility for oversight of PHPs because it makes their jobs SO much easier to just punt, than actually to sort out these potentially complicated cases.
Average expenditure per doc: $250-$310K (insurers won't cover treatment not medically indicated) and 3 months of their lives, followed by 3-5 years of intrusive monitoring, using tests created by some of the same individuals profiting from the scheme (and which tests have such unacceptably high positive rates that they are banned from forensic use by federal agencies). Victim docs are told to second mortgage their homes or invade children's educational funds to pay for treatment that is at a minimum three times longer than necessary, despite that it has been known for many years they are easier to treat because of the power of loss of licensure. They (even young resident physicians with no income as yet) are routinely threatened "isn't your license worth $50K up front?" by these vultures. Career or even life ending despair can result. How many deaths will it take to expose this scheme?
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