Historians will someday look back at the fall of American medicine and wonder how it was allowed to happen and link systemic as well as specific problems pervasively plaguing the profession with regulatory capture by the drug and alcohol testing, assessment and treatment industry.
Regulatory capture is a form of government failure that occurs when a regulatory agency created to act in the public interest, instead advances the commercial or political concerns of special interest groups that dominate the industry or sector it is charged with regulating and introduced in an article by George J. Stigler in 1971 entitled The Theory of Economic Regulation. The main idea of the article can be summarized in Stigler’s (1971: 3) affirmation that:
“…as a rule, regulation is acquired by the industry and is designed and operated primarily for its benefits.”
The basic hypothesis of Stigler is that an industry may use—or rather abuse—the coercive public power of the State to establish and enforce rules in order to obtain private gain.
Historians will at some point recognize 1995 as the “regulatory capture” inception point of American medicine when the Federation of State Physician Health Programs ( FSPHP ) forged arelationship with the Federation of State Medical Boards (FSMB), the national organization responsible for the licensing and discipline of doctors and memorialized in a 1995 Journal of Medical Licensure and Discipline(Vol82N3)with articles claiming high success rates in eight state PHPs.
An accompanying Editorial written by past President of the FSMB Barbara S. Schneidman, MD, MPH concluded that:
“cooperation and communication between the medical boards and the physician health programs must occur in an effort to protect the public while assisting impaired physicians in their recovery.”