Physician Health Programs (PHPs): The Ford Granada of Employee Assistance Programs (EAPs) and Stuntman Mike is at the wheel.

PHPs are essentially Employee Assistance Programs (EAPs)  for doctors, nurses and other health care professionals.    The vast majority of people know little or nothing about Physician Health Programs (PHPs) but they should. The grand plan is expansion to other occupations under what they are calling the “New Paradigm.”  Deemed “professional health programs”they don’t even have to change the acronym.

Physician Health Programs (PHPs) are being called  the “gold-standard” for EAPs.   Claims of unparalleled success are being used to promote PHPs to other populations as a “replicable model of recovery.”  Drs. Robert Dupont and Gregory Skipper are promoting PHPs as “A New Paradigm for Long-Term Recovery”  claiming an 80% success rate in doctors.   An article entitled “What Might Have Saved Philip Seymour Hoffman” claims the actor may still be alive today if he had access to one of these programs  and comments they “ought to be considered models for our citizenry” and the “best evidence-based addiction treatment system we have going.”

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Mercedes 450 SE

Such is not the case.  What is being touted as “gold standard” and “cream of the crop” is on closer inspection iron pyrite and curdled spit up.  I am reminded of the commercials comparing a Granada to a Mercedes when I was a kid.  I remember these commercials  well as I couldn’t wrap my head around them.  In one, as I remember it, two couples arrive at their parked adjacent cars with keys in hand. The Mercedes tries to open the door of the Granada and vice versa.  How is this scenario even possible I remember thinking. Was it a bar they just came out of  and they are drunk?     Is this related to “this is your brain on drugs?  Do they have some sort of memory problem like that old guy in the miracle ear commercial who looks confused when the waiter asks his preference for salad dressing and his companion yells “he said do you want Italian, thousand island or vinaigrette?”  How could anyone in a right state of mind  confuse a Ford Granada with a Mercedes 450SE?

 

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Granada


 

PHPs are not the Mercedes of EAPs but the jalopy with no breaks and broken steering of EAPs with Stuntman Mike from Quentin Tarantino’s Death Proof at the wheel.

Like smoke alarms and air bags,  EAPs are not in the forefront most peoples minds until they need them and like smoke alarms and air bags they usually work just fine for most people. Discerning and scrutinizing one’s EAP is not a common thing.  If your EAP was replaced by the PHP model you probably wouldn’t even know it. That is why this needs to be on your radar. Caveat emptor.  Forewarned is forearmed.

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Stuntman Mike

The dark underbelly of these programs are just beginning to be exposed in the general medical community.  See Pauline Anderson’s  Physician Health Programs- More Harm Than Good?  published on Medscape and  BMJ Editor Jeanne Lenzer’s “Physician health programs under fire” for an overview.  Look in the comments section for the horror stories.

Physician Health Programs  (PHPs) claimed “gold standard” for addiction treatment. “80% success rate” being used to promote “new paradigm” to other populations. 

1. National Physician Health Program Blueprint Study Publications List

2.  Setting the Standard for Recovery: Physicians’ Health Programs

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The claim of an 80% success rate is a 2009 study published in the Journal of Substance Abuse Treatment entitled  Setting the Standard for Recovery: Physicians’ Health Programs and authored by Robert Dupont,  A. Thomas McLellan,  William White, Lisa Merlo and Mark Gold.  This  study is the cornerstone of the “PHP-blueprint.” It is the very  foundation on which everything else is based, a Magnum opus used to lay claim to supremacy that has been endlessly repeated and rehashed in a plethora of self-promotion and treatment community blandishment.

To date there has been no academic analysis of the “PHP-Blueprint.”    There has been no Cochrane type analysis or critical review.    There has been no opposition to its findings or conclusions which are paraded as fact and truth without challenge or question and there is a general lack of concern from those both within and outside the medical profession.

One major problem with this claim of an 80% success rate is that close to 80% of those coercively enrolled in these programs do not fit the diagnostic criteria for substance use disorder or any other psychiatric diagnosis. In reality these programs cause far more harm and if we really looked at the impact of these programs and compared them to traditional EAPs the success rate would be abysmally low.


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The Expansion of Physician Health Programs (PHPs) to Other Populations

1.  Although these programs claim to help doctors they may actually be harming many and contributing to suicide.

2.  The plan is to greatly expand these programs to other populations and you could be next.

In 2012 Robert Dupont delivered the keynote speech at the Drug and Alcohol Testing Industry Association annual conference and described a “new paradigm” for addiction and substance abuse treatment and proposed expansion of this paradigm to other populations including workplace, healthcare, and schools.

It is therefore critical that the “PHP-blueprint” be examined using critical reasoning and evidence base.   All of this needs to be assessed in terms of legitimacy and intent.

Lack of Evidence-Base and Conflicts of Interest

A  cursory  analysis of the study on which this success rate is based reveals very little evidence base.

The claim of 80% success rate in physicians is based on Setting the Standard for Recovery: Physicians’ Health Programs is unfounded.  The study is a poorly designed using a single data set (a sample of 904 physician patients consecutively admitted to 16 state PHP’s).

It  is non-randomized and non-blinded rendering the evidence for effectiveness of the PHP treatment model over any other treatment model (including no treatment) poor from a scientific perspective.  The study contains multiple flaws in both reasoning (type I and type II errors) and statistical analysis that render its conclusions invalid.

In addition the impact of undeclared but substantial financial conflicts-of-interest (including funding by drug testing and addiction treatment industries) and personal ideological biases (including personal 12-step recovery from addictions) in the authors of this study also needs to be considered.

Moreover the misdiagnosis and over-diagnosis of addiction in physicians in this paradigm  incentivized by lucrative self-referral dollars for expensive 90-day treatment programs is a significant factor.

False Endpoints and High Mortality Rate

The mean age of the 904 physicians was 44.1 years. They report that 24 of 102 physicians were transferred and lost to follow “left care with no apparent referral.”

What happened to them? These are physicians with multiple identifiers (state license, DEA, UPIN, etc) not transient drifters.

More importantly what happened to those 48 who were reported to the Medical Board for noncompliance and had their licenses revoked–that would be the critical time when this population would be at most risk for completing a suicide. That would be when hope was lost and the coerced physician, knowing that the fight was over, would take that step.

The outcomes they used were the last reported status of the PHP participant enrolled in the program.   Measuring success of program completion in doctors compared to the general population is meaningless as the short-term outcomes are quite different in terms of the external consequences imposed.   The consequence of not completing a PHP is the invariably career ending.    So what happened to the 24 of who “left care with no apparent referral,” the 85 who “voluntarily stopped or retired,” and the 48 who “involuntarily stopped or license revoked.”

Whether you leave a PHP voluntarily, involuntarily, or with no apparent referral it is the end game and your career is over.  Comparing this to other populations where the consequences of failing to complete the program are not so final is inappropriate.     Claiming superiority over programs with a 40% success rate is unfounded because for most of those people the consequences are not so final and may mean nothing more than an increase in testing frequency.

The big question is what happened to the 157 physicians who left or stopped?  How many of them killed themselves. With an average age of 44 there were  6 reported suicides 22 deaths, and another 157 no longer doctors.  I would venture to say the number of suicides is a lot higher than they claim.  But using the last recorded PHP status as the final outcome obfuscates this.

Due to the severity of the consequences a 20% failure rate is quite concerning. This is of particular concern because many doctors (if not most) monitored by PHPs are not addicts.

As noted above, PHPs are essentially Employee Assistance Programs (EAPs)  for doctors. Most EAPs, however, were developed in the presence of trade unions and other organizations working on behalf of the best interests of the employee. This collaborative effort led to EAPs that were more or less “organizationally just” with procedural fairness and transparency.

Imposed 12-step ideology and use of non-FDA Approved Drug and Alcohol Testing

No such organizations exist for doctors.   Due to the absence of oversight and accountability  PHPs have been able to use non-FDA approved laboratory developed tests of unknown validity on doctors without any opposition.

The distinction between professional and private life as a fundamental value of our society  and the importance of this boundary was also upheld by these groups.

In the PHP paradigm no procedural fairness or transparency exists and the boundary between professional and private life has eroded.

PHPs impose 12-step ideology on all doctors referred to these programs.   State Medical Boards  enforce this in violation of the Establishment Clause of the 1st Amendment yet there is little recourse for doctors as they are threatened with non-compliance and loss of licensure.

Selling the PHP Paradigm

The use of 12-step  is most likely not ideologically driven but profit driven.

Abstinence based 12-step programs justify the use of frequent drug and alcohol testing with ongoing lifelong assessment and treatment.    As with drug-courts,  PHPs provide a lucrative model to the drug and alcohol testing, assessment and treatment industry.

The plan to expand this to other populations is outlined in the ASAM White Paper.

Screen Shot 2017-03-08 at 7.29.21 PMThis concerns all of us.  The first step needs to be a critical appraisal of  Setting the Standard for Recovery: Physicians’ Health Programs,  the foundation of their claims of an 80% success rate and a conflict-of-interest analysis of its authors.  The legitimacy of the study and its claims needs to be questioned.

It does not take a Cochrane review to see that the emperor has no clothes.  This is not difficult. It is straightforward and simple.

As an illegitimate and irrational authority it is necessary that this opinion remain unchallenged. We need to challenge it.

Historical, political, economic and social analysis reveals that the “PHP-blueprint” is a false-construct built on circumnavigation and obfuscation.  An evidence-based scrutiny of the literature would reveal it to be invalid and of little probative value.

But if  nobody speaks up it is inevitable that they will expand the “PHP blueprint”  to other employee assistance programs and schools.

This is not just about doctors.  You too are at risk for coercion, control, conformity and forced adherence to a  lifetime of abstinence and 12-step indoctrination and if you do not speak up now it won’t be a risk but a certainty.


PHYSICIAN OR PROFESSIONAL HEALTH PROGRAM SURVEY

Professional Health Program (PHP) Survey

Please click on the link below and complete the following survey if you have been monitored or are being monitored by a PHP.

Professional Health Program (PHP) Survey

This is a confidential survey. If you have concerns about anonymity please create an alternative alias email address (this video shows you how to create an alias G-mail address), then use the alias email address as your “name” for future correlation.

scotty

Recovery Related Racket: The Federation of State Physician Health Programs (FSPHP) represents the drug and alcohol testing, assessment and treatment industry not us. We need to name the enemy.

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“It is easier to believe a lie one has heard a hundred times than a truth one has never heard before.” –Robert S. Lynd

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1980s–Your Money or Your Medical License

Ridgeview Institute was a drug and alcohol treatment program for “impaired physicians” in Georgia created by G. Douglas Talbott, a former cardiologist who lost control of his drinking and recovered through the 12-steps of Alcoholics Anonymous. Up until his death on October 18, 2014 at the age of 90, Talbott owned and directed a number of treatment facilities for impaired professionals, most recently the Talbott Recovery Campus in Atlanta, one of the preferred referrals for physicians ordered into evaluation and treatment by licensing boards today.

G. Douglas Talbott is a prototypical example of an “impaired physician movement”physician–in fact in many ways he may be considered the”godfather” of the current organization.  He helped organize and serve as past president of the American Society of Addiction Medicine (ASAM) and was a formative figure in the American Medical Association’s (AMA’s) Impaired Physician Program.

The cost of a 28-day program for nonprofessionals at Ridgeview in 1987 was $10,000 while the cost was “higher for those going through impaired-health professionals program,” which lasted months rather than 28 days.1

In 1975 after creating the DeKalb County Impaired Physicians Committee for the Medical Association of Georgia, Talbott founded the Georgia Disabled Doctors Program for the assessment and treatment of physicians. Founded in part because “traditional one-month treatment programs are inadequate for disabled doctors,” and they required longer treatment to recover from addiction and substance abuse.   According to Talbott, rehabilitation programs that evaluate and treat the rest of the population for substance abuse issues are incapable of doing so in doctors as they are unlike any other of the inhabitants of our society. Physicians are unique. Unique because of their incredibly high denial”, and he includes this in what he calls the “Four MDs,” “M-Deity”, “Massive Denial” “Militant Defensiveness” and “More Drugs.”2   And these factors set doctors apart from the rest.

According to Talbott, “impaired doctors must first acknowledge their addiction and overcome their ‘terminal uniqueness’ before they can deal with a drug or alcohol problem.” “Terminal uniqueness “ is a phrase Talbott uses to describe doctors’ tendency to think they can heal themselves.“M-Deity” refers to doctors “being trained to think they’re God;”3 blinded by an overblown sense of self-importance and thinking that they are invincible-an unfounded generalization considering the vast diversity of individuals that make up our profession.   Screen Shot 2015-07-28 at 1.14.49 AM

Although this type of personality does exist in medicine,  it is a small minority -just one of many opinions with little probative value offered as factual expertise by the impaired physician movement and now sealed in stone.

This attitude, according to some critics, stems from the personal histories of the treatment staff, including Talbott, who are recovering alcoholics and addicts themselves. One such critic was Assistant Surgeon General under C. Everett Koop John C. Duffy who said that Ridgeview suffered from a “boot-camp mentality” toward physicians under their care and “assume every physician suffering from substance abuse is the same lying, stealing, cheating, manipulating individual they were when they had the illness. Certainly some physicians are manipulative, but it’s naïve to label all physicians with these problems.”1

American Society of Addiction Medicine (ASAM) President (1981-1983) LeClair Bissell was also highly critical of Talbott’s approach. Bissell, co-author of the first textbook of ethics for addiction professionals4 when asked if there was any justification to the claim that doctors are sicker than other people and more vulnerable to addiction replied:

“Well, based on my treatment experience, I think they are less sick and much easier to treat than many other groups. I think one reason for that is that in order to become a physician…one has to have jumped over a great many hurdles. One must pass the exams, survive the screening tests and the interviews, be able to organize oneself well enough to do examinations and so on, and be observed by a good many colleagues along the way. Therefore I think the more grossly psychotic, or sicker, are frequently screened out along the way. The ones we get in treatment are usually people who are less brain-damaged, are still quite capable of learning, are reasonably bright. Not only that, but they are quite well motivated in most cases to hang on to their licenses, the threat of the loss of which is frequently what puts them in treatment in the first place. So are they hard to treat? No! Are they easy patients? Yes! Are they more likely to be addicted than other groups? We don’t know.”5“I’m not much for the bullying that goes along with some of these programs,” Bissell commented to the Atlanta Journal and Constitution in 1987.3

The constitution did a series of reports after five inpatients died by suicide during a four-year period at Ridgeview.6 In addition there were at least 20 more who had killed themselves over the preceding 12 years after leaving the treatment center.1

Bissell, the recipient of the 1997 Elizabeth Blackwell Award for outstanding contributions to the cause of women and medicine remarked: “When you’ve got them by the license, that’s pretty strong leverage. You shouldn’t have to pound on them so much. You could be asking for trouble.”3

According to Bissell: “There’s a lot of debate in the field over whether treatment imposed by threats is worthwhile…To a large degree a person has to seek the treatment on his own accord before it will work for him.”3

A jury awarded $1.3 million to the widow of one of the deceased physicians against Ridgeview,7 and other lawsuits initiated on behalf of suicides were settled out of court.6

The Constitution reported that doctors entered the program under threats of loss of licensure “even when they would prefer treatment that is cheaper and closer to home.”8 The paper also noted that Ridgeview “enjoys unparalleled connections with many local and state medical societies that work with troubled doctors,” “licensing boards often seek recommendations from such groups in devising an approved treatment plan,” and those in charge are often “physicians who themselves have successfully completed Ridgeview’s program.”8

In 1997 William L. White interviewed Bissell whom he called “one of the pioneers in the treatment of impaired professionals.” The interview was not published until after her death in 2008 per her request.   Noting that her book Alcoholism in the Professions9“ remains one of the classics in the field”, White asked her when those in the field began to see physicians and other professionals as a special treatment population; to which she replied:

“When they started making money in alcoholism. As soon as insurance started covering treatment, suddenly you heard that residential treatment was necessary for almost everybody. And since alcoholic docs had tons of money compared to the rest of the public, they not only needed residential treatment, they needed residential treatment in a special treatment facility for many months as opposed to the shorter periods of time that other people needed.”10


1995 –The Big Con

In 1995 the impaired physicians movement gained an uninvited seat at the table of power. They accomplished this by offering “treatment” as an alternative to “discipline” and reporting remarkably high success rates.  Talbott reported a “92.3% recovery rate according to information compiled from a five-year follow-up survey based on complete abstinence and other treatment.”11

A 1995 issue of The Federal Bulletin: The Journal of Medical Licensure and Discipline, published by the Federation of State Medical Boards, contains articles outlining impaired physician programs in 8 separate states. Although these articles were little more than descriptive puff-pieces written by the state PHP program directors and included no described study-design or methodology the Editor notes a success rate of about 90% in these programs and others like them 12 and concludes:

“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.” 12No one bothered to examine the methodology to discern the validity of these claims and it is this acceptance of faith without objective assessment that has allowed the impaired physician movement through the ASAM and FSPH to advance their agenda;  confusing ideological opinions with professional knowledge.

“There is nothing special about a doctor’s alcoholism,” said Bissel

“These special facilities will tell you that they come up with really wonderful recovery rates. They do. And the reason they do is that any time you can grab a professional person by the license and compel him or her into treatment and force them to cooperate with that treatment and then monitor them for years, you’ll get good outcomes—in the high 80s or low 90s in recovery rates—no matter what else you do.”10“The ones I think are really the best ones were not specialized. There were other well-known specialty clinics that claimed all the docs they treated got well, which is sheer rot. They harmed a great many people, keeping them for long, unnecessary treatments and seeing to it that they hit their financial bottom for sure: kids being yanked out of college, being forced to sell homes to pay for treatment, and otherwise being blackmailed on the grounds that your husband has a fatal disease. It’s ugly.”10Stanton Peele’s “In the Belly of the American Society of Addiction Medicine Beast” describes the coercion, bullying, threats and indoctrination that are standard operating procedure in Talbott’s facilities.13  Uncooperative patients, “and this covers a range of sins of commission or omission including offering one’s opinion about one’s treatment,” are “threatened with expulsion and with not being certified-or advocated for with their Boards.”13

The cornerstone of treatment is 12-step spiritual recovery. All new patients are indoctrinated into A.A. and coerced to confess they are addicts or alcoholics. Failure to participate in A.A. and 12-step spirituality means expulsion from the program with the anticipated result being loss of one’s medical license.

In May 1999 Talbott stepped down as president of the American Society of Addiction Medicine (ASAM) as a jury awarded Dr. Leonard Masters a judgment of $1.3 million in actual damages and an undisclosed sum in punitive damages for fraud, malpractice, and the novel claim of false imprisonment.14

The fraud finding required a finding that errors in the diagnosis were intentional. Masters, who was accused of overprescribing narcotics to his patients was told by the director of the Florida PHP that he could either surrender his medical license until the allegations were disproved or submit to a four-day evaluation.

Masters agreed to the latter, thinking he would have an objective and fair evaluation. He was instead diagnosed as “alcohol dependent” and coerced into “treatment under threat of loss of his medical license. Staff would routinely threaten to report any doctor who questioned any aspect of their diagnosis or treatment to their state medical boards “as being an impaired physician, leaving necessary treatment against medical advice,”14  the equivalent of professional suicide.

Masters, however, was not an alcoholic.

According to his attorney, Eric. S. Block,  “No one ever accused him of having a problem with alcohol. Not his friends, not his wife, not his seven children, not his fellow doctors, not his employees, not his employers, No one.” 15

He was released 4 months later and forced to sign a five-year “continuing care” contract with the PHP, also under continued threat of his medical license.

Talbott faced no professional repercussions and no changes in their treatment philosophy or actions were made. They still haven’t.  They have simply tightened the noose and taken steps to remove accountability.


2011–The Federation of State Medical Boards (FSMB)  as Pawn of the  Federation of State Physician Health Programs (FSPHP)

 Up until his death, Talbott continued to present himself and ASAM as the most qualified advocates for the assessment and treatment of medical professionals for substance abuse and addiction.16

The 2011 FSMB Policy on Physician Impairment identifies, defines, and essentially legitimizes “potential impairment” and “relapse without use.”

A PHP Should be empowered to conduct an intervention based on clinical reasons suggestive of potential impairment.  

Unlike the Board which must build a case capable of withstanding
legal challenge, a PHP can quickly intervene based on reasonable concern."

“Empowered” to conduct an “Intervention” for reasons “suggestive” of “potential” impairment means a doctor can be pulled out of practice for anything.  It essentially gives them carte blanche authority. The disregard for physician rights, due process and validity is self-evident.

in 2011 The ASAM issued a Public Policy Statement on coordination between PHPs, regulatory agencies, and treatment providers recommending  that  only “PHP approved” treatment centers be used in the assessment and treatment of doctors.  A recent audit of the  North Carolina PHP found financial conflicts of interest and no  documented criteria for selecting the out of state treatment centers they used.  The common denominator the audit missed was that the 19  “PHP-approved” centers were all ASAM facilities whose medical directors can be seen on this list.

The FSMB House of Delegates adopted an updated Policy on Physician Impairment at their 2011 annual meeting distinguishing “impairment” and “illness”  stating that Regulatory Agencies should recognize the PHP as their expert in all matters relating to licensed professionals with “potentially impairing illness.”

In most states today any physician referred for an assessment for substance abuse will be mandated to do so in a facility just like Ridgeview.

There is no choice.   In mechanics and mentality, this same system of coercion, control, and indoctrination has metastasized to almost every state only more powerful and opaque in an unregulated gauntlet protected from public scrutiny, answerable and accountable to no one.  Laissez faire Machiavellian egocentricity unleashed.    For what they have done is taken the Ridgeview model and replicated it over time state by state and tightened the noose.  By subverting the established Physician Health Programs (PHPs) started by state medical societies and staffed by volunteer physicians they eliminated those not believing in the mentality of the groupthink.   They then mandated assessment and treatment of all doctors be done at a “PHP-approved” facility which means a facility identical to Ridgeview.  This was done  under the scaffold of the Federation of State Physician Health Programs (FSPHP).  They are now in charge of all things related to physician wellness in doctors.

G. Douglas Talbott defines  “relapse without use”  as  “emotional behavioral abnormalities” that often precede relapse or “in A A language –stinking thinking.”  AA language has entered the Medical Profession and no one even blinked.  It will get worse.

The ASAM has  monopolized addiction treatment in the United States.   It has imposed  it on doctors through the FSPHP.  The FSPHP political apparatus exerts a monopoly of force. It selects who will be monitored and dictates every aspect of what that entails.  It is a, in fact, a  rigged game.


PHPs no longer represent the interests of doctors or the public but the interests of the drug and alcohol testing, assessment and treatment industry.

It is important to recognize that PHPs do not represent the interests of doctors or the public.  PHPs represent the interests of the “recovery industry” including the multi-billion dollar drug and alcohol testing, assessment and treatment industries. Claiming an 80% success rate in doctors this system of institutional injustice is being brandished as the “new paradigm” of addiction treatment. Claiming it a replicable model, the plan is to convince other employee assistance programs to implement the “PHP-blueprint.”

There is enormous inertia—a tyranny of the status quo—in private and especially governmental arrangements. Only a crisis—actual or perceived—produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes politically inevitable.-Milton Friedman

  1. Durcanin C, King M. The suicides at Ridgeview Institute: Suicides mar success at Ridgeview with troubled professionals. Atlanta Journal and Constitution. December 18, 1987, 1987: A13.
  2. Gonzales L. When Doctors are Addicts: For physicians getting Drugs is easy. Getting help is not. Chicago Reader. July 28, 1988, 1988.
  3. King M, Durcanin C. The suicides at Ridgeview Institute: A Doctor’s treatment program may be too tough, some say. Atlanta Journal and Constitution. December 18, 1987a, 1987: A12.
  4. Bissell L, Royce JE. Ethics for Addiction Professionals. Center City, Minnesota: Hazelden; 1987.
  5. Addiction Scientists from the USA: LeClair Bissell. In: Edwards G, ed. Addiction: Evolution of a Specialist Field. 1 ed: Wiley, John & Sons, Incorporated; 2002:408.
  6. Durcanin C. The suicides at Ridgeview Institute: Staff members didn’t believe Michigan doctor was suicidal. Atlanta Journal and Constitution. December 18, 1987, 1987: A8.
  7. Ricks WS. Ridgeview Institute loses $1.3 million in suit over suicide. Atlanta Journal and Constitution. October 11, 1987, 1987: A1.
  8. King M, Durcanin C. The suicides at Ridgeview Institute: Many drug-using doctors driven to Ridgeview by fear of losing licenses. Atlanta Journal and Constitution. December 18, 1987b, 1987: A1.
  9. Bissell L, Haberman PW. Alcoholism in the Professions. Oxford University Press; 1984.
  10. White W. Reflections of an addiction treatment pioneer. An Interview with LeClair Bissell, MD (1928-2008), conducted January 22, 1997. Posted athttp://www.williamwhitepapers.com. 2011.
  11. Williams c. Health care field chemical dependency threat cited. The Tuscaloosa News. January 16, 1988, 1988: 16.
  12. Schneidman B. The Philosophy of Rehabilitation for Impaired Physicians. The Federal Bulletin: The Journal of Medical Licensure and Discipline. 1995;82(3):125-127.
  13. Peele S. In the Belly of the American Society of Addiction Medicine Beast. The Stanton Peele Addiction Website (accessed March 28, 2014)http://web.archive.org/web/20080514153437/http://www.peele.net/debate/talbott.html.
  14. Ursery S. $1.3M verdict coaxes a deal for doctor’s coerced rehab. Fulton County Daily Report. May 12, 1999b 1999.
  15. Ursery S. I was wrongly held in alcohol center, doctor charges. Fulton Count y Daily Report. April 27, 1999a 1999.
  16. Parker J. George Talbott’s Abuse of Dr. Leon Masters MD (http://medicalwhistleblowernetwork.jigsy.com/george-talbott-s-abuse-of-leon-masters ). Medical Whistelblower Advocacy Network.

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