The three e-mails below were received within a twenty-four hour period from a physician supporting (and in all likelihood involved in) drug courts and physician health programs (PHPs). E-mails such as this are invariably anonymous and I usually drag them right to the trash where they belong but the trio below provides valuable insight into the mentality of those involved. And for that reason I am posting them as they were received.

Under the nom de plume of “TT Wilson” the author presents non-sequitur and fallacious logic to promote drug courts, PHPs and the sanctification of an illegitimate and irrational medical specialty.

He presents either/or logical fallacy and false dichotomy. You are either with us or against us! He appeals to professionalism yet his words show he has no inkling of the true definition, resorts to simple-minded cliches and meaningless platitudes and then sinks into ad hominem attacks on my blog and then me.

Ironically he accuses me me of ranting in a rant!

He is a prototypical example of the sham-artist physicians typically involved in these programs–an authoritarian paternalistic know-it-all who can only rant under the shield of gang-stalking power or a shroud of absolute anonymity.

As I have said time-and-time again if any factual errors exist in my blog I will not only remove them but remove my blog.

So I am going to make this offer to “TT Wilson”–if you wish to provide a rebuttal of any of the documentary evidence I provide in my blog herein then do so now. If you can I will delete the whole kit and kaboodle. Simple as that.

You Sir are an incompetent and a coward. If not then prove me wrong. I challenge you to reveal your true identity. Let’s level the playing field a tad on this. It is easy to present an opinion while cowardly hiding behind a veil of anonymity. Let’s see if you have the courage to debate this publicly.

I won’t be holding my breath on this one.

February 7, 2015 7:45 PM

Comment: It looks like it is too late already. The ABAM is closer than ever to becoming a member of the ABMS, there is a big push from the Obama administration to fund addiction treatment and to greatly widen access. As communities see how well run addiction programs save lives and force crime away from their homes the trend will be very hard to stop. I agree, PHPs are draconian when they work with physicians thought to have SUDs, but I would rather have them too tough than too lax. And a sober physician should be OK with that.

February 7, 2015 3:00 PM

Comment: Actually well run drug courts help patients who would have otherwise kept using substances of abuse. Drug courts are quite dictatorial by design and clearly a defiant patient will defeat even the most caring and competent efforts to help them. Of course we prefer that the patients be in a stage of change that leaves them open to treatment, but more than a few we’ve helped were not about to change without pressure from the court.

And I stipulated well run drug courts. There are many incredibly poorly run drug courts. When a judge doesn’t get it things are just as bad or worse than when the medical team doesn’t get it. And the studies done are typically dismal. Very short, small sample size, no standardization.

As far as impaired physicians are concerned, it is not enough to just stop using and declare innocence. If a cardinal event has attracted the attention of the medial (sic) board and that board requires participation in treatment to maintain licensure, well that goes with the license. You can certainly choose not to participate, and the board can then choose to not let you practice. They do the same thing with physicians with psychiatric issues. And they encounter a huge amount of denial in this population, I would say more so than the lay population. At least the denial is louder.

Dictatorial — sure. Fair — well, no. But life is not fair.

As doctors we owe it to our patients to be held to a higher standard. If someone of authority says I need to be screened, they are most welcome to any fluid or hair sample they require. Is that fair? Surely not. Does that make it bad? Not at all.

Do you have a better approach? So far you haven’t demonstrated it in your myriad postings.

As far as ABAM is concerned, have you cried out about the ER boards, Pain Medicine boards, and all of the other boards that have been added to the charter members of the ABMS over the years? Heck, back in the day a buddy of mine was grandfathered into the board of Plastic Surgery without even taking a test. He sent them $500 and he was board certified. Got a really nice certificate too, but it didn’t come with a frame. Years later they started requiring fellowship training and actually taking a test.

I enjoy your site — clearly there are problems with the way care is being delivered by some individuals in some cases. Of course that is true of every aspect of medicine. No one is advocating that we shut down every other aspect of medicine. Well some are, but that is for another discussion.

My concern is that your ranting will deter some people away from meaningful treatment, very much like those who seethe against vaccinations lead the unknowing to not treat their children. If I was cynical I could invoke Darwin here. Thinning the herd.

And you might want to get some help with wordpress. This endless scrolling is distracting. I was missing a good third of your content.

February 7. 2015 9:45 PM

Comment: Finally made it to your last entry. Please learn how to conduct a wordpress blog — your technique is very distracting.

You protesteth too much good sir. Put aside your denial and get some treatment. I am sure Harvard was glad to be rid of you. They are very lucky you are out of there.

There might be some legitimate content in there somewhere, but by the time I reached the bottom of the page I was ready to hand you a mood disorder questionaire. Not that we really need you to fill one out to make a diagnosis.