Paul H. Earley, MD, DFASAM, Spring 2020

Tuesday, April 14, 2020
Paul H. Earley, MD, DFASAM

It is characteristic in this slot of our spring newsletter for the FSPHP President to reflect on their tenure, holding a spotlight on the progress made during the past two years. I will spare you, reader, the dalliance of a nostalgic trip down a very short lane.  Instead, I would like to look into the future, projecting a rough timeline of where we will be in the next five years. To do that, I will have to review elements of the pivotal progress we have made, however, so I confess you will have to endure a modicum of my nostalgic bent. In five years, the FSPHP will have firm committees and a strong board, working efficiently through rules of order, each member respecting the right of all to be heard, but prevented from slowing progress that, at times in our history, came from free-form discussion.  The constitution and bylaws will be firm and fair, thanks to the efforts of many to craft meaningful expansion of our membership, scope of care, and compassion for those who suffer.

All PHPs will have adopted best practices, evolving out of an iterative process consisting of standards, organizational review of those standards and expanding research. The three legs of this stool— standards,  performance review, and research—will ensure and confirm that PHPs have built the gold standard for chronic  disease management of safety sensitive workers. Many who work outside our niche will have adopted and  modified the elements of this amazing model. The addiction treatment world, for example, will recognize that a substantive dose of initial care, followed by a monitoring system that uses elements of contingency management,  peer support, and therapy (provided by caregivers who work with but not for a PHP) ensures remarkable outcomes for this complex chronic condition. PHPs will develop more nuanced approaches to lapses in remission and its antecedents, by using big data and artificial intelligence, thus improving our impressive track record even more.

Medical boards and the Federation of State Medical Boards (FSMB) already value what we do. As we continue our self-examination and self-improvement, medical boards across the United States will develop a more consistent view and understanding of what we do, because we are pushing hard for excellence in every state and province. In the coming years, we will be comfortable with constant reexamination of our protocols, procedures, and outcomes, ensuring we remain on track. Publishing these results in peer reviewed journals will be a routine part of examining and establishing our success. Even today, no other branch of behavioral medicine has five-year outcome data. We acknowledge that limitations exist in the design of these studies, but who else has characterized remission over a time frame anywhere close to five years? 

Finally, the FSPHP will work closely with others who care for safety-sensitive workers. Our protocols and research will lead to changes in cohorts far afield, for example, the criminal justice system. Some of our relatives who work with safety-sensitive workers may become part of our organization; some may choose to remain distinct yet walk alongside us as we continue to redefine the gold standard in chronic disease management for those who suffer from chronic biobehavioral illnesses.

Are these extravagant, pie-in-the-sky predictions? We think not. They will materialize if we work for them.

I thank you for allowing me to pilot this ship for what turned out to be a very short two years.