Introduction to Meetings and a Caveat

Support groups available to alcoholic and other drug dependent doctors are far from alike. Some are simple AA or NA groups and function largely according to the traditions of those organizations, yet almost all differ In some ways, albeit minor ones, from a "typical" AA group. Some are careful to avoid altogether the use of AA's name while traveling another path. Ask questions, assume nothing, and be prepared for yet another demonstration that alcoholics both individually and collectively are wonderfully varied.

GROUPS vs. MEETINGS
First off, if a number of alcoholics meeting together are to call themselves an "AA group" they are asked to be open to all alcoholics. If attendance is to be restricted, the word "meeting" should be used instead. Whether or not restricted meetings should take place at all is endlessly debated, but they have existed for many years and will certainly continue to do so. This introduction helps to keep expectations clear for all concerned so that people can find their way to the help they need and want and that AA's traditions are respected as well.

MEMBERSHIP
The membership of these groups is quite varied. The oldest and largest is International Doctors In Alcoholics Anonymous (IDAA). It has approximately 4500 members and has, ever since its founding In 1949, admitted to full membership any alcoholic or drug dependent "doctor" whose degree is in the field of health care. Members Include DDS's, DVM's, PhD's in psychology, nursing, social work, and the health sciences. While traditional AA groups do not admit Al-Anon members, this group does. To join, one simply writes or uses the membership form on this website and asks to be placed on the mailing list. If willing, individual members may be asked to help if a colleague is in trouble in their area or wants contact with a fellow physician or other doctor in recovery.

IDAA is not an umbrella organization that has chapters or subgroups, so that if a local meeting calls itself "an IDAA group," this means only that there are similarities. Each local group is quite autonomous. It is not controlled or endorsed by IDAA, nor are membership requirements necessarily the same. The size of the community and the numbers and disciplines of people in need will initially shape the group, while the groups themselves tend to change composition with time. The old adage that all it takes for a new meeting is two alcoholics, a coffee pot and a resentment is as true for professionals as for anyone else. There is constant change.

CONFIDENTIALITY AND ANONYMITY
Many groups are for advocacy and support only. Some are very careful never to monitor or report on anyone for any reason, even at the request of a person wanting proof of attendance. Other groups will attest to attendance on request. Others go further and become an actual monitoring arm of a state disciplinary board. Several have been chaired by a physician not himself an alcoholic who has been not only a ranking member of a state Impaired physician committee but actually the therapist of some of the physician group members as well! Clearly it will pay to learn the ground rules whenever possible before assuming that a particular degree of confidentiality exists.

Unfortunately there have been other problems with some of the special groups over the years that have sometimes resulted in the physician actually having less anonymity than the average layman approaching AA. Most of these actions have ceased with experience. At times lists of names have been prepared so that members could locate each other more easily and the lists have not then been wisely used. At other times unauthorized audiotapes have been made and then shared with medical students to show them that they too are not immune to addictive disease. Well, and good, but the speaker was not always consulted in advance and would not have agreed. These episodes fortunately have been rare but they have happened. Recognizing these mistakes helps to avoid them in future while admitting honestly that they have occurred. A physician deserves fully as much privacy in recovery as does anyone else.

INTERVENTION
A major frustration for many doctors has been the slowness of committees and organizations to reach out to the colleague who is in obvious trouble. AA groups quite rightly stick to "attraction, not promotion." At their best, they do not in any way push people around so that one is left with nothing and no one to fight but oneself and one's addiction. Meanwhile the local impaired physician committee may not be doing very much. To expect it to may not be realistic. Some groups have responded by taking on the dual function of outreach and subsequent support. One of the best organized and creative of these is Physicians Serving Physicians and is not an AA group. This Minnesota-based organization will approach a fellow physician in trouble, essentially gang up on the person and kindly but firmly try to maneuver him or her into treatment. This is not a game for amateurs but there are techniques to be learned and when this is well done, the success rate of such well planned interventions can be impressive.

TREATMENT CENTER SPONSORSHIP
There are a certain number of groups that assemble in meeting space provided by treatment centers. Sometimes this reflects nothing more than the generosity of the center and there are no strings attached. At other times it reflects an attempt by the center to establish itself as the place where professionals come to be treated. Physicians are, after all, a fairly influential group and there is status for the place known as the center where professionals come for treatment or for the person known as the "doctor's doctor".

Some treatment center groups are fee-charging therapy groups designed primarily for ongoing care of members of particular occupations. They frequently welcome people who had their primary treatment elsewhere. While their function may indeed include giving support, they are not support groups in the usual sense of the word. They have been known to present themselves in misleading ways in order to attract more patients.

WHAT TO DO?
In spite of some headaches along the way, most of the professional groups can be regarded as safe. Certainly for most the benefits have far outweighed the problems and has lead to a lot of recovery, fun and fellowship. While a little bit of creative paranoia is probably a good idea and a reasonable amount of investigation is in order before making assumptions about a particular group, there is only one really important caveat: that worry about the suitability of a particular group must never be used to justify paralysis while drinking and drugging continues.

No therapist, treatment center or group of human beings is perfect. Sometimes even alcoholics and addicts themselves are imperfect, but together can do what would be impossible for anyone to do alone. When a group can help others escape from the isolation and loneliness that is the most painful part of addiction, it can be truly exciting. Join AA and IDAA now!