Pubdate: Tue, 21 Jan 2003 Source: Abbotsford Times (CN BC) Copyright: 2003 The Abbotsford Times Contact: http://www.abbotsfordtimes.com/ Details: http://www.mapinc.org/media/1009 Author: Dr. James Zacharias Bookmark: http://www.mapinc.org/find?136 (Methadone) METHADONE TREATMENT DICTATED BY ADMINISTRATORS, NOT DOCTORS THE EDITOR: Thank you for headlining the article 'Swanney takes on doc college' [Times, Jan. 10], about former Abbotsford doctor James Swanney. It maintains the memory of this great human being in this town. Some corrections are in order. Peter Hickey is in charge of the B.C. College of Physicians and Surgeons' methadone program but he's no doctor. He's not even an MSc. He's got no graduate degree of any kind. The only initials he can support are B.A., B.Ed., B.S. [Pharm]. His work history has been in the government employ as a civil servant. I first saw his name on a rubber stamp in 1986 in the Ottawa narcotics department. He eased out here when the federal government made narcotic control issues more provincial. He hasn't done clinical work in his field for an obvious long time. Yet he wields big bureaucratic power in this area where the art of medicine ought to flourish. Close interpersonal professional relationships not bureaucratic paper trails should manage patients requiring management of the disease of narcotic addition. The situation cries out for a big readjustment of strategies here. The situation would parallel that of an accounting running a diabetic clinic. Just picture it: "Keep them insulin doses down, too much can be fatal, you know." You won't find Dr. Carl Strohl's name in the physician registry either. [He was part of the team that critized Swanney.] He's a psychologist. MSP doesn't cover psychologist services. He and his cronies need methadone patients to cough up $60 a month. It is in his self-interest to insist that methadone patients must get professional services. Only big clinic settings can provide the infrastructure to include his ilk. He may find it tempting to be less than objective when his opinion is sought in an audit. There are things that could be said regarding Dr. Ray Baker, but the details are getting long for this discussion. Hickey is right when he says, "One of the goals is to normalize life the methadone patients." What he doesn't say is that the restrictions he enforces ensures that no patient can have a normal life. They can't start work until the pharmacy opens and they take their medicine there. What employer would stand for a worker never being able to start before 9 a.m. one to five days a week? This doesn't even address the regular visits required to a far distant clinic one to four times a month to see the methadone clinic doctor for 15 seconds. Hickey is many paper shuffles away from reality. If the B.C. methadone program is "recognized as the best program in North America," it is so only in the eyes of the administration types. Here on the ground, the B.C. methadone program is truly an indignity foisted on the most unfortunate patients of our communities. You wouldn't treat your sick mother this way. Dr. James Zacharias Abbotsford - --- MAP posted-by: Josh