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February 21, 1995

Ask Dr. Salvo

Dear Dr. Salvo,

Herewith enclosed find several secret documents I stole for you last month. Just as you had heard it rumored, they bear certain resemblances to public documents. I call them secret because hardly anybody has ever heard of them before. Not long ago one of our residents was fired because he would not comply with a new rule -- the Drug Testing Policy. The latter was promulgated, sort of, in August 1994. These documents, however dull, should see the light of day, so here they are. Please excuse my indignant annotations!

Your doubly faithful,

TO: All Employees
FROM: Stephen Simmons, Senior
Hospital Administration
RE: Drug Test Policy
DATE: August 10, 1994

The University of South Alabama Hospitals are committed to maintaining a safe, healthy and efficient work environment for all employees and to rendering the highest quality of health care to our patients. In keeping with these goals, USA Hospitals will immediately implement a new Drug Testing Policy.

Since the policy calls for a change from our current practice, employees are encouraged to carefully read the policy and discuss questions they might have with their department head. The attached brochure will fully explain the policy as it relates to new employees and current staff.

The implementation of this policy is a positive step toward the assurance that all USA Hospital employees will have a drug-free work environment, providing a safe and productive work place for our staff.



The goal of this Policy is to provide and maintain a drug free work environment for all University of South Alabama Hospital employees. Such an environment is supportive of the objective of USA Hospitals to establish a safe and productive work place, and is necessary to assure the highest standards of care rendered to patients.


The use, presence in the body, sale, distribution or possession of drugs by University of South Alabama Hospital employees while working or while present on University Hospital property is prohibited. Over-the-counter drugs and drugs prescribed by a physician for the employees' personal use in quantities not exceeding reasonable or specified dosage requirements are not subject to this Policy. Employees using medication prescribed by a physician or using over-the- counter drugs are responsible for being aware of any potential effect such drugs may have on their reactions, judgement, or ability to perform their duties, and if impairment is possible, to report such use to their immediate supervisor either at the time of reporting to work or prior to reporting to work.


Each person who is accepted for employment by the University of South Alabama Hospitals will be required as a condition of employment to submit to a drug screen test. The Health Nurse or her designee will initiate the drug screen test during the pre-employment physical.

Prospective employees should advise the Health Nurse or her designee, at the time of testing, if they are under the care of a physician and receiving prescribed medications which might cause a positive drug screen test. Individuals testing negative, who complete all other aspects of the pre- employment process, will be eligible for employment. Individuals who have unsatisfactory test results may be reconsidered for employment after providing documentation to the Personnel Manager that they have successfully completed an approved drug rehabilitation program. Notice regarding applicant drug screening will be posted in the Personnel Relations Department reception area for reviewing by prospective employees.


All temporary employees, student employees, regular staff, administrative personnel and physician housestaff of University of South Alabama Hospitals are subject to alcohol and/or drug screen tests, at the determination of the employees' department head, the Administrator on-call or the hospital Administrator, as a condition of continued employment, under the following conditions:

1. If there is reasonable cause to suspect that the employee is in violation of this policy; or,

2. If the employee is or may have been involved in a job site accident or incident which results or might have resulted in serious bodily injury or property loss or damage; or

3. If an employee is selected at random for testing in order to monitor and ensure compliance by all employees with this policy.

The University of South Alabama Hospitals recognize that drug abuse and/or dependency are medical/behavioral conditions that can be successfully treated. Confidential assistance with these types of problems are available through the University of South Alabama Substance Abuse Education Prevention Center.

If an employee tests positive, under condition stated in #1, #2, and/or #3, unless it is otherwise set forth, the employee will be required to accept a referral to the University of South Alabama's Substance Abuse Education Prevention Center. Failure to accept the referral and/or failure to complete rehabilitation established by the Substance Abuse Counselor, will result in termination. Notwithstanding the above, in certain instances where an employee has caused bodily harm or death to a patient, another employee or individual at the work place, and a positive drug or alcohol test has followed such occurrence, disciplinary action, up to and including termination, may be taken.

Upon successful completion of counseling of the established rehabilitation program, the employee must submit a letter of release from the treating facility indicating any follow-up treatment, prior to their return to work. Failure to comply with follow-up treatment will result in termination.

When an employee returns to work, he/she will be required to sign the agreement for Conditions of Employment in the office of Personnel Relations and will be subject to unannounced drug/alcohol testing for 12 months or longer as recommended by the Substance Abuse Counselor. Failure to abide by the Conditions of Employment will result in termination.

An employee who refuses to submit to drug testing as provided for in this Policy will be terminated immediately.

Dear Doubly,

These are indeed curious documents. I would like for S.I.R., the Serious Investigative Reporter, to enquire into such questions as: How many faculty members received this flyer? When? Was there any discussion with the faculty senate (or other such body)? A neat way for the administrators to settle all this would be to put everybody on probation/suspension until the requisite body fluid had been tested; then reappoint them if they are still interested. Or, fire everyone now and start over?

What astounds the reader is the total innocence of the implications of such a policy, as indicated by the debonair dismissal of rights against illegal search and seizure (in Item 3 under Employee Drug Testing). What about self- incrimination? Is this why USA is called "Oblivion U."?

Other questions for S.I.R., or indeed, Doubly, for you and fellow moles to investigate:

Who gave this policy to Mr. Simmons for (alleged) distribution? Who wrote it? Who asked for it? Doesn't this document unwittingly set forth the doctrinaire views of the PRN, i.e., proof of use = proof of abuse = proof of impairment in the performance of professional duties = grounds to confiscate medical license or to fire the employee? Yes, it does.

"The employee will be required to accept a referral to the University of South Alabama's Substance Abuse Education Prevention Center"? How so? Suppose the targeted employee has decided to go to Betty Ford's place, or Mayo's, or Menninger's?? Isn't it illegal, or at best unethical to forcibly refer patients to yourself? [This is the besetting sin of PRN -- dictating to physicians where they must be treated, by what methods, and how long. Conflicts of interest are broadly visible in such shady maneuvers, and will be part of at least one current lawsuit in Mobile and Montgomery.]

In the next issue we will enlighten our readers with the glad news about Dr. Douglas Talbot of Atlanta, and his plans to replace the mental health departments of each state with a tidy little committee of doctors reporting to and remitting to -- himself, the Dalai Lama of all forms of self abuse, pardon the expression.

Meanwhile, moles and fellow pilgrims -- look alive! Sue somebody! Courage, Doubly!


P.S. The Salvo vs. MASA suit has just been referred to the Supreme Court of Alabama. If it turns out well, a number of you Caduceans have constitutional (civil rights) grounds for more suits.

-- February 21, 1995

The Harbinger