20 minute watch, 12 min read.
Medical thriller author and health care systems expert Darryl Bollinger joined me to discuss Darryl’s book Treatment Plan, a 2023 novel. Treatment Plan is a suspenseful thriller that immerses the reader in the complex and corrupt world of drug addiction treatment.
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READ the transcript below, lightly edited for length and clarity
Welcome to From Fact To Fiction
LINDA: Hello, everyone. Thank you very much for joining us today on From Fact to Fiction, where we unpack the truth behind my favorite specialty thrillers. Think Michael Crichton, Robin Cook, Tom Clancy.
And while these works differ in specialty, from spy to medical to techno thrillers, each immerses the reader in a new but realistic world. And the best of these blend fact with fiction so well that it's hard to tell the difference. You don't know what is, what could be, or what's totally impossible.
It will take an expert to know.
So each time we meet, I'll pair up with an expert and we'll select a new specialty thriller. We'll not only talk about why we love the book, but unpack the truth behind the fiction.
Introducing Treatment Plan
Our book today is the 2023 novel Treatment Plan by Darryl Bollinger.
It's about retired special agent Jon Cruz who lives a solitary life in South Florida. His best friend implores him to find his daughter who's vanished from a local drug treatment center.
Drug-addicted patients cycle into and out of treatment centers, staying only as long as their families or insurance pay. Families go broke trying to cure their loved ones. The cycle never stops.
Is this true? How can they stop the cycle?
That's the topic for today's episode.
Our Author/Expert Darryl Bollinger
Our expert today is also our author, medical thriller author Darryl Bollinger.
Darryl spent 28 years working in the healthcare industry and also has a master's degree in healthcare administration from Trinity University. He has eight medical thrillers.
Darryl's wish is that his readers will be transported and entertained in the same way that he still is today. That's why he writes.
And that's exactly why I love specialty thrillers. They take you to a world away.
Welcome, Darryl Welcome to From Fact to Fiction.
DARRYL: Sure, Linda, and thank you for having me today.
(To learn more about Darryl and his medical thrillers, see our Meet the Expert post, or go to darrylbollinger.com).
Unpacking the Facts Behind Treatment Plan
Let's get right to your book, 2023 novel, Treatment Plan.
Can you tell us a little more about it and what inspired you to write this book?
DARRYL:
The primary motivation was an NPR article that I read. In fact, I referenced that at the end of the book. It talked about dumping addiction patients, dumping them on the street corner in Delray Beach, Florida, which is where the novel is set.
And believe it or not, Southeast Florida is kind of the epicenter of the addiction treatment industry, the Mecca for drug treatment programs.
And I find it very disheartening to see things like that because I've seen it from the inside. And it's just horrific and wrong on so many levels. And so I wanted to be able to expose that and talk about that in a way that makes sense and that people can understand.
In this particular area, South Florida, the majority of the people in the addiction treatment centers and facilities in that area come from other areas of the country. And they actively recruit in other areas of the country.
A lot of people like to send their loved ones to that area because, one, there's a wide variety of options available. And two, it's a way to kind of distance yourself from what's involved in treating addictions.
LINDA: Yes, the book seems very realistic and horrifyingly realistic.
I read a line in your book that struck me and I still think about it: rinse and repeat.
Can you describe for our listeners what that means?
DARRYL: Well, I think Jon Cruz, my protagonist, says it best in the book. He's talking to his detective friend and talking about an overdose who was dumped in the streets of Delray Beach.
And when they're talking about this person, he says:
“Probably already back in rehab, rinse and repeat.’" He knew that for most addicts, rehab was a revolving door which suited the treatment centers. Typical of the U.S. healthcare system, you make money from doing things, not from fixing things.
And that is so much a part of our entire healthcare system, that it bears repeating and understanding that healthcare is truly a business. There's a profit motive in it.
You have for-profit players, not-for-profit players. You have individuals. You have voluntary agencies like Alcoholics Anonymous, Narcotics Anonymous. You have religious organizations involved.
But at the end of the day, health care is a business and everybody is running it like a business. And that's where that came from in terms of Jon. That was his attitude.
In any industry, there are good players and bad players. But there are too many bad players, in my humble opinion, and the bad players want to repeat the cycle. And treating any kind of mental health issue, like addiction is very complicated and it's usually a long-term prospect.
So you can't just admit somebody to a treatment program for a week and expect them to be, “cured.” It's a much longer process than that. And so I think a lot of players want to really have people come through the revolving door and come back into the system so that they can make money off of that.
And it's sad and it's horrifying to even say it out loud, but it's so true. And again, I saw it firsthand.
LINDA: Yeah, I was struck by that. And in the book, one of the companies is actually going to IPO. And so they've got to put forth a great bottom line for their quarterly report to send to their potential shareholders. And it's not just those. They are also, I think, owned by private equity, right? They will always try to eke out that last little bit of profit margin.
DARRYL: Yeah.
LINDA: So would you recommend going to a non-profit treatment center, assuming they exist?
DARRYL: No. Not really, and the reason, Linda, is I really dislike the moniker not-for-profit. I worked for a large not-for-profit hospital system.
And I think it's misleading because that leads you to believe that the entity is not interested in maintaining a bottom line, if you will. And basically, even nonprofits or not-for-profits, whether they're religious organizations or any other, they have to make money, to exist and to be able to provide things. So I really dislike the term not-for-profit because they're all trying to make a profit, some more aggressively than others and some more, I think, morally correct than others.
But they're all trying to make a profit. And I don't think that should be the single criteria for seeking out a particular treatment center.
LINDA: Is there anything you'd like to tell us about, how they operate in the real world from a patient's perspective?
DARRYL: One thing I guess I should clarify is there are a lot of different types of treatment centers. But they're interconnected. You have inpatient care, which is an inpatient program, which means you check into a program and you're there. You have outpatient programs. You have individual therapists and counselors. I already mentioned voluntary agencies like AA. You have religious organizations.
And part of the issue is there are varying degrees of regulation involved in those different types of entities. And that's one of the reasons Florida has always been such a mecca.
And I'll give you a good example, which to my knowledge is still true.
Everybody's heard of halfway houses or sober homes. They go by a lot of different names. Well, in Florida, those are totally, completely unregulated. If I want to go out and open up a sober home in my neighborhood tomorrow, provided I meet the zoning requirements that some communities have, there's no licensing required for that. There's no background check on me to do that.
And some of the more unscrupulous ones, they will take referrals or give referrals to other people that are in the chain.
There's numerous examples. Some of the more devious ones, they will actually recruit an addict to go into a program for the sole purpose of recruiting patients for another type or another modality of treatment and they get paid a bounty for that. All of which is completely illegal and immoral but that kind of thing goes on.
I think the best thing I can say is do your homework. Don't trust the ads or even referrals from other people, because a lot of people don't know or see all these things that go on behind the scenes.
You have to be your own advocate, either for yourself or for your loved ones. And don't be afraid to ask questions. If you see something that you think is suspicious, ask a question about it. If you don't get an answer you'd like, contact the appropriate authorities. Let them investigate. And don't hesitate to do that. That keeps the good programs good and it helps root out the bad programs.
But it's very, very difficult because there's no registry that you can go to. Ratings are worthless. They don't really mean anything. You just have to be careful and do your homework.
I don't mean to depress you with all of this.
LINDA: laughs. It's so enlightening. The information is great and it makes for such terrifying fiction, right? That's why we write thrillers. What would thrillers be without bad guys? And you've got them at your fingertips and everywhere.
Well, is there anything else you'd like to tell us about the facts behind the fiction of the book? I asked you a lot about drug treatment centers. Is there anything else you'd like to add?
DARRYL: I guess the only thing I would add is the title Treatment Plan. There's some fact behind that. I know for a fact that some facilities–again, there are scrupulous and legitimate ones– but for the unscrupulous players, this is not unheard of: When you admit a loved one to a treatment center, the first thing they want to know is how you're going to pay for it.
Are you going to write a check? Is it covered by insurance?
Most of them do what they call treatment plans. Basically, this is a document that they prepare for your particular care and your particular illness, whatever it may be.
And I know for a fact that there are facilities that tailor the treatment plan to the payment.
If, for example, you have health insurance that covers 30 days in a treatment program, surprisingly not, the “treatment plan” they come up with for you is 30 days. And if the next person that walks through the door with the same presentation, the same pathology or similar pathology, and their insurance only covers two weeks, then guess what? Their treatment plan is a two-week treatment plan.
And this is not made up. This actually happens. People should be very cautious in terms of evaluating different programs and how they work.
To me, the treatment program should be somewhat independent of your ability to pay, but again, all these places are businesses.
LINDA:
And unlike critical care in a hospital, I saw a quote in your book: “no payment, no service, no exceptions.”
And I guess it probably is that way?
DARRYL: It very much is so. And even for those that have insurance, when the insurance runs out…And that gets back to the patient dumping.
As referenced in the NPR article that kind of was the genesis for the book, this happens on a regular basis when people are literally kicked out on the street because they or their family can no longer afford to pay, which is just horrible.
I actually made a couple of visits to Delray Beach and talked to some of the local people. And I ended up talking with somebody in a restaurant. Her husband was a first responder in Delray Beach. And I was telling her about [the book]. And she said, my husband can tell you, this happens on a weekly basis where patients–or residents as are a lot of times called in these programs–are dumped on the street because they can no longer afford to pay.
LINDA:
Wow. So, I guess usually we end this by saying, okay, fact or fiction?
But I think we know the answer here. So, does Treatment Plan accurately reflect the business of drug treatment centers? And I think you'd say our answer, unfortunately, is absolutely fact in this case, right?
DARRYL: Yeah. Unfortunately, I think it is.
People ask me all the time, for all of my books, is this really true? And I tell them, I said, well, it's fiction based on fact. And that's the way I write it. I want it to be authentic and representative, good and bad.
And unfortunately, you get both of those.
LINDA: Goodness. All right. Well, thank you. I think our time is done.
And then our facts, we have unpacked the facts behind the fiction.
And I'd just like to thank you so much for joining us today, Darryl.
Please come back and speak to us about elder care, and maybe some of your other books, too. We love to hear about all of the other aspects [of the health care system]. It's really so interesting to get this knowledge from an expert. And so it's been so great to have you here.
You'll come back, right?
DARRYL: Absolutely. And thank you again for having me. I enjoyed it and always love to talk about health care and the things that go on in the health care system.
So thank you again.
LINDA: Thank you.
We'll post all the links to your books and a link to the NPR article and keep everyone posted on your upcoming release and all the other book reviews that we do.
So thank you again, everyone, for joining us and have a great day.
Find Darryl at darrylbollinger.com. Read the NPR article here.
Note - If you are interested in being an author/expert on the show, please drop me a note or leave a comment.
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