How many piano tuners are there in Chicago?


Do you know how many piano tuners there are in Chicago? Or closer to our primary purpose, how many problem drinkers could be referred to AA through HCP (health care professionals)? The answer to the latter is cause for both concern and grounds for hope.

There is no correct answer to these questions in any practical sense because no one knows the answers. However it is possible to get a very close approximation using what is called “Fermi problem solving.” A Nobel Prize winning physicist, Enrico Fermi (1901-1954), was famous for being able to make estimates with little or no actual data, for questions that seemed impossible to answer.



The method, still used by Google in open-ended job interview questions, relies upon a process to discover what we don’t know. There are an infinite number of ways one might solve these problems, but the final number is not the point—the thought process, the set of assumptions and deliberations, is the answer. 

Reflecting on my last ArenA post, “Data Matters” and contemplating what to write about this month, it struck me how impossible it is to know with absolute certainty what inspiration, intuitive thought or decision my Higher Power has planned for me today. What I do know is that the process of earnestly practicing the principles of AA in all my affairs, will get me closer to  knowing—without knowing, what is the next right thing to do (or write about ;-). 

Ready to learn how many problem drinkers could find AA after a nudge from their doctor or therapist? Let’s apply Fermi’s process to discover the potential. 



We start off with what is already known. Then make rational assumptions until .. viola! a close approximation emerges. Follow along:

  1. The European Commission estimates there are 90’000 working psychiatrists in the EU. Since health professionals may also include psychologists, therapists, addiction counselors, GPs, etc., let’s round that number to a conservative 100K practicing professionals in CER.
  2. As the CER Health Liaison Officer (HLO), I’m privy to data from recent membership surveys in Basel, Zurich and Aviano, Italy, fellowships. Those surveys found 20% of Basel, 25% of Zurich and 28% of Aviano AA members began their recovery journey through HCP referral.
  3. Next we make an assumption that a single HCP sees 5 (new) patients per week and works 40 weeks per year for a total of 200 patients. And let’s presume 20 of those 200 (10%), exhibit problem drinking symptoms. 
  4. Now a little math and extrapolation: 100K HCP x 20 potential alcoholics is 2 million and multiplying 2 m. x 20% (the low end of HCP referrals documented in recent surveys), AA in Europe could be on-boarding 40,000 new members per year! 
  5. Perhaps our host nation fellowships are seeing robust numbers of newcomers referred by HCP? If so, God bless. But supposing 5% of those 40K referrals choose an English-speaking AA group. From a pool of 40’000 referrals, we could be seeing 2000 new members per year swelling CER ranks. 

I don’t know about yours, but in my Zurich fellowship, we are delighted to welcome 2-3 newcomers per month and ecstatic if one of them is ready to truly surrender, get a sponsor and stick around for the miracles to come. 



The disparity between this Fermi guesstimate and observed reality could be cause for concern. However, even if my back of the envelope guesstimating is way off, HCP are ideally positioned to help many alcoholics by cooperating with local AA groups for their patients. 

Lives saved, families reunited, self-respect restored—by reaching health professionals with a message they understand is clearly for the benefit of their patients—humbly putting our own amazing stories of recovery in the background.

Review my article, The Distinction Is Not Trivial, because too often when carrying the message to professionals, we forget they are not an alcoholic, nor do they care about OUR recovery. HCP only interest is what we can offer THEIR patients. Delivering 1) the message that AA is an ideal support community for patients who want to stop drinking and stay sober, and 2) data proving AA facilitates long-term sobriety, cooperation with local HCP can begin and referrals follow.

According to the 2020 GSB membership-wide survey, there are 723 English Speaking Groups in CER. The same survey reported CER has 1720 – 3260 members. Rounding to 2500, and applying the Swiss surveys’ 20% HCP referral rate, means around 500 of us got here thanks to our friends in the health profession. Those 500 likely informed their GP or HCP of their “allergy to alcohol.” Maybe they went further, crediting AA as the key to joyful living despite being an alcoholic. Or maybe not … yet? 

Since Feb. 2022, I’ve helped establish three HCP outreach working groups (OWG) in my home country of Switzerland and one in Italy. The data-driven outreach approach was developed and tested in Basel and Zurich, then copied and executed by Kit K. in Aviano, where she scored a big win on a nearby NATO airbase. Now Geneva, where the Swiss medical establishment utterly failed to prevent another alcoholic death of despair earlier this year, has launched and is collecting survey data as you read this. 



These outreach initiatives began without Fermi estimations, government statistics or large folding money budgets. They began with one alcoholic talking to another. Newcomers shared with me at local AA meetings, at IG and privately after meetings, how their counselors or doctors didn’t understand their drinking problem and worse, dished out terrible advice (just control your drinking). Then in the same breath they leaned in and asked, ‘So what are we going to do about it?’ 

That’s the question I ask you to raise at your group’s next business meeting. Before sending 7th Tradition donations “down” the service structure, propose allocating a few hundred EUR to reach 100 local HCP with an offer of cooperation. Think of the impact: if only 10 local health professionals out of 100 refer one patient per month to English-speaking AA, it’s possible to add 120 new members per year to your fellowship. 

Aviano showed successful outreach can be realized with only one member taking action. In contrast, English-speaking AA Zurich counts 80 members, 18 meetings/week and a strong Intergroup. But Zurich OWG have received little support from IG to date; its 8 active members (and counting) organized from a personal motive to carry the message to HCP who are uninformed, misinformed and possibly prolonging the suffering of alcoholic patients.



I or newly organized OWG members, can show you, or your group, how to quickly and easily start HCP outreach in your local community—regardless if you’ve never done PI or any service outside your group before. There’s no minimum sobriety required—just willingness to pass along what was freely given to all of us. 

On a parting note; while participating in these fledgling OWG meetups, it’s impossible not to recognize the spontaneous smiles, laughter and camaraderie being of service generates. You don’t want to miss this. Contact me and let’s get HCP outreach started in your city!


Submitted by Joel B.

Health Liaison Officer (HLO) of 

Continental European Region of Alcoholics Anonymous Great Britain


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