Dental, Medical boards wield enormous leverage over licensees, but Supreme Court ruling could temper that

Posted on Louisiana Voice

February 23, 2019 by tomaswell

Trying to decipher which was the first to employ Gestapo-like extortion as a means of controlling licensees is like solving the chicken-or-the-egg riddle, but there’s no question that the methods employed by the Louisiana Board of Dentistry and the Louisiana State Medical Licensing Board are eerily similar.

Both employ highly questionable investigative methods, both impose stiff fines followed by even more outrageous fines if the licensee displays any will to resist what may even be bogus charges, and both make generous use of the most effective punishment: revocation of licenses—taking away the victim’s very means of earning a livelihood.

And both also occasionally force recalcitrant dentists and physicians to attend costly rehab clinics either in addition to or in lieu of license revocations. And those rehab clinics can cost as much as $30,000 a month.

Sometimes, a professional is sent to a facility that has its own abuse problems. Take the case of Slidell dentist KENNETH STARLING, who, in addition to having to pay an $8,000 fine, was sent by the dental board to a place called Palmetto Addition Recovery Center in Rayville in Richland Parish in 2010.

But PALMETTO, it turned out, was involved a 2009 lawsuit after one of its staff members, Dr. Douglas Wayne Cook, became sexually involved with one of the center’s patients.

And even while at Palmetto, the dental board continued targeting him. Could that be because he practiced in the same town as influential board member Dr. Edward Donaldson?

And while the practices of the dental board have been publicized often by LouisianaVoice, the state medical board essentially plays by the same rules. And, just as with the dental board, the name of Palmetto Addiction Recovery Centers surfaces on a regular basis in report after report, along with Pine Grove Recovery Centers in Hattiesburg, Mississippi, and Physicians’ Health Foundation of Louisiana.

I have chosen to delete the names and locations of the following examples, but the cases serve as examples of an uneven playing field, often dependent upon on the physician in question:

Following his arrest on charges of distribution and possession of controlled and dangerous substances in 2005, Dr. __submitted to substance abuse evaluation at Palmetto. “Apparently, the physician had submitted to chemical dependency treatment on two prior occasions. Upon his discharge from Palmetto, he underwent residential treatment at Pine Grove. His license was reinstated in 2009 but in 2013, the board received information indicating that the physician “had returned to the use of controlled or other mood-altering substances.” In 2018, after being placed on indefinite probation in 2014, his license was “reinstated without restriction.”

___________entered a plea of guilty to one count of Medicaid fraud in 2002 and subsequently underwent in-patient chemical dependency evaluation for cocaine abuse. Following completion of his criminal penalty, he was referred to Physician Health Foundation’s Physician Health Program (PHP). Following his reinstatement in 2008, he was disciplined again in 2018, this time placed on probation for unspecified violations.

___________ was diagnosed in 1999 with cocaine and alcohol addiction and in 2000 was referred to Talbott Recovery Campus in Atlanta, Georgia through Physicians’ Health Foundation and later to Fontainebleau Treatment Center in Mandeville. His license was reinstated in 2006 but in 2007, he again came under scrutiny for drug abuse and was again referred to a PHP monitoring program and he was placed on probation by the board for a 10-year period in 2008. He was reinstated “without restriction” in 2018.

____ entered a plea of guilty to one count of health care fraud in 2009. In addition to criminal penalties, the board suspended his license for 90 days, placed him on probation for five years, and fined him $3,000. Following his reinstatement in December 2009, it was subsequently learned in 2011 that he had been issuing prescriptions of narcotics, including OxyContin, from his home and vehicle since May 2009 under the auspices of a practice site not approved by the board. The board again suspended his license, this time for six months and he was placed on probation for 10 years.

_____ voluntarily entered into a two-week program at DePaul Hospital in New Orleans for cocaine dependency in 1995 and 1996 before transferring to Talbott Marsh in Atlanta. The board in 1998 ordered him into additional treatment in PHP at Palmetto and placed him on probation for five years. In 2003, he was again placed on five-year probation for failure to comply with requirements set forth in the 1998 order. His license was reinstated “without restriction” in 2018.

But when a Lafayette NEUROSURGEON becomes involved in suspected arson and subsequently enters a plea of guilty to one count of felony obstruction of justice, the Louisiana State Board of Medical Examiners is strangely silent.

Dr. Nancy Rogers was arrested in 2012 in connection with the fire at Levy-East Bed & Breakfast in Natchitoches, a blaze that caused $500,000 in damage to the unoccupied building. No motive has been given for the fire, but investigators determined it to have been intentionally set.

But in the case of Dr. ARNOLD FELDMAN of Baton Rouge, the board came down especially hard.

In a terse December 20, 2018, LETTER TO FELDMAN, board Executive Director Vincent Culotta, Jr., wrote, “Per the decision and order of the Louisiana State Board of Medical Examiners dated April 13, 2015, the amount due is as follows:

Cost of proceeding—$456,980.60
Administrative fine—$5,000
Total: $461,980.60.

This is not intended as a treatsie on Feldman’s guilt or innocence, but it’s rather difficult to fathom what “proceedings” could cost nearly $457,000 but that’s the way the dental and medical examiners boards operate. While members of both boards are appointed by the governor, they are apparently accountable to no one and able to set fines and costs at whatever amounts they wish.

Feldman served briefly as a member of the Physicians’ Health Foundation until he started asking questions that made certain people uncomfortable. Four months later, he found himself in the board’s crosshairs. But during his short tenure, he learned that the medical board funnels about a million dollars a year into the foundation. Apparently, there is no accounting for those funds.

Moreover, he said, the so-called “independent judges” hearing cases for possible board disciplinary action are paid by the board investigator’s office, which creates something of a stacked deck going into the process—not to mention an obvious conflict of interest.

Physicians aren’t the only ones to encounter an uncooperative medical board. The Legislative Auditor was forced to SUE the board in order to obtain board records so that it could perform its statutorily-mandated job of auditing the board’s financial records.

Senate Bill 286, the so-called physicians’ Bill of Rights, passed the SENATE by a unanimous 36-0 vote last year but never made it to the floor of the House after being involuntarily deferred in committee.

But a rare unanimous DECISION by the U.S. Supreme Court exactly two months later, on February 20, could impact the way these boards mete out exorbitant fines.

Even though the high court’s ruling on Timbs v. Indiana is considered a blow aimed at criminal justice reform, particularly in the so-called policing for profit through asset forfeiture, its effects could spill over into the way civil fines are handed down by regulatory bodies.

The ruling, written by Justice Ruth Bader Ginsburg, falls back on the Eighth Amendment that guarantees that no “excessive fines” may be imposed, a concept that dates back to the Magna Carta and later embraced by the framers of the U.S. Constitution.

It will be interesting to see if any dentist or physician victimized by either of these boards files legal action based on the Supreme Court’s most recent ruling.

If someone does, it could be a game changer.

Louisiana Voice

Trying to decipher which was the first to employ Gestapo-like extortion as a means of controlling licensees is like solving the chicken-or-the-egg riddle, but there’s no question that the methods employed by the Louisiana Board of Dentistry and the Louisiana State Medical Licensing Board are eerily similar.

Both employ highly questionable investigative methods, both impose stiff fines followed by even more outrageous fines if the licensee displays any will to resist what may even be bogus charges, and both make generous use of the most effective punishment: revocation of licenses—taking away the victim’s very means of earning a livelihood.

And both also occasionally force recalcitrant dentists and physicians to attend costly rehab clinics either in addition to or in lieu of license revocations. And those rehab clinics can cost as much as $30,000 a month.

Sometimes, a professional is sent to a facility that has its own abuse problems. Take…

View original post 1,141 more words


2 thoughts on “Dental, Medical boards wield enormous leverage over licensees, but Supreme Court ruling could temper that

  1. Michael, you should get a prize for your website and the investigative journalism that the whole site represents.

    I am very pleased when I hear you talking about declaring “war” on these jokers. Especially you. We have some others among us that simply don’t have what it takes to be (figurative) killers. Some have resigned themselves to setting up shop (and home) in the labyrinth they got dropped in. They don’t really hope to get out. They just want to make it a little more comfortable in the present zeitgeist. We have others which are “ragers” but cannot really drive their protests home. I mean, that is okay. Most people when they are feeling strong feelings make “emotional gumbo” out of it. Ha! Anyway, my comment is not to disparage others but to express my appreciation of you. Everybody has a place. You and me? We’re (figurative) killers – maybe serial killers. Ha! 😉

    *Important disclaimer:* All allusion to physical violence is COMPLETELY figurative. Christian Wolff has no plan, intention, or will to literally physically harm anyone and he actively discourages all forms of physical violence.

    On Sat, Mar 16, 2019 at 3:13 AM Disrupted Physician wrote:

    > mllangan1 posted: ” ” >


  2. My Life and career were destroyed way back in 1994 by the KY Medical Board. NC Not much better.
    If you want actual names check up on previous post on the North Carolina Medica Board (NCMB) Facebook site. Unfortunately, FB is a terrible, confusing, disjointed, chaotic, dysfunction site to organize any effective media support. Medical Error Transparency Plan (METP) on FB not cohesive.
    My May 12 2019 Post on Facebook at North Carolina Medical Board (NCMB) site

    What is the real purpose behind the North Carolina Medical Board’s (NCMB) Facebook page? On its official website, its stated purpose is “to regulate medicine and surgery for the benefit and protection of the people of North Carolina.” From that site, the public is directed on how to file a grievance against a NC physician. The NCMB’s Facebook page, in contrast, seems to feature an endless stream of pictures of the board members and the meetings, schedules, and ceremonies, all designed to give the public the impression that the NCMB is working diligently on the public’s behalf. In reality, it is a purely social media site to promote itself favorably to the public.
    From my ex-physician standpoint, there’s a lot more going on behind the NCMB’s closed doors than the public realizes, including scapegoating or destroying some physicians’ careers and lives for public relations or “other” agendas. In all but the most ridiculous grievances filed by vindictive patients (e.g. like my patient who complained to the NCMB because I would not support her request for total disability from knee arthritis) the NCMB has a purely adversarial relationship with physicians. This is actually a situation which lawyers, NC Physician’s Health Program (NCPHP), treatment facilities such as Pine Grove Recovery Center in Hattiesburg, MS, hospital administrators, corporations and competing physicians exploit: “Comply or we will report you to the NCMB and label you as a ‘disruptive’ physician.” I think the NCMB claims that its members are almost entirely physicians, as if all physicians are honorable and have noble intentions. Nothing could be further from the truth, and there is always a Judas in every group. Same goes for the legal profession. My basis for making these accusations is outlined in my book and supported by my bitter and devastating personal experience, hospital, court and legal records, videos of proceedings, and newspaper sources. No one would believe me otherwise.
    In my case, the NCMB basically harassed me for a 7-day suspension in 2002 for publicly chewing out a lazy registration worker at Albemarle Hospital, Elizabeth City, NC. She should have been fired on the spot for obstructing registration of a patient who was in severe distress when in fact all the paper work had been done. The NCMB used this one event to launch a full-blown investigation of me as part of its new crusade against the so called “disruptive physician.” This investigation initially included a screening referral to the NCPHP, even though my 7 day suspension did not meet the NCMB’s stated 10 day requirement for an NCMB investigation in the first place. NCPHP cleared me. Stressed out from the NCMB harassment, the Albemarle Hospital Medical Executive Committee (MEC) suspension, and the Albemarle Hospital administrator Sharon Tanner who had an agenda of driving me out, I electively went on courtesy staff which meant I would not be required to take emergency room call. No matter. When I did not appear in the emergency room to see a non-emergent patient at midnight before a long trip, my orthopedic surgery competitor, who had been trying to run me out of town because I would not join his practice (which would allow him to reduce his overhead and have a captive buyer when he retired but wanted me to continue paying my ongoing rent on my office, and whom I suspect was largely the reason the previous 5 orthopedic surgeons had left after only two years each) reported me to his crony on the MEC. Another crony, the Chief of Surgical Staff, scoured the by-laws for grounds to suspend me. My patient was “admitted” by my competitor, whom I had on occasion quietly covered for when he had a conflict in Edenton, NC. I returned 4 days later from my trip, and my patient was sitting in his wheelchair in the parking lot, smoking but had received no treatment for his still dislocated total hip replacement. Some “emergency!” This time, I received a 30 day suspension. The suspension stated that this “would serve as precedent for any such future acts,” except of course, when it didn’t. From there, an evaluation by the Center for Professional Well Being in Durham, NC was ordered, and then a 3rd evaluation by the NCMB’s own forensic PhD psychology and MD psychiatry experts in Raleigh who performed a complete battery of psychologic testing. These experts were left wondering: “Why are you being evaluated so many times?” All three of these investigations cleared me, and specifically, no formal medical or behavior therapy was “required.” In my opinion, that was a subtle way of saying, “you’re getting screwed, Dr. Hubbard, but we can’t admit that to the NCMB. They are a referral source.” I was finally sent to Talbott Recovery Center in Atlanta for a 4th evaluation. EVERY physician who was referred there under threat of Medical Board action if he did not comply received a recommendation for 3 month in-house “therapy,” meaning he would be torn from his practice and could have pay up to $50,000 for his “treatment.” After all, these facilities had beds to fill. Many of these treatment centers were not covered by insurance. NCPHP had been investigated by the NC State auditor for this cozy relationship between NCPHP and certain select treatment facilities. This arrangement was essentially enabled by the threat of the NCMB taking action against the hapless physician if he did not comply. In my case, it was “comply Dr Hubbard, or we will report you to the NCMB and they will revoke your license.” Pure extortion. I “chose” to go to Pine Grove. My exile would allow Tanner to bring in another surgeon to take over in addition to the one she had recently recruited. This second surgeon however withdrew. On my arrival at Pine Grove, I was suddenly “diagnosed” as an alcoholic and/or drug impaired physician and required to attend Caduceus, the 12-step program, AA meetings, submit to urine drug screens, even though there had never been any failed test, accusation, suspicion, inference, rumor or evidence of me ever having been an impaired physician or inappropriately prescribing narcotics, etc.! In fact, my DEA license is still good until October 2019 with no history of any restriction or investigation since I had started internship in 1982! Then I was accused of being a sex addict and had to attend sex counseling. I was surprised I wasn’t diagnosed as a pedophile! But wait! Actually, the counselor there accused me of going to the mall to pick up girls! Then I was accused of being a philanderer and required to read a book called “Man Enough.”
    When I returned to Elizabeth City and tried to pick up the remains of my “career,” I let NCPHP know what had happened. Immediately, and without any written communication, NCPHP released me from my follow up contract over the phone, and I never heard from them again. Then I finally received a one-line written notice from the NCMB that its investigation was over. Meanwhile, the orthopedic replacement hired during my exile turned out to have been the alcoholic all along, and he left for Farmville, Virginia!
    Later, the Albemarle Hospital administrator, Sharon Tanner, was caught in an extortion plot to drive out a local radiation oncologist who finally had to mic herself, and wound up receiving a settlement for a sealed amount and left.
    My competitor’s arrangement with another colleague in Edenton which had been in violation of the medical staff by laws had been used to isolate me with no call coverage, otherwise, he arguably would have been more amenable to a local cross coverage arrangement. When I challenged Tanner on the call radius bylaws, she got the hospital attorney’s opinion, which she would not disclose. No matter, the bylaws were suddenly changed to accommodate my competitor’s arrangement whereby he could isolate me with no coverage while he and his “partner” from Edenton could cover for each other.
    Still later, other active staff doctors were refusing to come in to see their own patients when requested by the ED. Nothing happened to them. I asked Robert Powell MD the chief of MEC who had suspended me, “Hey Rob, I said waving his memorandum! How come I get suspended 30 days for my first and only offense while on courtesy staff but these doctors on active staff have multiple violations, and yet nothing happens to them? I thought I had set a precedent? His only response was “I’ll be so glad when I am no longer chief of the medical executive committee.”
    There’s more. Both the Chief of Staff and the Chief of Surgery who had signed my suspensions quite hypocritically had physically assaulted nurses!
    Later, I learned that the neurosurgeon at Albemarle Hospital had abandoned his patient by not coming to see her in the emergency room for a critical post-op epidural back surgery infection. That patient died several days later. He could no longer practice, presumably because he was now uninsurable. Suspension? Like my 30 day suspension? Never! This surgeon was rescued by Tanner with the creation of his position as Chief Medical Officer and $275,000 salary!
    A year after I left the hospital in 2013, Tanner was suddenly escorted out of the hospital under police guard. Apparently, when she arrived at the hospital around 2000, the hospital was in the black around 40 million, but when she left in 2013 the hospital was in the red around 100 million. She had been reportedly raking in a $400,000 a year salary while she slowly ran the hospital into the ground.
    There were hardly any tears upon Tanner’s departure. I am still trying to find the YouTube video posted by all the OR techs and nurses who lined up Riverdance style and sang a parody called “Ding-Dong the Witch is Gone.” Incredibly she had also left a mess at her previous hospital position in northern Virginia.
    Even more incredulous was learning that the neurosurgeon who had practiced In Elizabeth City prior to the above mentioned one, had washed out from rehab three times and his license finally suspended or revoked by the NCMB. He wound up at….. Pine Grove as a treating physician addictionologist! I won’t get into how some Medical Boards are destroying good physicians’ careers simply because they happened to use cannabis to treat their menstrual cramps, with no signs or indications of drug abuse. “Disruptive physician?” “Severe cannabis addiction?” or just an excuse for lawyers to financially rape physicians and medical boards to pass “feel good” disciplinary action?
    You should have gotten a lawyer you say? Spend tens of thousands of dollars to defend myself against shit like this? It is a waste of money. Remember, lawyers LOVE this adversarial situation between Medical Boards and doctors. It’s about $$$$.
    I arrived at Albemarle Hospital in Elizabeth City, NC population 18,000, in 1995. They had already cycled 5 orthopedists in and out the previous 6 years, and while I was there, another 6 or 7 cycled thru and the most recent one is now getting ready to leave. This turnover is unprecedented for any similar sized town. Does this not tell you anything? The medical industry, profession, or whatever you want to call it, is a cesspool of cronyism and corruption. Admittedly, it works both ways. Patients who have legitimate grievances or solid grounds for medical malpractice can be stonewalled by the “system,” and are left having to deal not only with emotional devastation like I did, but also physical harm -for the rest of their lives.
    The NCMB will never investigate the full story if it has an agenda, usually claiming “it doesn’t have the resources.” It is out to discipline as many doctors as it can for public relations and does so with great relish. An accused physician has a choice: either submit or else try to fight and have the lawyers carve him up financially. When I tried to contact the NC press in Raleigh and Charlotte, my story went nowhere. No response. No response from the NCMB or the NCPHP either. My only “platform” is Face Book or my memoir, “My Medical-Legal Back Pages,” which Archway requested I write as “fiction,” even when it is based entirely on true events. The response from the NCMB on its Facebook site is only “we don’t handle legal matters on FB. We’ll forward your FB post to our legal department.” The NCMB has an army of lawyers, but I never received a response, not even a rebuttal or a threat, and certainly not an apology.
    In my opinion, this NCMB Facebook page is a façade. Like all State Medical Boards, for all practical purposes NCMB operates behind closed doors. Some physicians get railroaded while others who are “connected” get off. Take my case back in KY in 1994, for example. Dr. Ascuncion was exonerated by the Board even though he had abandoned my patient, repeatedly lied during his testimony and had clearly tried to solicit a conspiracy to cover up the cause of death, while I was suspended and placed on probation for not checking the medication, even when I had ordered the correct drug and dose. He was covered under the same insurer as Hardin Memorial Hospital in KY and it was shown that the grievant family had obviously perjured their accusation against me as an accomplice in the conspiracy and this gave Dr. Ascuncion ammunition for his defense.
    But your KY suspension was so long ago you say? Can’t you move on? No, you can never put it behind you. It is as if it had happened yesterday and it makes you a mark for other medical boards, just like I was for the NCMB. It is the quintessential scarlet letter, and you have to practice where no one else will, if you can. I finally had to let my full, unrestricted NC license lapse in October 2018. I couldn’t do a thing with it. Not even work on the Indian Health Service (IHS). My continuing medical education (CME) requirements for orthopedic board recertification had been fulfilled for the recertification exam in October 2019, but no longer mattered. (Incidentally, I had never failed a medical school test, NBME I, II, III test, original Board certification exam, or previous recertification exam in my entire medical career.)
    You only have to Google the KY Board of Medical Licensure or the KY Bar Association and look under reviews on the right-hand side to see the NCMB is not the only state medical board that railroads physicians. I am practically the only reviewer/poster on that website, as very few members of the public ever read those, about the State Bar Association, and instead focus only on sensational acts committed by doctors which inflame the public and sell newspapers, or are featured on national television like I was on “A Current Affair. “
    Admittedly, the NCMB doesn’t have control over hospitals, as that is left to the Joint Commission On Accreditation (JCOA). But that should not excuse the NCMB from evaluating a doctor’s conduct in its proper context. In my case, the NCMB basically made a rush to judgment and had an agenda. I was suspended by my hospital, so I must have been treated fairly, right? So what if the NCMB’s own approved and preselected evaluators were hinting otherwise?
    The NCMB is politicized and weaponized.

    My Book, written as fiction, Nom de Plume Bryce Sterling. A long slog and quite frankly very few people actually bought it, and if they did less than half even finish it.


    Doctor Loses Medical License For Legally Treating Her Menstrual Cramps With Cannabis
    The state prohibits doctors from ever using cannabis, even if it’s for the medical purpose of managing the pain of menstrual cramps.
    Photo by HRAUN/Getty Images
    When Dr. Yolanda Ng was offered a job as a pediatric nephrologist at Providence Sacred Heart Children’s Hospital in Spokane, Washington, she was thrilled. She’d already been working in the position for five months as a locum, the medical industry equivalent of a temp, and liked the work. Plus, they were happy to allow her to split time between Spokane and San Jose, where her family lives. Little did she know, accepting the job would effectively end her medical career.
    “As part of that job, just for the paperwork, I had to do a drug screen,” she said. “Which I thought was actually going to come back negative, because it had been awhile. But it came back positive.” For cannabis.
    The result was due to a cannabis tincture Ng had been using to treat menstrual cramps. A friend of her’s recommended it and provided her with a bottle, saying his girlfriend had used it to great success. Ng saw it as a safer alternative to over-the-counter meds like Ibuprofen, which she knew could damage her kidneys over time. Ibuprofen also gave her an upset stomach if she took it overnight when she needed relief to sleep. Cannabis, however, did not.
    Because Ng used cannabis strictly outside of the workplace—only 2 or 3 times a month, in her estimation—and because personal use is legal in Washington, she didn’t think it would be an issue. Neither did her direct supervisors, as she’d always had good performance.
    Nonetheless, the hospital’s administrators wanted to run the positive test by the state’s medical commission just to be safe. That was Ng’s first—of what would become many—interactions with the Washington Physicians Health Program (WPHP), which eventually caused her to lose her medical license.
    All but four states have PHPs, with a mix of state-run and privately operated programs. The programs were developed in the late 70s as a response to increased scrutiny of substance abuse by medical professionals from state medical boards. PHPs were founded and championed by physicians who had themselves experienced substance abuse issues and sought a kinder, gentler solution than getting called up in front of the board. In theory, a doctor could go to the Physicians Health Program, complete their treatment plan, and leave with nothing on their professional record.
    Now, PHPs treat issues ranging from anxiety to opioid addiction, with the goal of helping physicians get discreet treatment and get back to practicing. However, critics of the Physicians Health Program system contend that it often does quite the opposite, operating more as a method of funneling patients into costly rehab centers than as an actual service to physicians. According to Ng, that’s exactly what happened to her.
    Critics of the Physicians Health Program system say that it just funnels patients into costly rehab centers.
    After her hospital administrators sought the advice of the Washington Medical Commission (WMC), they were instructed to stop her from practicing until she could meet with someone at the Washington Physicians Health Program. She met with the WPHP, she said, and they told her that they couldn’t conclude she had a problem with cannabis and would need further evaluation. They then gave her a list of three clinics that could perform an assessment, two in the Midwest and one in Oregon.
    “I asked them why it would be specific centers, and they said that it was because those centers are really good at dealing with marijuana,” she said. “Out of all of the ones they gave me, I picked the one that was the closest, in Oregon.”
    Her supervisors, she said, approached the Physicians Health Program wondering why she wasn’t allowed to simply use the clinic at the hospital she already worked at. They were told that the three centers offered were the only ones qualified to do the assessment.
    Dr. J Wesley Boyd, a Harvard psychiatry and bioethics professor, and former associate director of the Massachusetts Physicians Health Program, described that as “horse shit.”
    “The University of WA has a first-rate medical school, and presumably a first-rate psychiatry department with plenty of psychiatrists who are specialists in addiction and/or forensics or both,” he said. “There is zero reason why a regularly trained addiction psychiatrist could not perform an evaluation on Yolanda or anyone else in her shoes.”
    The real reason she was given a short list, he surmises, was because those clinics were cozy with the Physicians Health Program. Since leaving the Massachusetts PHP program over ethical concerns, Boyd has become a prominent critic of the PHP system, arguing that—while it is well-intentioned—it has become rife with conflicts of interest. While consulting on an audit of the North Carolina Physicians Health Program, he encountered a particularly glaring one.
    “The former head of the PHP was running one of the 4-day evaluation centers that also offered the 90-day treatment,” he said. “Lo and behold, that was one of the places they’d send people to all the time.”
    He added that PHP recommendations of treatment centers are often backed by studies on their relative success rates. But those studies, he cautioned, are often done by the PHPs themselves. “The only people who I’ve ever seen write papers with primary data are individuals who are running the programs,” he said. And, he added, many doctors who are referred don’t have a real substance abuse issue, which artificially inflates success rates. Ng’s situation, he said, neatly illustrates the point.
    She ended up at Hazelden Betty Ford’s Springbrook clinic, in Newberg, Oregon, for a three-day inpatient evaluation. She was told the evaluation would cost $5000, which she figured was worth it to clear everything up.
    But just calling to set up the appointment unnerved her, she said, as they began discussing financing for a three-month stay right off the bat. When she told them she didn’t plan to stay that long, they replied that, “Oh I guess you could go and come back, a lot of people do that too.” This was a big red flag for her: “I was like, What about if I go and don’t come back, because you don’t even know what the end result will be? But obviously, they did.”
    There, she met with a psychiatrist and psychologist, both of whom told her she was fine. She did some group therapy, at which the other participants frequently asked her “Why are you here?” But the ultimate diagnosis rested with a certified drug counselor, who concluded that she was a cannabis addict.
    “She said that, based on what I had been telling her and all the questions from the DSM-4 (a manual which defines cannabis use disorder), I qualified as a severe substance abuser,” Ng said. One of those questions is about whether a patient has missed work because of substance use.
    “I had to say, Yes, because I’m here and being here is making me miss work,” Ng said.
    Her final meeting, she said, was where things got really uncomfortable. She was called into a room with the counselor and other staff from Springbrook. The psychiatrist she’d spoken with and representatives of the Washington Physicians Health Program were on the phone. The counselor delivered her recommendation: 90-day inpatient treatment for severe cannabis use disorder, at a cost of $50,000.
    The counselor delivered her recommendation: 90-day inpatient treatment for severe cannabis use disorder, at a cost of $50,000.
    Photo by Electra-K-Vasileiadou/Getty Images
    “Everything that they did just didn’t seem kosher and something just felt weird about it,” she said. “But when I really decided to leave was when I said, I don’t want to do this. And they were like, Well, we’re appalled that you don’t think your medical license is worth $50,000.”
    To her, that felt like extortion. She said she also felt coerced to comply, as the nearest airport was an hour away, and her credit cards and phone were still locked up. The treatment center requires patients to hand them over upon arrival. When she arrived, she was picked up in a limo. Leaving, the center staff told her, would require her to call her own cab. Also, the only center staffer with the keys to patient lockers had gone home for the day, they said, further complicating the matter.
    She was eventually able to call a cab by borrowing calling cards from some of her fellow patients, and the center staffer was called back to unlock her personal items. She was ultimately able to make the last flight back to San Jose, where she planned to discuss the best course of action with her family.
    Hazelden Betty Ford did not respond to an email or phone call requesting comment.
    Micah Matthews, the WMC’s Deputy Executive and Legislative Director, said, of Ng’s Hazelden tale, “These are unsubstantiated comments and I will not respond to the specifics alleged by Dr. Ng.” However, he added that, “The WMC has only two tools, both disciplinary, available for use and both tend to have significant professional impact. As such, WPHP is the preferred route for use in practitioner health and impairment instances because it is confidential, non-disciplinary, involves the employer, and has a long record of success.”
    But according to Boyd, the PHP’s recommendations carry so much power that it may as well be the disciplinary body in these cases. Medical commissions tend to take recommendations from Physicians Health Programs at face value, he said. And he’s heard the same story from other physicians being asked, while attending an inpatient evaluation, whether they thought their medical career was worth the cost of the 90-day extension.
    Matthews, however, said the WMC takes steps to ensure that PHPs are independent and ethically operated.
    “Dr. Boyd is a known PHP critic and we respectfully disagree with his claims,” he said. “His experience with Massachusetts does not relate to Washington or WPHP. That being said, we know of no financial ties between WPHP and the clinics they recommend. We know this because they are contractually required to attest to the WMC annually that there are no financial relationships between WPHP and those evaluators they recommend.”
    Matthews added that the Washington Physicians Health Program makes it clear that the evaluation and any recommended treatment do not have to occur at the same treatment center, though Ng said that was not the way it was portrayed to her at Hazelden.
    Boyd says, from his experience, the connections between PHPs and treatment centers are more informal. The treatment centers don’t fund the PHPs directly, he said, but often sponsor their national meetings and hand out other perks.
    “I went to one national meeting while I was associate director, and the representatives from those centers were taking the PHP directors out to dinner,” he recalled. “Wining and dining them and stuff like that.”
    This, he said, is why he imagines they refused to accept an independent evaluation he performed on Ng as an alternative and refused to let her be evaluated at the University of Washington. Matthews said, instead, it’s because the WMC simply only accepts preapproved assessments. Whatever happened at Hazelden, Boyd said his evaluation did not find any evidence of cannabis use disorder.
    “With Yolanda, I have no idea how they could have possibly diagnosed her with severe cannabis dependence based on her history of using three times a month,” he said. “Also, when she got to Hazelden, her drug screen was negative, including for marijuana.”
    Ng was contacted several times by the Washington Physicians Health Program to ask if she planned to return to Hazelden, ultimately informing them that she wouldn’t. WPHP, as is standard practice, then reported her as noncompliant to the WMC, which requested that she sign an indefinite suspension agreement. To reinstate her medical license, the agreement required her to complete the WPHP’s recommended treatment.
    “They were calling her and calling her saying, We’re going to keep calling you until you sign it,” said Nicole Li, a Washington State lawyer who defends medical professionals in administrative proceedings, and who took on Ng’s case pro bono. “And so she just signed it, without ever talking to a lawyer and without knowing that that would affect her California license.”
    After being notified that her California license had been terminated, Ng contacted Li, but there was little she could do, as agreeing to the suspension closed the matter and precluded a hearing. Li says she tried to get the WMC to accept Boyd’s independent evaluation, or to allow her to visit a psychiatrist at UW, in hopes of getting the board to change its decision.
    “If you’re fucked here, you’re fucked for the rest of the country,” Li said. “That’s what makes me so mad about how they bullied Yolanda into signing that piece of paper because she never even got a hearing. That’s all I want them to do, but they won’t.”
    Matthews noted that Ng is still able to complete the Washington Physicians Health Program and have her license reinstated. He also added, “I feel compelled to point out that Dr. Ng finds herself in this situation due to her own choices, starting with her choice to partake in cannabis outside of the protections granted to qualified medical patients under Washington law.”
    But, he later clarified, using legal cannabis would get a doctor referred to the Washington Physicians Health Program as well, as would obtaining and using a medical cannabis authorization. The issue is impairment, he said, not performance.
    Reminded that Ng said she never used cannabis at work or when on-call, he said it didn’t really matter. The presence of cannabis metabolites on a urinalysis is a problem in and of itself, because “it indicates recent use,” and hospitals receive federal money. So it would put a physician’s hospital privileges in jeopardy which, despite cannabis being legal in Washington State, becomes a problem for Washington State.
    Similarly, a physician is allowed to have a medical cannabis authorization, but anything on the list of qualifying conditions would “lead both the WMC and the employer to consider if the practitioner is capable of current clinical practice.” Though he said that the WMC was “supportive of the existing law relating to cannabis,” he made it clear that there wasn’t really any way a physician could use cannabis without running afoul of the WMC.
    He made it clear that there wasn’t really any way a physician could use cannabis without running afoul of the WMC.
    “There’s a two-fold problem here,” Li said. “One is a financial conflict of interest and the other is a misunderstanding about pot.”
    While she also agrees that it’s possible to have a problem with cannabis, she said that the WPHP’s and WMC’s stance on cannabis is outdated, and out of touch with Washington’s cannabis laws.
    “It’s an outrage,” said Dr. Sunil Aggarwal, a Washington State physician who specializes in helping patients use medical cannabis. “It’s a testament to the stranglehold of the zero-tolerance, all-use-is-misuse, drug-rehab-industry-driven system that the medical guilds have essentially sold themselves to.”
    Aggarwal says medical institutions, for now, must be beholden to the DEA’s definition of marijuana, which says it has no accepted medical use and a high potential for abuse. And that keeps doctors from learning more about the drug, at a time when doctors who understand cannabis are desperately needed. While he said he hasn’t had any issues with the WMC, despite being an outspoken medical cannabis advocate, he said most doctors are afraid to engage with cannabis for fear of a potentially devastating referral to the Physicians Health Program.
    That referral was certainly devastating to Ng’s medical career. Even if Ng were to attend rehab and get her license reinstated, the amount of continuing education she’d have to make up would be prohibitive, Li said, as would the cost.
    “There were no complaints about [Yolanda] in the workplace,” says Li. “In fact they wanted her to come on full-time. She’s now been out of work for—what?—three years.”
    But to Ng, the choice to walk away was clear: “I was single and I didn’t have a family that depended on me. I hadn’t been deep into my career yet. My dignity was worth a lot more than doing this thing that I knew was wrong.”
    Talking about the experience, she hopes, will help doctors caught in similar situations who aren’t able to walk away so easily. Many physicians are afraid of being labeled, as Boyd said, sardonically, “a bellyaching doctor who is in denial about their addiction.” Many also have families, she said, and cannot afford a career change.
    Aggarwal, for his part, was optimistic: “The fact that she’s fighting it has increased awareness. Many doctors I know have just gone to those treatments, and she refused. That’s very brave.”

    Dr Louise Andrew actually evaluated me in 2003 when she was at The Center for Professional Well Being and saw no need for any treatment behavioral or drug or otherwise and that I was able to practice with reasonable skill and safety etc. etc. This above article from the magazine Herb that has been taken down, but is referencd by Dr Louise Andrew below. I have been informed that Dr Ng went into research.

    Dr. Loses license for Marijuana Use
    Published on September 8, 2018

    Louise B ANDREW MD JD FIFEM (MD Mentor)Follow
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
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    This headline is becoming all too common. Yolanda Ng’s is one of about half a dozen cases I’ve heard of in WA alone where a physician who uses medicinal or recreational marijuana in a state where it is perfectly legal (for normal citizens), has been diagnosed with “marijuana addiction” (which doesn’t exist) and sentenced to 90 day out of state drug rehab costing tens to hundreds of thousands of dollars by a physician health program (PHP) using the rent seeking power granted by the medical licensure board. Extortion is not too strong a term for a racket that mandates involuntary fitness for duty evaluation, by an entity that tailors a diagnosis to suit a client (the PHP) and that then self refers for treatment for a non existent condition, for a time period that is three times that prescribed for any non-physician for the same condition. Such “treatment” is not covered by insurance, because insurance criteria are not met for inpatient services (they are not medically justified). (And to bill insurance under such circumstances would presumably result in insurance fraud charges against the biller). So physicians like Dr. Ng are extorted for cash up front to cover the preordained inpatient treatment, that is often, as in her case, prescribed even before the sham evaluation commences. And later taunted with such questions as “isn’t your medical license worth that much?” (in this particular instance, $50K. It can reportedly be far higher). (note: it appears Herb has taken this article down when the reporter moved on. However, the case is also recently excerpted here.)
    I too have witnessed the wining and dining and other lucrative sponsorships conferred by these “preferred rehab facilities” at meetings of the Federation of State Physician Health Programs mentioned by Boyd in the Ng article, and have seen in FSPHP publications that these same “preferred” rehab/perennial sponsors at FSPHP national meetings also facilitate regional PHP “retreats” at posh resorts. The North Carolina state audit of that PHP ( confirmed that these same facilities provided “scholarships” to PHPs that looked suspiciously like referral kickbacks (although it appears in the wake of the NC audit that such “scholarships” are now channeled through the NC Med Society Foundation rather than going directly to the PHP).
    I don’t know where this is going to stop. The $34B Drug Rehab industry ( has clearly found a willing source of referrals in PHPs nationwide, especially those very high end rehabs that claim to be especially qualified to treat physicians. Limousine from airport to get there, but “you’re on your own to get back” was reported by this young physician whose wallet and phone were taken from her upon entry. There may be a closer media look at these purportedly “preferred” centers coming down the pike. NC’s PHP was unable to come up with any qualifying criteria distinguishing its “preferred” centers to provide to the NC auditor who inquired about them, so one is led to believe that the sole qualification for the “preferred” designation may be a center’s willingness to tailor a physician’s diagnosis (absent sufficient diagnostic criteria to merit insurance coverage) so as to justify a demand for unjustifiably lengthy inpatient treatment (coupled perhaps with willingness to pony up contributions to the individual PHPs and/or to their national trade organization, the FSPHP).
    Two things I do know are 1) because this is currently quite a profitable relationship for the PHPs and the FSPHP, it will take exposure on a massive scale of what is increasingly being revealed by victims of the scam, to demonstrate irrefutably the emerging pattern and practice of “diagnosing for dollars” ( that seems to be at the heart of this scam. And 2) that the pool of victims will continue to expand for as long as physicians remain blissfully ignorant of how this scheme works, believing that they will be treated fairly by organizations (PHPs) that baldly claim they exist to protect them from licensure actions, when in actuality these are the very organizations through whose agency such catastrophic and often seemingly non-justifiable licensure actions are being taken against physicians unwilling to be extorted, as was Yolanda Ng.
    Oh, and one more thing. If we continue to eat our young for ridiculous reasons like using marijuana for menstrual cramps, we will all die without qualified medical assistance. Worse, we will probably deserve it, if we continue to stand aside and do nothing.

    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues

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    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
    The excellent article referenced can now be found at,-Hard-Realities-and-How-to-Risk-Manage-Them.-_bl31951.htm The line above quoted from Schoppmann “Physicians, as their medical license is a privilege and not a right under the law, hold a set of dramatically compromised rights under the law and are routinely, and increasingly, wrongfully labeled as “Disruptive”, “Impaired” and/or an “Outlier”. Any one of these “Scarlet Letter” labels is a virtually permanent and potentially career ending accusation. ” So true. Thanks for sharing.

    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
    Common theme in so many of these cases is “I didn’t know what was happening until after it hit me” (I thought they really were here to help me, and if I cooperated I would be exonerated because I am a good person, did nothing wrong, etc) and “I didn’t get a lawyer because I was afraid it would make me look like I had something to hide.” So, KEY QUESTION: How can we reach the VERY BROADEST physician audience to dispel these common notions and stem resultant mistakes BEFORE they occur? Or are we just going to continue to lose a huge swath of docs because of their trust in the system they have been told exists to protect them? Many PHPs are now giving presentations in medical schools proudly trumpeting the “we’re here to help you” message. Will the rest of us just sit by and tsk as they consistently eat our young?

    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
    Helpful additional insight into machinations of NCMB/PHP. You of course were released because you went along to get along. Your digitless replacement? Is he not impaired in performing certain operations now I wonder? I would caution you to check your NCMB record to see whether anything defamatory appears there, as some others have discovered too late.
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    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
    The above reply looks odd because the prior commenter apparently removed his comment. I do hope he did not find he was a victim of defamation and decide to cut his losses. My comment stands.

    William Goren, J.D., LL.M.
    Consultant/Attorney/FINRA Arbitrator
    Where was her ADA knowledgeable attorney?
    1 Like
    2 Replies

    Louise B ANDREW MD JD FIFEM (MD Mentor)
    Physician Advocate specializing in physician health and wellness, litigation stress management, and medical board issues
    Like many before her, she did not get one until after the (second) axe had fallen according to the article. Again, like many others she probably assumed that her CA license would not be affected and she didn’t need WA license. BIG mistake.

    Veronica Castillo
    ⭐Published Writer 📝 Traveling Vegan 🌱 Cannabis Advocate ♿️ ADA💥 #15daysofada

    Liked by 1 person

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