Physician Suicide and Organizational Justice: The Role of Hopelessness, Helplessness and Defeat

Physician Suicide and Organizational Justice: The Role of Hopelessness, Helplessness and Defeat

Michael Langan, M.D.

screen-shot-2016-10-06-at-7-27-51-pm

They can be a terror to your mind and show you how to hold your tongue
They got mystery written all over their forehead
They kill babies in the crib and say only the good die young
They don’t believe in mercy
Judgement on them is something that you’ll never see
They can exalt you up or bring you down main route
Turn you into anything that they want you to be–Bob Dylan, Foot of Pride

In  F. Scott Fitzgerald’s  The Great Gatsby, Nick Carraway observes that “the loneliest moment in someone’s life is when they are watching their whole world fall apart, and all they can do is stare blankly”      In 1896 Émile Durkheim described “melancholy suicide” as being “connected with a general state of extreme depression and exaggerated sadness, causing the patient no longer to realize sanely the bonds which connect him with people and things about him. Pleasures no longer attract.”     Heightened perceptions of defeat and entrapment are known to be powerful predictors of suicide. According to the “Cry of Pain” model people are particularly prone to suicide when life  experiences are interpreted as signaling defeat, defined as a sense of a “failed struggle.” Unable to find some sort of resolution to a defeating situation, a sense of entrapment proliferates and the perception of no way out provides the central impetus for ending one’s life.

Although no reliable statistics yet exist, anecdotal reports suggest a marked rise in physician suicide in recent years. From the reports I am receiving it is a lot more than the oft cited “medical school class” of 400 per year.

This necessitates an evaluation of predisposing risk factors such as substance abuse and depression, but also requires a critical examination of what external forces may be involved.  What acute and cumulative situational and psychosocial factors are involved in the descent from suicidal ideation to planning to completion?   What makes suicide a potential option for doctors and what acute events precipitate and trigger the final act?

Depression and Substance Abuse no Different from General Population

The prevalence of depression in physicians is close to that of the general population1,2 and, if one looks critically at the evidence based literature, substance abuse in medical professionals approximates that of the general population.  Controlled studies using DSM diagnostic criteria indicate that physicians have the same rates (8-14%) of substance abuse and dependence as the general population,3 and slightly lower rates compared to other occupations.4,5  Epidemiological surveys reveal the same. Hughes, et al.6 reported a lifetime prevalence of drug or alcohol abuse or dependence in physicians of 7.9%, markedly less than the 14.6% prevalence reported in the general population by Kessler.7

Job Stress and Untreated Mental Illness Risk Factors

Job stress coupled with inadequate treatment for mental illness may be factors contributing to physician suicide according to one recent study. Using data from the National Violent Death Reporting System, Gold, Sen, & Schwenk, 2013 8 compared 203 physicians who had committed suicide to more than 31,000 non-physicians and found that having a known mental health disorder or a job problem that contributed to the suicide significantly predicted being a physician.

Physicians were 3.12 times more likely to have a job problem as a contributing factor. In addition, toxicology testing showed low rates of medication treatment.  The authors concluded that inadequate treatment and increased problems related to job stress are potentially modifiable risk factors to reduce suicidal death among physicians. They also warned that the database used likely underestimated physician suicides because of “underreporting and even deliberate miscoding because of the stigma attached.”8

Few studies have evaluated the psychosocial stressors surrounding physician suicide but there is no reason to believe they are any different from the rest of the population. Although the triggering life events and specific stressors may vary outside, the inner psyche and undercurrent of thoughts and feelings should remains the same.   Perhaps the same drivers of suicide identified in other populations are contributing to physician suicide.

Perceived Helplessness, Hopelessness, Bullying and Defeat

Perceived helplessness is significantly associated with suicide as is9Hopelessness10,11  Bullying is known to be a predominant trigger for adolescent suicide12-14   One study found that adolescents in custody who were bullied were 9.22 times more likely to attempt suicide than those were not bullied.15

Heightened perceptions of defeat and entrapment are known to be powerful contributors to suicide.16,17

The “Cry of Pain” model 18,19 specifies that people are particularly prone to suicide when life experiences are interpreted as signaling defeat which is defined as a sense of “failed struggle” or loss of social position and resources.. The person is unable to identify an escape from or resolution to a defeating situation, a sense of entrapment proliferates with the perception of no way out, and this provides the central impetus for ending ones life. There is a helplessness and hopelessness that precipitates the descent from ideation, to planning, and then to finality.

Organizational Justice Important Protective Factor

In a study on Italian and Swedish female physicians, degrading experiences and harassment at work were found to be the most powerful independent variables contributing to suicidal thoughts.20Degrading work experiences harassment, and lack of control over working conditions were found to be associated with suicidal thoughts among Italian and Swedish male university physicians.21

Evidence exists for the role of rescue factors (i.e. social support) as buffers against suicide in the face of varying degrees of life stress.22,23 The study of female physicians revealed meetings to discuss stressful work experiences as a potential protective factor, 20 and support at work when difficulties arose appeared to be a protective factor for the male physicians.21   In line with this, studies of Finnish physicians found that control over one’s work and organizational justice were the most important determinants of work-related wellbeing.24,25 Organizational justice has been identified as a psychosocial predictor of health and wellbeing. 26 27  Low organizational justice has been identified as a notable risk factor for psychological distress and depression.28,29

Historical Precedent-the Suicides at Ridgeview

Could these factors be playing a role in physician suicide?  They evidently did at the Ridgeview Institute, a drug and alcohol treatment program for impaired physicians in Metropolitan Atlanta created by G. Douglas Talbott.

Talbott helped organize and served as past president of the American Society of Addiction Medicine (ASAM) and was a formative figure in the American Medical Association’s (AMA’s) Impaired Physician Program. He has owned and directed a number of treatment facilities for impaired professionals, most recently the Talbott Recovery Campus in Atlanta, one of the preferred referrals for physicians ordered into evaluation and treatment by licensing boards.

After creating the DeKalb County Impaired Physicians Committee for the Medical Association of Georgia, Talbott founded the Georgia Disabled Doctors Program in 1975 in part because “traditional one-month treatment programs are inadequate for disabled doctors.” According to Talbott, rehabilitation programs that evaluate and treat the rest of the population for substance abuse issues are incapable of doing so in doctors as they are unlike others. He bases this uniqueness on “incredibly high denial”, and what he calls the “four MDs,” “M-Deity”, “Massive Denial” “Militant Defensiveness”, and “More Drugs.”30

Contingency Management = Extortion Using Medical License

According to Talbott, “impaired doctors must first acknowledge their addiction and overcome their ‘terminal uniqueness’ before they can deal with a drug or alcohol problem.” “Terminal uniqueness “ is a phrase Talbott uses to describe doctors’ tendency to think they can heal themselves. “M-Deity” refers to doctors “being trained to think they’re God,”31 an unfounded generalization considering the vast diversity of individuals that make up our profession. This attitude, according to some critics, stems from the personal histories of the treatment staff, including Talbott, who are recovering alcoholics and addicts themselves. One such critic was Assistant Surgeon General under C. Everett Koop John C. Duffy who said that Ridgeview suffered from a “boot-camp mentality” toward physicians under their care and “assume every physician suffering from substance abuse is the same lying, stealing, cheating, manipulating individual they were when they had the illness. Certainly some physicians are manipulative, but it’s naïve to label all physicians with these problems.”32

American Society of Addiction Medicine (ASAM) President (1981-1983) LeClair Bissell was also highly critical of Talbott’s approach. Bissell, co-author of the first textbook of ethics for addiction professionals 33 when asked if there was any justification to the claim that doctors are sicker than other people and more vulnerable to addiction replied:

“Well, based on my treatment experience, I think they are less sick and much easier to treat than many other groups. I think one reason for that is that in order to become a physician…one has to have jumped over a great many hurdles. One must pass the exams, survive the screening tests and the interviews, be able to organize oneself well enough to do examinations and so on, and be observed by a good many colleagues along the way. Therefore I think the more grossly psychotic, or sicker, are frequently screened out along the way. The ones we get in treatment are usually people who are less brain-damaged, are still quite capable of learning, are reasonably bright. Not only that, but they are quite well motivated in most cases to hang on to their licenses, the threat of the loss of which is frequently what puts them in treatment in the first place. So are they hard to treat? No! Are they easy patients? Yes! Are they more likely to be addicted than other groups? We don’t know.”34

I’m not much for the bullying that goes along with some of these programs,” Bissell commented to theAtlanta Journal and Constitution in 1987.31

The Constitution did a series of reports after five inpatients committed suicide during a four-year period at Ridgeview.35  In addition there were at least 20 more who had killed themselves over the preceding 12 years after leaving the treatment center.32

Bissell, the recipient of the 1997 Elizabeth Blackwell Award for outstanding contributions to the cause of women and medicine remarked: “When you’ve got them by the license, that’s pretty strong leverage. You shouldn’t have to pound on them so much. You could be asking for trouble.” 31

According to Bissell: “There’s a lot of debate in the field over whether treatment imposed by threats is worthwhile…To a large degree a person has to seek the treatment on his own accord before it will work for him.”31

A jury awarded $1.3 million to the widow of one of the deceased physicians against Ridgeview,36 and other lawsuits initiated on behalf of suicides were settled out of court.35

The Constitution reported that doctors entered the program under threats of loss of licensure “even when they would prefer treatment that is cheaper and closer to home.” 37

The paper also noted that Ridgeview “enjoys unparalleled connections with many local and state medical societies that work with troubled doctors,” “licensing boards often seek recommendations from such groups in devising an approved treatment plan,” and those in charge are often “physicians who themselves have successfully completed Ridgeview’s program.”37

The cost of a 28-day program for nonprofessionals at Ridgeview in 1987 was $10,000 while the cost was “higher for those going through impaired-health professionals program,” which lasted months rather than 28 days.32

In 1997 William L. White interviewed Bissell whom he called “one of the pioneers in the treatment of impaired professionals.” The interview was not published until after hear death in 2008 per her request.   Noting her book Alcoholism in the Professions 38 “remains one of the classics in the field”, White asked her when those in the field began to see physicians and other professionals as a special treatment population. She replied:

“When they started making money in alcoholism. As soon as insurance started covering treatment, suddenly you heard that residential treatment was necessary for almost everybody. And since alcoholic docs had tons of money compared to the rest of the public, they not only needed residential treatment, they needed residential treatment in a special treatment facility for many months as opposed to the shorter periods of time that other people needed.”39


Talbott claimed a “92.3 percent recovery rate, according to information compiled from a five-year follow-up survey based on complete abstinence and other treatment.”40

“There is nothing special about a doctor’s alcoholism,” said Bissel

“”These special facilities will tell you that they come up with really wonderful recovery rates. They do. And the reason they do is that any time you can grab a professional person by the license and compel him or her into treatment and force them to cooperate with that treatment and then monitor them for years, you’ll get good outcomes—in the high 80s or low 90s in recovery rates—no matter what else you do.”39

“The ones I think are really the best ones were not specialized. There were other well-known specialty clinics that claimed all the docs they treated got well, which is sheer rot. They harmed a great many people, keeping them for long, unnecessary treatments and seeing to it that they hit their financial bottom for sure: kids being yanked out of college, being forced to sell homes to pay for treatment, and otherwise being blackmailed on the grounds that your husband has a fatal disease. It’s ugly.”39

Stanton Peele’s “In the Belly of the American Society of Addiction Medicine Beast” describes the coercion, bullying, threats and indoctrination that are standard operating procedure in Talbott’s facilities.41 Uncooperative patients, “and this covers a range of sins of commission or omission including offering one’s opinion about one’s treatment,” are “threatened with expulsion and with not being certified-or advocated for with their Boards.”41 The cornerstone of treatment is 12-step spiritual recovery. All new patients are indoctrinated into A.A. and coerced to confess they are addicts or alcoholics. Failure to participate in A.A. and 12-step spirituality means expulsion from the program with the anticipated result being loss of one’s medical license.

Fraud, Malpractice, False Diagnoses and False imprisonment

In May 1999 Talbott stepped down as president of the American Society of Addiction Medicine (ASAM) as a jury awarded Dr. Leonard Masters a judgment of $1.3 million in actual damages and an undisclosed sum in punitive damages for fraud, malpractice, and the novel claim of false imprisonment.42  The fraud finding required a finding that errors in the diagnosis were intentional. After being accused of excessive prescribing of narcotics to his chronic pain patients, Masters was told by the director of the Florida PHP that he could either surrender his medical license until the allegations were disproved or submit to a four-day evaluation. Masters agreed to the latter, thinking he would have an objective and fair evaluation, but was instead diagnosed as “alcohol dependent” and coerced into the Talbott recovery program. He was forced to stay in the program under threat of his medical license as staff would routinely threaten to report any doctor who questioned any aspect of their diagnosis or treatment to their state medical boards “as being an impaired physician, leaving necessary treatment against medical advice”42  which would mean the loss of his licensure.

However, Masters was not an alcoholic. According to his attorney, Eric. S. Block,  “No one ever accused him of having a problem with alcohol. Not his friends, not his wife, not his seven children, not his fellow doctors, not his employees, not his employers, No one.” 43   He was released 4 months later and forced to sign a five-year “continuing care” contract with the PHP, also under continued threat of his medical license. Talbott faced no professional repercussions and no changes in the treatment protocols were made. Talbott continued to present himself and ASAM as the most qualified advocate for the assessment and treatment of medical professionals for substance abuse and addiction up until his death last year.44

Same System Imposed on Doctors Today—Institutional Injustice Worse due to Laboratory Developed Tests. Fortified Scaffold and Tightened the Noose.

In almost all states today any physician referred for an assessment for substance abuse will be mandated to do so in a facility just like Ridgeview. There is no choice. There is one difference however.   When the Ridgeview suicides occurred the plethora of laboratory developed tests were not yet introduced.

A decade ago Dr. Gregory Skipper introduced the first laboratory developed test for forensic testing and used it on doctors in physician health programs.   These non-FDA approved tests of unknown validity presented a new unpredictable variable into the mix with a positive test necessitating another assessment at an out of state treatment facility—a “PHP-approved” assessment facility. The addition of this laboratory Russian Roulette renders the current system much worse than it was at the time of the Ridgeview suicides.

And if a positive test occurs there are no safeguards protecting the donor. LDTs are unregulated by the FDA. There is no oversight and no one to file a complaint with.

In addition state PHPs have no oversight or regulation.  They police themselves. Medical boards, departments of public health and medical societies provide no oversight. Accountability is absent.

Moreover they have apparently convinced law enforcement that when it comes to doctors it is a “parochial issue” best handled by the medical community. I have been hearing from doctors all over the country who have tried to report crimes to the local police, the state Attorney General and other law enforcement agencies only to be turned back over to the very perpetrators of the crimes. “He’s a sick doctor, we’ll take care of him.”

The “swift and certain consequences” imposed on those monitored in these programs is an effective means of silencing most.   The media has generally bought into the  exaggerated danger of the “impaired” and “disruptive” physician constructs created by these groups.  The media has in fact, intentionally or otherwise,  been complicit in spreading  the propaganda and misinformation put out by these groups to create moral panics associated with these false constructs and the bogus dangers they pose.   Reporting corruption and fraud to local newspapers and investigative reporters is largely futile.   This is not because these reports lack veracity or supporting evidence but because the reports are being made by doctors who have been accused of substance use or behavioral problems.  The mere label “impaired” or “disruptive” seems sufficient to disregard the claims of the accused.

screen-shot-2016-10-07-at-12-44-04-pm

Urgent Need to Admit to the Problem

There has been an increase in physician suicide in the past decade.   By my estimate the numbers are going to be far higher than the oft-cited 400 per year. The speculation as to cause has been unenlightening and in fact frustrating.   Knowledge of anatomy, access to dangerous drugs, increased workload and even student loans have been proposed as contributing factors. Although there has been some tangential mention of physician health programs it has been indirect.

Direct and defined discussion is necessary and state PHPs need to be named as a possible contributor to suicide.  Admitting the possibility there is a problem is the first crucial step in defining and addressing the problem.    The 1980s historical precedent is correlated with physician suicide.  The current system is not only based on Ridgeview but has been fortified in scope and power.  The physician health movement has effectively removed due process from doctors while removing answerability and accountability from themselves.

And they have not only fortified the scaffold but widened it from substance abusing doctors to all doctors. “Potential impairment” and “relapse without use” were introduced without any meaningful resistance and they are now using a panoply of non-FDA approved laboratory developed tests of unknown validity to test for substances of abuse in a zero-tolerance abstinence based monitoring program.

With no regulatory oversight the stage is set not only for error but misuse as witch-pricking devices for punishment and control.  Doctors across the country are complaining of the very same abuses Leonard Masters did–false diagnoses, misdiagnosis, unneeded treatment and fraud.

In summary, any doctor who is referred to their state PHP today is required to have any assessment and treatment at a “PHP-approved” facility based on Ridgeview.  It is mandated.  There is no choice.  Coercion, control and abuse at Ridgeview was associated with multiple suicides in doctors in the 1980s.  

The use of non-FDA approved tests of unknown validity worsens the abuse and fits the “cry of pain” model of hopelessness, helplessness and despair.  Locus of control is  lost and organizational justice is absent.   The factors associated with suicide are loud and clear.  

Why is it so difficult to provoke further discussion and inspire critical thinking on this topic?   Examining, questioning and researching strategies for recognizing  (and undoing ) oppressive institutional structures should be recognized and supported by everyone.   Cognitive dissonance, apathy, ignorance (willful or otherwise), indifference and neutrality to issues concerning oppression and abuse only serves to reinforce oppression and abuse.   To be confronted or resolved these issues must be recognized and addressed and this is not going to happen until everyone is involved in it’s interrogation.

 How many more must die before this happens?

Why is the relationship between these programs and physician suicide still an elephant in the room?

  1. Ford DE, Mead LA, Chang PP, Cooper-Patrick L, Wang NY, Klag MJ. Depression is a risk factor for coronary artery disease in men: the precursors study. Archives of internal medicine. Jul 13 1998;158(13):1422-1426.
  2. Frank E, Dingle AD. Self-reported depression and suicide attempts among U.S. women physicians.The American journal of psychiatry. Dec 1999;156(12):1887-1894.
  3. Brewster JM. Prevalence of alcohol and other drug problems among physicians. JAMA : the journal of the American Medical Association. Apr 11 1986;255(14):1913-1920.
  4. Anthony J, Eaton W, Mandell W, al. e. Psychoactive Drug Dependence and abuse: More Common in Some Occupations than in Others? Journal of Employee Assistance Res. 1992;1:148-186.
  5. Stinson F, DeBakely S, Steffens R. Prevalence of DSM-III-R Alcohol abuse and/or dependence among selected occupations. Alchohol Health Research World. 1992;16:165-172.
  6. Hughes PH, Brandenburg N, Baldwin DC, Jr., et al. Prevalence of substance use among US physicians. JAMA : the journal of the American Medical Association. May 6 1992;267(17):2333-2339.
  7. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.Archives of general psychiatry. Jun 2005;62(6):593-602.
  8. Gold KJ, Sen A, Schwenk TL. Details on suicide among US physicians: data from the National Violent Death Reporting System. General hospital psychiatry. Jan-Feb 2013;35(1):45-49.
  9. Rivers I, Noret N. Potential suicide ideation and its association with observing bullying at school.The Journal of adolescent health : official publication of the Society for Adolescent Medicine.Jul 2013;53(1 Suppl):S32-36.
  10. Lester D, Walker RL. Hopelessness, helplessness, and haplessness as predictors of suicidal ideation. Omega. 2007;55(4):321-324.
  11. Beck AT. Hopelessness as a predictor of eventual suicide. Annals of the New York Academy of Sciences. 1986;487:90-96.
  12. Hinduja S, Patchin JW. Bullying, cyberbullying, and suicide. Archives of suicide research : official journal of the International Academy for Suicide Research. 2010;14(3):206-221.
  13. Hertz MF, Donato I, Wright J. Bullying and suicide: a public health approach.The Journal of adolescent health : official publication of the Society for Adolescent Medicine. Jul 2013;53(1 Suppl):S1-3.
  14. Kim YS, Leventhal B. Bullying and suicide. A review. International journal of adolescent medicine and health. Apr-Jun 2008;20(2):133-154.
  15. Kiriakidis SP. Bullying and suicide attempts among adolescents kept in custody.Crisis.2008;29(4):216-218.
  16. Taylor PJ, Gooding P, Wood AM, Tarrier N. The role of defeat and entrapment in depression, anxiety, and suicide. Psychological bulletin. May 2011;137(3):391-420.
  17. Lester D. Defeat and entrapment as predictors of depression and suicidal ideation versus hopelessness and helplessness. Psychological reports. Oct 2012;111(2):498-501.
  18. Williams JMG. Cry of Pain. Harmondsworth: Penguin; 1997.
  19. Williams JMG, Crane C, Barnhofer T, Duggan DS. Psychology and suicidal behavior: elaborating the entrapment model. In: Hawton K, ed. Prevention and treatment of suicidal behavior: from science to practice. Oxford: Oxford University Press; 2005:71-89.
  20. Fridner A, Belkic K, Marini M, Minucci D, Pavan L, Schenck-Gustafsson K. Survey on recent suicidal ideation among female university hospital physicians in Sweden and Italy (the HOUPE study): cross-sectional associations with work stressors. Gender medicine. Apr 2009;6(1):314-328.
  21. Fridner A, Belkic K, Minucci D, et al. Work environment and recent suicidal thoughts among male university hospital physicians in Sweden and Italy: the health and organization among university hospital physicians in Europe (HOUPE) study. Gender medicine. Aug 2011;8(4):269-279.
  22. Borowsky IW, Ireland M, Resnick MD. Adolescent suicide attempts: Risks and protectors.Pediatrics. 2001;107(485).
  23. Clum GA, Febbraro GAR. Stress, social support and problem-solving appraisal/skill: Prediction of suicide severity within a college sample. Journal of Psychopathology and Behavioral Assessment.1994;16:37-46.
  24. Lindfors PM, Meretoja OA, Toyry SM, Luukkonen RA, Elovainio MJ, Leino TJ. Job satisfaction, work ability and life satisfaction among Finnish anaesthesiologists. Acta anaesthesiologica Scandinavica.Aug 2007;51(7):815-822.
  25. Heponiemi T, Kuusio H, Sinervo T, Elovainio M. Job attitudes and well-being among public vs. private physicians: organizational justice and job control as mediators. European journal of public health. Aug 2011;21(4):520-525.
  26. Elovainio M, Kivimaki M, Vahtera J. Organizational justice: evidence of a new psychosocial predictor of health. Am J Public Health. Jan 2002;92(1):105-108.
  27. Lawson KJ, Noblet AJ, Rodwell JJ. Promoting employee wellbeing: the relevance of work characteristics and organizational justice. Health promotion international. Sep 2009;24(3):223-233.
  28. Hayashi T, Odagiri Y, Ohya Y, Tanaka K, Shimomitsu T. Organizational justice, willingness to work, and psychological distress: results from a private Japanese company. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine. Feb 2011;53(2):174-181.
  29. Lang J, Bliese PD, Lang JW, Adler AB. Work gets unfair for the depressed: cross-lagged relations between organizational justice perceptions and depressive symptoms. The Journal of applied psychology. May 2011;96(3):602-618.
  30. Gonzales L. When Doctors are Addicts: For physicians getting Molly Kellogg is easy. Getting help is not. Chicago Reader. July 28, 1988, 1988.
  31. King M, Durcanin C. The suicides at Ridgeview Institute: A Doctor’s treatment program may be too tough, some say. Atlanta Journal and Constitution.December 18, 1987a, 1987: A12.
  32. Durcanin C, King M. The suicides at Ridgeview Institute: Suicides mar success at Ridgeview with troubled professionals. Atlanta Journal and Constitution.December 18, 1987, 1987: A13.
  33. Bissell L, Royce JE. Ethics for Addiction Professionals. Center City, Minnesota: Hazelden; 1987.
  34. Addiction Scientists from the USA: LeClair Bissell. In: Edwards G, ed.Addiction: Evolution of a Specialist Field. 1 ed: Wiley, John & Sons, Incorporated; 2002:408.
  35. Durcanin C. The suicides at Ridgeview Institute: Staff members didn’t believe Michigan doctor was suicidal. Atlanta Journal and Constitution. December 18, 1987, 1987: A8.
  36. Ricks WS. Ridgeview Institute loses $1.3 million in suit over suicide. Atlanta Journal and Constitution. October 11, 1987, 1987: A1.
  37. King M, Durcanin C. The suicides at Ridgeview Institute: Many drug-using doctors driven to Ridgeview by fear of losing licenses. Atlanta Journal and Constitution. December 18, 1987b, 1987: A1.
  38. Bissell L, Haberman PW. Alcoholism in the Professions. Oxford University Press; 1984.
  39. White W. Reflections of an addiction treatment pioneer. An Interview with LeClair Bissell, MD (1928-2008), conducted January 22, 1997. Posted athttp://www.williamwhitepapers.com. 2011.
  40. Williams c. Health care field chemical dependency threat cited. The Tuscaloosa News. January 16, 1988, 1988: 16.
  41. Peele S. In the Belly of the American Society of Addiction Medicine Beast. The Stanton Peele Addiction Website (accessed March 28, 2014)http://web.archive.org/web/20080514153437/http://www.peele.net/debate/talbott.html.
  42. Ursery S. $1.3M verdict coaxes a deal for doctor’s coerced rehab. Fulton County Daily Report.May 12, 1999b 1999.
  43. Ursery S. I was wrongly held in alcohol center, doctor charges. Fulton Count y Daily Report. April 27, 1999a 1999.
  44. Parker J. George Talbott’s Abuse of Dr. Leon Masters MD (http://medicalwhistleblowernetwork.jigsy.com/george-talbott-s-abuse-of-leon-masters ).Medical Whistelblower Advocacy Network.

 

cropped-screen-shot-2016-10-10-at-9-32-40-pm1

Please donate to this effort below.  Your contribution can and will make a difference.  https://www.gofundme.com/PHPReform

Physician Suicide

Physician Suicide.

Physician Suicide 101:  Secrets, lies and solutions by Dr. Pamela Wible, M.D., is now featured on KevinMD.com.  Please read and comment!   We need to use this as a stepping stone to start discussing the Elephant in the room; state Physician Health Programs (PHPs) organized under the Federation of State Physician Health Programs.  These programs once served the dual purpose of helping sick doctors and protecting the public from harm.

Taken over by the “impaired physician” movement the current manifestation is one of absolute power and unrestrained managerial authority with no meaningful oversight, regulation or accountability.  It is a culture of institutional injustice that is preventing doctors from seeking help for fear of being ensnared and monitored by them.  Those being monitored by them are subject to bullying, abuse and forced 12-step indoctrination under threat of loss of licensure.  Many of these doctors do not even have an addiction or substance use disorder.   Situational factors, a “one-off” or even a false accusation can result in monitoring by these programs that encourage confidential referral for things such as being behind on medical charts.  Sham peer-review is rampant.32-640x472

Moreover, the authority bestowed on this group is both illegitimate and irrational. The mechanics and mentality of the Federation of State Physician Health Programs conforms to that of the American Society of Addiction Medicine (ASAM). Although there are some Addiction Psychiatrists involved, the vast majority are  “specialists” in “Addiction Medicine.

The ASAM is not even recognized by the American Board of Medical Specialties as a bona fide specialty. It is a Self-Designated-Medical-Specialty; an AMA term used to keep track of what any group of doctors is calling themselves.

Screen Shot 2014-11-29 at 11.04.53 AM

Dr. Gregory H. Miday (1982-2012) A Doctor who would have made this world a better place.

In fact, American Board of Addiction Medicine (ABMS) “board certification” is little more than a diploma mill.

Yet these “specialists” are now in charge of ALL things related to PHYSICIAN HEALTH.

Many of the physicians running these programs had their licenses revoked and got them back by claiming salvation through the good graces of Alcoholics Anonymous and other 12-step methodology. Many have felony convictions. Some have double felonies.

At best we have unqualified zealots. But one major problem I have heard over and over again from physicians forced into these programs is an absolute lack of justice, empathy and even civility by those in charge.

A note from Dr. Karen Miday whose son Greg died by suicide after having a Corona in Peurto Rico while on vacation:

Dr. Gregory H. Miday ( 1982-2012) My physician son died of suicide 2 years ago while being monitored by the Missouri PHP. When he called to notify them of his relapse (while vacationing in Puerto Rico) and his intent to admit himself to a local public treatment center (decision made in consultation with his psychiatrist during an office visit that morning) the PHP said they did not approve of the plan. They told him to come speak with them instead. He chose otherwise. His phone calls to the PHP were the last ones he ever made. Clearly, he did not see them as benevolent. I sincerely doubt that he is their only casualty. Yet, where are the statistics? How many others have died under their watch. Strangely, the clinical director ( an RN, and likely recovering addict) told my husband that no internal review of my son’s case was planned. Such reviews after a suicide are mandatory at every public mental health facility I have practiced at. Our best and our brightest are being subjected to substandard care without any oversight or accountability. I can’t bring my son back. I do hope, however, that others will join me in an effort to pull the curtain back on these programs and perhaps save other lives. Karen Miday, MD, Cincinnati, OH

Misconduct, fraud, and even crimes are being reported.

Perhaps the 12-step salvation is just a ruse for some of them; a convenient cloak under which to hide all manner of abuse with impunity and immunity.

These individuals have been granted unrestrained managerial prerogative and absolute power over doctors. They decide not only who to monitor but how that monitoring proceeds in every last detail. Our fates, literally, lie in the hands of this group. No more physicians should die by this system of institutional injustice, bullying and pseudoscience. The conflicts-of-interest are abhorrent and would be incomprehensible in any other venue.

Isn’t it time we take charge? And the solution is fairly simple.

Oversight, regulation, and auditing by OUTSIDE groups. That is how it’s done everywhere else. Why do these guys get a pass?  Why would anyone be against procedural fairness and transparency in any situation? These are legitimate questions.

State Medical Societies, Departments of Public Health, the American Medical Association, the American Council on Graduate Medical Education, the Institute of Medicine and other Accreditation and Professional Organizations need to start addressing this.

This is a Public Health Emergency that is not going away.  It needs to be addressed directly and with urgency; not with kid gloves and temporization.

Accountability is without exception.  It requires both the provision of information and justification for actions.   Accountability also requires consequences for actions if they breach standards-of-care, ethics and the law.

 Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good.

Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

The Medical Profession under Dictatorship–Revisiting Dr. Leo Alexander’s prescient warnings from 1949

Source: The Medical Profession under Dictatorship–Revisiting Dr. Leo Alexander’s prescient warnings from 1949

Advertisements

May 2, 2017 Oral Argument Before Massachusetts Supreme Judicial Court

Disrupted Physician

Screen Shot 2017-05-15 at 12.17.35 AM

Zena Crenshaw-Logal

Executive Director at National Judicial Conduct and Disability Law Project, Inc.

Want to know how it all got started? Michael Langan, M.D., host of our internet radio broadcast, “Protecting Doctors, the Rx for Healthy Patients” and author of the blog “Disrupted Physician”, recently had a few moments to share that story before the Massachusetts Supreme Judicial Court.

Listen carefully to Dr. Langan’s presentation and the response by counsel for the Massachusetts Board of Registration in Medicine.

Then decide if you’ve heard an account of bureaucratic terrorism.

Is this not the Board’s message? Question us and we’ll destroy you in a tangle of red tape, vague aspersions, loop holes, and delays.

And will a man and his family be a cost that the Court considers worth paying to vindicate the seemingly unadulterated power of a state agency — all purportedly in the name of medical patient safety?

https://lnkd.in/e9R67W

View original post 771 more words

May 2, 2017 Oral Argument Before Massachusetts Supreme Judicial Court

Source: May 2, 2017 Oral Argument Before Massachusetts Supreme Judicial Court

Screen Shot 2017-05-15 at 12.17.35 AM

Zena Crenshaw-Logal

Executive Director at National Judicial Conduct and Disability Law Project, Inc.

Want to know how it all got started? Michael Langan, M.D., host of our internet radio broadcast, “Protecting Doctors, the Rx for Healthy Patients” and author of the blog “Disrupted Physician”, recently had a few moments to share that story before the Massachusetts Supreme Judicial Court.

Listen carefully to Dr. Langan’s presentation and the response by counsel for the Massachusetts Board of Registration in Medicine.

Then decide if you’ve heard an account of bureaucratic terrorism.

Is this not the Board’s message? Question us and we’ll destroy you in a tangle of red tape, vague aspersions, loop holes, and delays.

And will a man and his family be a cost that the Court considers worth paying to vindicate the seemingly unadulterated power of a state agency — all purportedly in the name of medical patient safety?


The document is notable for several reasons:

1. It shows clear evidence of collusion between the state physician health program (PHP) and its drug testing lab to commit forensic fraud (the detail is way beyond any of the documentary evidence found in the Dookhan case).  It includes a faxed request from the PHP to the lab requesting the donor ID # on an already positive drug test be changed and the chain-of-custody be “updated.”

2.  The documents show top-down corruption as the collusion is between the medical director of the state PHP (Physician Health Services, inc), Dr. Luis Sanchez (who is also past president of their national organization the Federation of State Physician Health Programs (FSPHP)  which is based in Massachusetts and the Vice President of laboratory operations at United States Drug Testing Labs (USDTL), Joseph Jones.

3.  The documentation of fraud was provided to Board of Registration in Medicine “board” counsel Deb Stoller and Tracy Ottina on December 15, 2011 but never acknowledged or addressed by the board.  Since 2011 scores of suicides have been attributed to allegedly falsified tests (these same tests from the same lab and ordered by state PHPs throughout the country–in the past few months I know three doctors who have killed themselves as a result of the same chains-of-causation (starting with these falsified tests).  Board counsel Stoller was involved in blocking due process and fundamental fairness in the  case of one doctor who killed himself here in Massachusetts who was a friend of mine.  She and Ottina and the Physician Health and Compliance Unit have evidently been  concealing evidence provided by doctors that is both exculpating for them and implicates the PHP in misconduct for years.   It appears that is their function as these “liaisons” to medical boards were put in place at the request of PHPS and apparently operate in the same manner as the “PHP-approved” assessment and treatment centers (who engage in “diagnosis rigging” to charge for assessments ($4-8K) and (inevitable) “treatment” (overwhelming majority of cases unneeded) to the tune of $80-120K) followed by 5-year contracts for drug and alcohol testing using expensive non-FDA approved and non-regulated laboratory developed tests (LDTs) 1-3 week for up to $600.00 per week.  All of this is cash only out-of-pocket no insurance accepted (if it were the racket would be dismantled within a month).    These document contain direct evidence of crimes (including felonies)-no other evidence is needed.

Stoller and Ottina were provided evidence forensic fraud in December of 2011, concealed it and the consequences have been much more far-reaching and grave than Annie Dookhan—-the number of families, careers and lives that have been destroyed since December 2011 is inestimable!   Dozens if not hundreds of suicides have occurred since that time, the loss of countless careers and the snuffing out of careers as they are just beginning (they are now targeting medical students–more sheep for the slaughter). This racket is starting to be exposed in the medical community and the chatter is increasingly increasing–it will make the mainstream media shortly and this grand-scale corruption will be clear.

So what is Massachusetts going to say when it is realized two state attorneys and an assistant AGO knew about it all along and did nothing for years?  There is no plausible deniability here and the willful blindness and veil of constructed ignorance are tread shallow water.   Forensic Fraud and Perjury are not that complicated and obvious to anyone with a modicum of common sense.   AAG Bertram claims no crimes have occurred because no one has been charged with any.  Brilliant!  I didn’t go to law school but I always thought that a crime was determined by the actions (or inactions) of someone as applied to written laws.

Please take a look at the documents.    The  big story  will come out sooner or later.  You should be a part of the solution and on the right side of history when this whole shit-house goes up in flames!

MOTIONS FILED PRIOR TO ORAL ARGUMENTS

1,  Motion to Take Judicial Notice of Adjudicative Facts

2.  Motion to TakeJudicial Notice of Law (Establishment Clause of the First Amendment)

3..Motion to Take Judicial Notice of Adjudicative Facts Pertaining to Violation of the Establishment Clause of the First Amendment

MOTIONS FILED AFTER ORAL ARGUMENTS

4. Petition for Judicial Notice

Source: Medical Students at Risk as Fraudulent Physician Health Programs (PHPs) Cast a Wider Net–Need to Address This Problem at State Level

cropped-screen-shot-2016-10-10-at-9-32-40-pm1

Please donate to this effort below.  Your contribution can and will make a difference.  https://www.gofundme.com/PHPReform

screen-shot-2014-11-26-at-7-10-56-pm1

May 2, 2017 Oral Argument Before Massachusetts Supreme Judicial Court

Screen Shot 2017-05-15 at 12.17.35 AM

Zena Crenshaw-Logal

Executive Director at National Judicial Conduct and Disability Law Project, Inc.

Want to know how it all got started? Michael Langan, M.D., host of our internet radio broadcast, “Protecting Doctors, the Rx for Healthy Patients” and author of the blog “Disrupted Physician”, recently had a few moments to share that story before the Massachusetts Supreme Judicial Court.

Listen carefully to Dr. Langan’s presentation and the response by counsel for the Massachusetts Board of Registration in Medicine.

Then decide if you’ve heard an account of bureaucratic terrorism.

Is this not the Board’s message? Question us and we’ll destroy you in a tangle of red tape, vague aspersions, loop holes, and delays.

And will a man and his family be a cost that the Court considers worth paying to vindicate the seemingly unadulterated power of a state agency — all purportedly in the name of medical patient safety?

https://lnkd.in/e9R67W

VIEW THE ORAL ARGUMENTS @ https://lnkd.in/e9R67WU

Documentation of Collusion Between state Physician Health Program and Drug-Testing Lab provided to Board Counsel Deb Stoller and Tracy Ottina  December 15, 2011 

(Bertram claims this was carefully considered at a December 21, 2011 Board Hearing but it is date-stamped one month after the hearing).  The document is notable for several reasons:

1. It shows clear evidence of collusion between the state physician health program (PHP) and its drug testing lab to commit forensic fraud (the detail is way beyond any of the documentary evidence found in the Dookhan case).  It includes a faxed request from the PHP to the lab requesting the donor ID # on an already positive drug test be changed and the chain-of-custody be “updated.”

2.  The documents show top-down corruption as the collusion is between the medical director of the state PHP (Physician Health Services, inc), Dr. Luis Sanchez (who is also past president of their national organization the Federation of State Physician Health Programs (FSPHP)  which is based in Massachusetts and the Vice President of laboratory operations at United States Drug Testing Labs (USDTL), Joseph Jones.

3.  The documentation of fraud was provided to Board of Registration in Medicine “board” counsel Deb Stoller and Tracy Ottina on December 15, 2011 but never acknowledged or addressed by the board.  Since 2011 scores of suicides have been attributed to allegedly falsified tests (these same tests from the same lab and ordered by state PHPs throughout the country–in the past few months I know three doctors who have killed themselves as a result of the same chains-of-causation (starting with these falsified tests).  Board counsel Stoller was involved in blocking due process and fundamental fairness in the  case of one doctor who killed himself here in Massachusetts who was a friend of mine.  She and Ottina and the Physician Health and Compliance Unit have evidently been  concealing evidence provided by doctors that is both exculpating for them and implicates the PHP in misconduct for years.   It appears that is their function as these “liaisons” to medical boards were put in place at the request of PHPS and apparently operate in the same manner as the “PHP-approved” assessment and treatment centers (who engage in “diagnosis rigging” to charge for assessments ($4-8K) and (inevitable) “treatment” (overwhelming majority of cases unneeded) to the tune of $80-120K) followed by 5-year contracts for drug and alcohol testing using expensive non-FDA approved and non-regulated laboratory developed tests (LDTs) 1-3 week for up to $600.00 per week.  All of this is cash only out-of-pocket no insurance accepted (if it were the racket would be dismantled within a month).    These document contain direct evidence of crimes (including felonies)-no other evidence is needed.

Stoller and Ottina were provided evidence forensic fraud in December of 2011, concealed it and the consequences have been much more far-reaching and grave than Annie Dookhan—-the number of families, careers and lives that have been destroyed since December 2011 is inestimable!   Dozens if not hundreds of suicides have occurred since that time, the loss of countless careers and the snuffing out of careers as they are just beginning (they are now targeting medical students–more sheep for the slaughter). This racket is starting to be exposed in the medical community and the chatter is increasingly increasing–it will make the mainstream media shortly and this grand-scale corruption will be clear.

So what is Massachusetts going to say when it is realized two state attorneys and an assistant AGO knew about it all along and did nothing for years?  There is no plausible deniability here and the willful blindness and veil of constructed ignorance are tread shallow water.   Forensic Fraud and Perjury are not that complicated and obvious to anyone with a modicum of common sense.   AAG Bertram claims no crimes have occurred because no one has been charged with any.  Brilliant!  I didn’t go to law school but I always thought that a crime was determined by the actions (or inactions) of someone as applied to written laws.

Please take a look at the documents.    The  big story  will come out sooner or later.  You should be a part of the solution and on the right side of history when this whole shit-house goes up in flames!

MOTIONS FILED PRIOR TO ORAL ARGUMENTS

1,  Motion to Take Judicial Notice of Adjudicative Facts

2.  Motion to TakeJudicial Notice of Law (Establishment Clause of the First Amendment)

3..Motion to Take Judicial Notice of Adjudicative Facts Pertaining to Violation of the Establishment Clause of the First Amendment

MOTIONS FILED AFTER ORAL ARGUMENTS

4. Petition for Judicial Notice

Source: Medical Students at Risk as Fraudulent Physician Health Programs (PHPs) Cast a Wider Net–Need to Address This Problem at State Level

cropped-screen-shot-2016-10-10-at-9-32-40-pm1

Please donate to this effort below.  Your contribution can and will make a difference.  https://www.gofundme.com/PHPReform

Win a 1964 Rolling Stones Vinyl  45 signed by Mick Jagger, Keith Richards, Brian Jones, Bill Wyman and Charlie Watts–It is your if you can show physician health program director Dr. Luis Sanchez committed fewer than 3 felonies!

 

Screen Shot 2017-01-29 at 11.59.24 PM.png

It has been almost 6  months since I offered over $25 thousand dollars in cool prizes to anyone who could show that past president of the Federation of State Physician Health Programs (FSPHP)  and Medical Director of Physician Health Services, inc. (PHS) Dr. Luis “aka the dirty” Sanchez did not commit multiple felonies  (December 9, 2016)  and no one has been knocking at my door.   All of these prizes can be seen in the post below:

I am Offering Over $25,000 in cool prizes to anyone who can show past FSPHP President Sanchez did not commit at least 3 felonies based on documentary evidence alone! I claim the documents show direct evidence of multiple serious crimes –prove me wrong and the whole lot is yours!

Perhaps the booty isn’t good enough so I added a 1964 Decca  7″ 45 RPM original pressing of Little Red Rooster  (A) and Off the Hook (B) on vinyl signed by Mick Jagger, Keith Richards, Brian Jones, Bill Wyman and Charlie Watts.  This was in addition to the over 25 K of other prizes previously offered. All anyone has to do is look at the documents and show how Sanchez committed fewer than three felonies. If Sanchez committed only two felonies you win!  If Sanchez committed just one felony you win!  Simple enough?

Dr. Sanchez machinations and misconduct can be seen here.  It took a formal complaint with the College of American Pathologists to get the truth out.  More of this fiasco can be seen here and here.   What Sanchez  and his co-conspirators did is egregious and ethically reprehensible.  It shows a complete lack of moral compass and personal integrity.  What was done from collection to report to coverup  and everything in-between is in fact indefensible on all levels (procedurally, ethically, and legally).  So too are the actions of Board attorney Deb Stoller (who not only covered it up forensic fraud but was complicit in it) and those of Assistant Attorney General Bryan Bertram (who is continuing to participate in a cover-up of a cover-up) in violation of ethics and professional conduct. In a perfect society Sanchez would have his medical license revoked and the other two would have been disbarred by now.  In a perfect society all three would be held accountable for crimes.  Does Bertram’s superiors know what he is doing? I don’t think so.  They will at some point.

I think everyone would agree that there should be zero-tolerance for forensic fraud and cover-up and cover-ups of cover-ups in positions of power.    Any person of honor and civility would agree. The documentary evidence shows with clarity that this subterfuge and chicanery was not accident or oversight.  It was intentional and purposeful misconduct.  It is indefensible. Attorneys cannot ignore the obvious.

Transparency, regulation, and accountability are necessary for these groups.

To be fair if Sanchez  can give any  procedural, ethical, or legal explanation for his actions then I stand corrected.  Same applies to his apologists, lackeys and  morally challenged counterparts Stoller and Bertram.  Just one will suffice.  I’ll erase my blog and vanish into oblivion.  No questions asked. Into the woodwork.  But If this trio  cannot then this malfeasance needs to be addressed openly and publicly.   It is their agencies responsibility to correct this –however late the hour may be.  My suspicion is that all of this has been blocked from going upstream.

Forensic fraud has grave and far reaching effects and in this case has severely impacted many people and includes patient deaths. Perhaps this trio needs to take a “moral inventory” and see that this this type of behavior causes real damage to real people and put a faces on it.  The increasing comments on Pauline Anderson’s latest Medscape article would be a start.

Perhaps Sanchez, Stoller and Bertram  need to be asked these questions by an  investigative reporter. Direct and simple questions deserve direct and simple answers.  “Not my department” and “no comment” are no longer acceptable.  We need to demand answers.

It is people just like this who are killing physicians across the country.   The body count is vast and multiple. This type of behavior is directly and temporally related to the recent epidemic of suicides in doctors.  They have removed themselves from conventional accountability by withholding information and suppressing facts. No longer.  The sympathizers and apologists who refuse to acknowledge or investigate wrongdoing will be held to account. Sanchez, Stoller and Bertram believe they are beyond reproach; complacent in the belief they are protected from harm and insulated from investigation.   The evidence, however, is not going away. Neither am I. Neither are the growing legion of ethical individuals who want to drain this swamp.

Corruption is misuse of entrusted power.  It occurs when those who have been given authority to carry out expected goals instead use their position and power to benefit themselves and others close to them. Abuse of power is particularly egregious when that person is doing the opposite of what he or she is supposed to do.

Accountability is necessary to prevent corruption and necessitates both the provision of information and justification for actions;  what was done and why?   The other defining factor of accountability is the ability of outside actors to punish and sanction those who commit misconduct or wrongdoing.    Without these constraints corruption is inevitable.

This is corruption plain and simple and  The doctors and patients of Massachusetts and the doctors and patients of this entire country deserve better than this.

As no checks and balances exist I am offering 25K in prizes and now adding a 1964 45″ signed by the Rolling Stones; Mick Jagger, Keith Richards, Brian Jones, Bill Wyman and Charlie Watts.  One of the problems in this system cognitive dissonance and the belief that there must be something more to it.  There isn’t.  Fact is I could offer you my car, everything I own or my very soul and you would still not be able to disprove that Sanchez committed multiple felonies, that Stoller not only  covered it all up but was complicit and that Bertram is engaging in a cover-up of a cover-up by misusing administrative law and is in violation of the rules of professional conduct and basic ethics and morality. So here’s the ticket.  Either come get the prizes or help me get this exposed and dismantled.  Either defend them or help me hold them accountable. Silence is not an option.

 

Source: Adding 1964 Rolling Stones Decca 7″ 45″Off the Hook” Vinyl signed by Mick Jagger, Keith Richards, Brian Jones, Bill Wyman and Charlie Watts to 25 K in prizes previously offered to the first person who can disprove FSPHP President did not commit multiple felonies!
Screen Shot 2014-11-26 at 7.10.56 PM

Medical Students at Risk as Fraudulent Physician Health Programs (PHPs) Cast a Wider Net–Need to Address This Problem at State Level

Disrupted Physician

article-2213636-155C7ED2000005DC-475_634x733.jpg

An old joke asks “How does a doctor define an alcoholic?”  Answer–“anybody who drinks more than he does.”   How does a physician health program (PHP)  define an alcoholic?  Answer –anybody who walks through the front door. These profiteers and “addiction addicts” want to test the urine, blood, hair and nails of the entire population but their current net has now expanded to medical students.   They want to test them all and let God sort them out but in reality, a zero-tolerance paradigm utilizing non-FDA approved tests of unknown validity would be  ruinous. With recreational and experimental drug use common in young adults a profession that refuses to accept anyone who tests positive for drugs will exclude large numbers of brilliant, talented individuals and dismissing highly talented people in medicine for what might be a one-off recreational non problematic drug experience would retard its advance.

Screen Shot 2017-04-14 at 10.11.53 PMThe use of these non-FDA approved tests…

View original post 1,079 more words

Recovery Related Racket: The Federation of State Physician Health Programs (FSPHP) represents the drug and alcohol testing, assessment and treatment industry not us. We need to name the enemy.

Source: Recovery Related Racket: The Federation of State Physician Health Programs (FSPHP) represents the drug and alcohol testing, assessment and treatment industry not us. We need to name the enemy.

Gay Doctor coerced by Physician Health Program (PHP) into mandated 12-step treatment and monitoring for sex addiction: The slippery slope begins

Source: Gay Doctor coerced by Physician Health Program (PHP) into mandated 12-step treatment and monitoring for sex addiction: The slippery slope begins

gay-friendly-doctor

State Physician Health Programs -coercion, control and abuse.

This anecdote concerning  a gay doctor’s revelation he liked his non monogamous lifestyle leading  to a forced acceptance of a “sex addiction”  diagnosis, mandatory inpatient treatment and indoctrination into 12-step recovery was just posted on the physician social network SERMO.    If the pattern looks familiar it is.

Screen Shot 2015-04-10 at 11.56.04 PM

Physician Health Programs (PHPs) are non-profit NGOs that exist in every state ostensibly to help impaired doctors and protect the public from harm.  PHPs have no regulation or oversight and have essentially removed all accountability. Under the ruse of protecting a doctors anonymity and providing confidentiality they have built barriers of opacity.  Most doctors are unaware how they work unless they become involved with them and they are not on the radar of the public at large–they need to be.

Organized under the Federation of State Physician Health Programs, (FSPHP),  state medical boards have abdicated their responsibility and consider them expert authority on all things related to physician health–a logical fallacy that has placed illegitimate and irrational authority in professional control of medicine once again proving that knowledge isn’t power and ignorance often reigns.

PHPs encourage confidential referrals for “warning signs” such as those on the list below from the Massachusetts PHP, PHS, Inc. and guarantee  the reporters anonymity.  All semblance of due process has been removed.  Medical boards have given state PHPS complete and absolute managerial control over  assessment,  treatment and monitoring.  PHPs are not healthcare providers but monitoring agencies.  If a PHP recommends an “assessment” of a reported doctor there is no choice in the matter.   No allowances for a second opinion,  outside support or appeal exist.Screen Shot 2015-03-06 at 7.33.17 AM

This doctor was apparently reported to his state PHP because a patient thought she smelled alcohol on his breath.  As it turned out, the accusation was bogus but by being honest and forthcoming about his sexual orientation in the interview the PHP mandated an “assessment.” for unrelated issues.  A not uncommon scenario as reports of behavioral issues often end up with hair tests for alcohol and other substances resulting in mandated assessments for “substance use disorder” followed by a five-year monitoring contract with the PHP and weekly urine tests.

The PHP provides  a list  of three or four facilities drawn from the same pool of “PHP-approved” assessment and treatment centers. However, an audit of the N.C. PHP found no written objective criteria or quantitative measurements existed on how these assessment and treatment centers are “approved” by the PHP.  The common denominator seems to be that these facilities are  (1) 12-step ASAM directed, and (2) willing to “tailor” an assessment to support a predetermined diagnosis. It is, in fact, a rigged game.  Unfortunately the medical boards have been duped into mandating assessments at these centers under threat of loss of medical license and specifically exclude non “PHP-approved” assessments.

This scaffold  is also the unspoken and hushed major contributor to physician suicide—It is the elephant in the room no one speaks of out of fear of being targeted.    Doctors who really need help for mental health, substance abuse or other issues are afraid to get it for fear of being reported to the PHP.  Those already monitored are subject to all sorts of psychological, financial and emotional abuse.

The Federation of State Physician Health Programs (FSPHP)  has a relationship with Pine Grove.  It is one of the “PHP-approved” facilities and two of their staff, Phillip Hemphill, PhD and James C. “Jes” Montgomery, MD are are listed as Program Faculty at the FSPHP annual educational conference and business meeting on April 24-27, 2015 in Fort Worth Texas.

26well-gaydoctor-tmagArticle

Political Abuse of Psychiatry

Political abuse of psychiatry is the “misuse of psychiatric diagnosis, detention and treatment for the purposes of obstructing the fundamental human rights of certain groups and individuals in a society.  The coercive use of psychiatry represents a violation of basic human rights in all Cultures.Screen shot 2013-05-13 at 1.29.38 PM

What has occurred in the medical profession is no different from China or the Soviet Union under totalitarian rule where dissent is disapproved, often punished, and those perceived as threats to the existing system can be effectively “neutralized with trumped up psychiatric illness” and by this stigmatization reputations were ruined, power was diminished, and voices were hushed.

Screen Shot 2015-03-12 at 11.17.53 PM

Political abuse of psychiatry involves the deliberate action of diagnosing someone with a mental condition they do not have as a means of repression or control and if you do not believe it is occurring right here today then take a look here and here to see how they are colluding with commercial drug testing companies to engage in forensic fraud and the assessment and the treatment centers to fabricate data to support non-existent diagnoses.

“Sex Addiction” used as a tool to Discriminate

There has been a lot of “chatter” in PHP circles concerning “sex addiction” and I knew they had been aligning themselves and setting up specialized programs at certain facilities.  It seemed unusual as many of the key players who erected and run this scaffold have themselves been involved in sexual misconduct.   Screen Shot 2015-01-09 at 5.22.34 PM

009935_3_thumb

One of the architects of the current system, Dr. Robert Walzer, M.D., J.D. who was instrumental in tinkering with administrative and medical practice laws to remove the due process and appeal rights of doctors surrendered his license in 2001 due to inappropriate sexual relationships with patients.  He was the co-author of the current physician health program paradigm.

Dr. Margaret bean-Byog, M.D, Chairman of the credentialing 7109298-Mcommittee for the first certification exam and ASAM president surrendered her medical license after being accused  of sexually abusing one of her patients, a Harvard medical student who subsequently died by suicide.

Somehow, I don't think this is quite what they had in mind!And the FSPHP seems to treat doctors involved in sexually related misconduct in a favorable light.  Take for instance, Dr. James Peak, M.D., a child psychiatrist who was sent to prison on a federal child pornography conviction taken under the wing of the Montana PHP.  After “proving” he only ‘”looked” at pornography of young boys but never abused any using a polygraph “lie-detector” test his license was reinstated in no time at all.  His treatment includes going to one AA meeting and one 12-step sex addict meeting per week.  My guess is they need more staff at the PHP or one of the assessment centers.

Screen Shot 2015-04-11 at 2.25.11 AM

I had been wondering what the motivation was behind this focus on “sex addiction” and my suspicions seem to be correct.

I have since heard of a second case of a gay doctor being forced into his state Physician Health Program (PHP) in Alabama.

Once under the control of the PHP most doctors are afraid to come forward because of the “swift and certain” consequences imposed on them.  All they have to do is say the doctor was “noncompliant” to the medical board and it is over.  They lose their license and there is not a thing they can do about. it.  I have heard from doctors in multiple states going to law enforcement,  the Attorney General,  the media and the ACLU only to have the door slammed in their faces. Myself included.    .

The coercion, control, ethics, and civil and human rights violations remain hidden.  The crimes remain hidden. So too will this.

It appears the FSPHP is following the same pattern they have with the “impaired” and “disruptive” physicians–to discriminate.    The targeting of gay, lesbian or transgender doctors for what they do in their private lives is predictable.  It is an inevitable part of this well oiled slope of coercion, control, obedience and abuse.

The import of this can not be overestimated.


References:

Position Statement on Political Abuse of Psychiatry. Paper presented at: Global Initiative on Psychiatry2005.Birley JL.

Political abuse of psychiatry. Acta psychiatrica Scandinavica. Supplementum. 2000;399:13-15.

4-stage-plan1week-4-human-rights-8-638

Backdraft: How Firefighter Arson was Reduced by Admitting, Defining and having Zero-Tolerance for the Problem–A Lesson for the Medical Profession

Disrupted Physician


match

Firefighter Arson

In his book “Fire Lover: A True Story,” Joseph Wamnaugh profiles Fire Captain and  Senior Arson Investigator for the Glendale California  Fire Department John Orr.  Known for his uncanny instincts in solving arson cases, Orr often astounded other investigators with his seemingly brilliant deductions in determining the causes of incendiary crime.

As it turns out, neither instinct nor brilliance played any role.   Orr solved many of these cases by first-hand  knowledge. He actually started many of the infernos he fought.  Burning down businesses and homes for over a decade, investigators suspect Orr may have intentionally set as many as 2000 fires.

John Orr John Orr

One involved a large Pasadena hardware store that killed four people including a 3-year old toddler and his grandmother. Orr is now serving a life-sentence at Lompoc Penitentiary.  Details of his arsonist acts are described in chilling detail in his own book,  “Points of Origin…playing with fire.”

The problem of arsonist firefighters…

View original post 5,057 more words