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

Advertisements

Doctor suicides prompt calls for overhaul of mandatory reporting laws – Australian Broadcasting Corporation

http://abc.net.au/news/2017-04-13/doctor-suicides-prompt-calls-for-overhaul/8443842?pfmredir=sm

Posted 13 Apr 2017, 6:14am

The suicides of three young doctors in New South Wales within just five months has led to calls for a review of mandatory reporting laws, which many health professionals believe are stopping doctors from asking for help.

Psychiatrist Dr Helen Schultz said practitioners were reluctant to come forward for fear of losing their medical licence.

“I get really caught between that R U OK Day and tell everyone [about your mental health] and there’s no stigma … to actually, tell nobody, keep it to yourself. Because that grey area could end up being misused against you,” Dr Schultz said.

A mature-aged student when she came to medicine, Dr Schultz struggled with her own mental health. She sought help after the suicide of a colleague, but wasn’t sure she would do so today.

“I was feeling very disenfranchised with doing medicine … I was crying driving to work, I felt very low self-esteem at the time and I went and saw this person and this person got me help,” she said.

“But would I tell somebody now if I was that fourth year student in an era of mandatory reporting? I don’t know.”

‘They were going to save many lives’

If you or anyone you know needs help:

Professor Brad Frankum, president of the Australian Medical Association (NSW), said mandatory reporting could be “a very challenging and threatening experience for anybody”.

“If a doctor discloses to their treating [doctor] that they have drug addiction problems or mental health problems, then it is mandatory for that treating doctor to report that to AHPRA [Australian Health Practitioner Regulation Agency],” he told 7.30.

“Once that report happens, AHPRA can’t ignore it of course and an investigation needs to take place.”

Prof Frankum said in the past 12-18 months he was aware of three young doctors in training who had taken their lives, as well as two senior doctors and a young medical student.

“They were going to save many lives and do great things, and that potential is lost,” he said.

Family could see young doctor was struggling

One of those young doctors was Chloe Abbott, who had just landed a job at Sydney’s St Vincent’s Hospital to do her physician training, with dreams of becoming an endocrinologist.

“It was just this calling that she had that she wanted to help others. She wanted to make other people’s lives better,” her mother Leonie Eagles said.

Last year those closest to Chloe began to notice the determined young doctor was struggling.

“I did say to Chloe in September 2015 that I was really worried that this job was going to cost her her life,” her sister Jessica said.

Chloe’s friend, Dr Zac Turner, recalled Chloe was also grappling with the death of a colleague, a young registrar who had taken her own life.

“Quite dramatically it affected Chloe. They were working together at Campbelltown, they were part of the same network,” Dr Turner said.

“You work from before dawn to well after dusk at night with people. There’s a real community and family and camaraderie, in some aspects, in the hospital and I don’t think she processed that particularly well, I don’t know if the support was there.”

Late last year Chloe was admitted to a psychiatric inpatient ward.

Few knew at the time that Chloe was facing a career crisis: her medical registration had been suspended.

In January this year, Chloe took her own life. Her family is still struggling to come to terms with it.

“Six months ago I never would have thought I’d have a daughter that would have committed suicide,” Leonie Eagles said.

“I had a daughter who loved her life, sisters, boyfriend, and to think that she’s given that up because of the positions medicine has put her in is just heartbreaking.

“They can’t sweep this under the carpet and say we’ll look at it in six months, 12 months. Four more people could have lost their lives in six months.”

‘Young doctors need to be supported’

Seven weeks into the job, NSW Health Minister Brad Hazzard says his department is taking the issue of young doctor suicides seriously.

“It’s a cultural issue which goes back for decades and we need to make sure that the older doctors supervising the younger doctors understand in this day and age those pressures need to be recognised, and the young doctors need to be supported,” he said.

“We’re bringing a forum of all these young doctors and older doctors as well together in June to allow them to express their concerns.”

Psychiatry registrar Dr Ben Veness is seeking a special commission of inquiry, and has written to Mr Hazzard on behalf of 150 of his colleagues.

“In our letter we ask for an in depth investigation into what are the factors that are underlying doctors’ distress,” Dr Veness said.

“What I think we need to do is something different from what’s been done before and that is looking at other industries as well, having expertise from outside, things like the mining industry which has also suffered from high suicide rates.

“Also we’d like to see what are the things that are being done or could be done to identify doctors who are at risk, so we’re not waiting for a tragic event like one of these suicides.”

See:  The+Future+of+the+VDHP.+A+Discussion+Paper+prepared+on+behalf+of+AMAVic+MPBV++VDHP  The future of the Victorian Doctors Health Program

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!

screen-shot-2016-12-09-at-12-18-42-pm

According to Erich Fromm rational authority is based on competence, experience, and mutual respect.  Irrational authority is often disguised as benevolent paternalism and is designed to perpetuate or intensify conditions of inequality through the use or threat of force, deceptiveness, and secretiveness.

The Federation of State Physician Health Programs (FSPHP) has has operated as an unexamined authority for the past 25-years .  They have pushed practice and policy unquestioned and without opposition that has gravely harmed individual doctors, the medical profession itself and the public at large.  Everything they have done has been done to benefit themselves and their drug and alcohol assessment, testing and treatment affiliates in the provision of protections, power and profits.

Examining the specific practice and policy pushed reveals a body of false-claims making designed to facilitate the systemic use of coercion and threats, remove all due process protections and fundamental rights from physicians and prevent, block and eliminate the evidence.  This practice and policy collective has created a culture of impunity, immunity and deference that is able to successfully conceal ethical violations and crimes.  Uncovering their wrongdoing is a nearly impenetrable gauntlet. It is a system of institutional injustice that is undoubtedly a major contributor to the suicide epidemic in the profession.  They have been able to conceal the truth, avoid investigation and prevent punishment for years by removing themselves from all accountability and outside inquiry. Direct and specific questioning appears to be their Achille’s heel as the recent spat of articles critical of these programs is showing just how much of an illegitimate authority they really are.

In her rebuttal to Pauline Anderson’s article “Physician Health Programs: More Harm Than Good?” FSPHP President Doris Gunderson dismissed the accusations of fraud and abuse in one fell swoop as  “allegations rather than facts” and second hand anecdotes.  Countering allegations of an absence of oversight and regulation she states:

screen-shot-2016-01-13-at-9-56-37-am

“In fact, we operate under a microscope, answering to individual practitioners, medical boards, malpractice carriers, defense attorneys, state attorneys, medical societies, hospitals, medical schools and residency training programs. We are also accountable to patient safety entities and a Board of Directors.”

Untrue. Accountability demands both provision of information and justification for actions to outside entities capable of punishing misconduct. . What was done and why?  No such entity exists and no pathway for appeal or grievance redressal exists either. Zero accountability.  Ditto for the “PHP-approved” assessment and treatment centers. As cash only out-of-pocket facility they remove themselves from the prying eyes of insurers.

screen-shot-2016-01-13-at-9-55-47-amThe North Carolina PHP Audit  found the past FSPHP President and NC PHP director Warren Pendergast could not identify the qualitative or quantitative indicators used for “approving”  PHP-approved facilities. The best he could come up with is “reputation” and “word of mouth” yet state medical boards mandate evaluations of doctors at these  facilities and specifically exclude  non-“PHP-approved” facilities.This is enforced by the Federation of State Medical Boards Policy on Physician Impairment.  Each state managed by the FSPHP utilizes the same dozen or so facilities and each state medical board mandates it under threat of disciplinary action.  It is in fact a rigged game.

Denying accusations of coercion Gunderson states in her rebuttal to Anderson’s article:

“The detractors of PHPs interviewed for the article maintain that PHPs are coercive. Yet the report fails to mention that PHPs have no authority to mandate treatment and monitoring, suspend or revoke licensure, or otherwise discipline physicians.”

screen-shot-2015-10-07-at-7-11-18-pmThe report fails to mention it because it is more either/or logical fallacy based on the false dichotomy between “treatment” and “punishment” that is often used to promote the FSPHP mythology.  Although PHPs do not have the legal authority to mandate, suspend or revoke a license they have the functional authority to do so.   This is also dictated by public policy.  (ASAM Policy on Coordination Between Treatment Providers,  Professionals Health Programs, and Regulatory Agencies).

Legitimate authority articulates ethical, evidence-based, or internally consistent arguments when challenged.  Legitimate authority does not simply delegitimize one’s opponent and use logical fallacy and obfuscation to avoid addressing the substance of an argument. In her rebuttal Gunderson claims the NC Audit was favorable to them because no evidence of abuse was found.  This is akin to a serial killer claiming victory because no bodies were found in his dungeon replete with torture devices and restraints. State auditor Beth Wood set this straight when she told the BMJ in  Physician Health Programs Under Fire  that the holes were big enough in the program “you could drive a truck through them” and it would be “difficult, if not impossible, to defend” oneself against an incorrect assessment” as no ability to “appeal a diagnosis or assessment” existed.

screen-shot-2016-01-13-at-9-52-11-am“Compounding the problem, said Wood, was that “the chief executive and medical director were in total control of entire process.” They assessed allegedly impaired doctors, but when those assessments were contested, they were responsible for presenting complaints to the state medical board. The doctors concerned were not allowed to be present and were not allowed to see the programs’ medical reports on them.”

Multiple Barriers Removing Accountability at Multiple Levels

The  inability to obtain one’s own medical records or lab reports is the first obstacle one must overcome. The second barrier is that even if documents are obtained there is no one to give them to.  The third is the existence of “point people” who deflect, block and otherwise dismiss valid complaints.  The only oversight provided to the involved labs is an an accreditation agency, the  College of American Pathologists (CAP) They can investigate and correct but do not have the ability to sanction.

screen-shot-2016-12-09-at-1-13-29-pmOf the many hundreds of doctors I have spoken to and who have taken my survey not one has been able to obtain evidence of abuse.  It was either refused, censored or doctored.   I have obtained documentary evidence that is specific, detailed and unequivocal.

It is therefore critical it be recognized for what it shows and it is morally imperative that those involved be held to account as the documents illustrate clearly and undeniably a collusion between a state PHP and its drug testing lab to fabricate evidence.  The corruption is top-down as it involves another former FSPHP President Luis Sanchez and the VP of Laboratory operations at USDTL Joseph Jones.  As explicit and detailed as it is in revealing unequivocal  black and white crimes it has been ignored by the usual channels.

Research on street criminals suggests the certainty of punishment has the strongest deterrent effect (basically will I be caught) and the more people think they will be arrested for a crime the less likely they are to commit it. Criminals weigh their actions against possible gains and consequences and the risk of consequences in this system have been essentially zero.  Diagnosis rigging, coercion, threats and abuse are rampant because they have no fear of punishment.  The Chairman of the commission that examined the  causes of the 2008 financial collapse compared the  relatively small fines paid by corporations to “someone who robs a 7-Eleven, takes $1,000 and being able to settle for $25 and no admission of wrongdoing.” He added,“Will they do it again? Absolutely, because it pays.” This is like someone who robs a 7-Eleven, takes $1,000 and never gets caught so he goes to the next 7-Eleven and takes $2000 then hits as many 7-Elevens as he can for as much as he can.

Multiple Crimes, Multiple Felonies and Egregious Misconduct.  Fabrication, Falsification, Concealment and Perjured Evidence. Color-of-Law Abuse, Civil Rights Violations 

In June of 2011 I signed a patent-license agreement with a company to bring an epinephrine auto-injector to FDA approval  within three years.  It was recently mentioned in an NBC news article in the wake of Mylan’s Epipen price hike and the patent  documents can be seen here and a slideshare overview here.  This was successfully derailed the following month when I was asked by the state PHP to have an alcohol test.  This was for no apparent reason. I have never been accused of having an alcohol problem and my work performance at MGH was reported as “impeccable.” There were no issues in any arena.  The events are described in detail here, here, and here.

The blood test was reported positive to the medical board on July 19, 2011 as seen here:   positive-peth-july-19-2011    I requested records but PHS refused but relented in December 2011 and I obtained the   USDTL Litigation Packet  which contained a faxed request from PHS to the lab requesting my unique  identification number and a “chain-of-custody” be added to an already positive report See key docs here.:12:3:2011 Litigation Packet (Selected)

The records showed falsely created and fabricated evidence. Clear fraud. I filed a complaint with the College of American Pathologists CAPLetter.  They investigated and forced USDTL to correct the test as reported in an  October 4, 2012 letter from the lab to Sanchez. Instead of revealing the correction the two concealed the revision and reported “non-compliance”  two weeks later  and board took disciplinary action against my license.  In December 2012 CAP contacted me to followup on the outcome of the revised test which I was unaware of.   I informed them they did not tell me and confronted  PHS but they claimed no knowledge of it.. On December 11, 2012 Sanchez reports to the board that he just found out that the test was revised but it had nothing to do with the disciplinary action taken by the board..  Sanchez and Jones deny there was any correction 67-days earlier and stand by their guns.

In August of 2014 I was able to obtain the complete USDTL documents under new HIPPA-Privacy Rule for labs which removed PHS approval.  Full docs can be seen here:  August 6, 2014 to Langan with health materials.   The  October 4, 2012 correction from USDTL to Sanchez  contradicting Sanchez claim of not finding out about the correction until December is included.Note the language used in the  Letter claiming Sanchez was informed of the revised  test 67-days after he actually was.

Recently obtained documents under records reform act –  Langan PDF copy  They show documents entered as evidence date-stamped and entered into the administrative record after the hearings at which they were to be heard.   Multiple others missing and never addressed.   It is now clear that Stoller concealed all documents relating to PHS misconduct since December of 2011.

Specific and detailed evidence of criminal activity was provided to Board Attorney Deb Stoller over the course of more than five-years. This showed clear collusion between the state physician health program and one of their preferred national drug testing labs.  It is important to recognize the gravity of what this means.   I provided a state officer with evidence of crimes similar to Annie Dookhan–clear fabrication and collusion to fabricate evidence. She suppressed it.     This is much much worse than Annie Dookhan as the lab is used by state physician health programs across the country and over the past five-years their have been multiple suicides of doctors who have allegedly been given fabricated drug and alcohol tests just like mine.    Many of these doctors were given positive tests right before they were to complete a 5-year contract and this is a pattern that seems to be occurring as the rule rather than the exception.   Facing five more years of abuse some doctors have chosen to end their lives rather than continue with the PHP.

Specific and detailed evidence of the fraud was given to Deb Stoller over the course of five-years and she did nothing about it to protect Sanchez.   The impact of this is much greater and the consequences much more severe than what occurred with Dookhan.  As The documents clearly showed felony crimes this is egregious and indefensible.

screen-shot-2016-12-09-at-1-14-00-pmWhat is chilling is that this request to falsify evidence was done by fax and the lab complied with full knowledge that the positive-test would result in grave and possibly permanent consequences for someone.  The moral detachment of Jones is incomprehensible to me.  If I was offered a  million dollars at this moment to fabricate a drug test on some stranger I would not do it. I would not for any amount of money and I don not believe the majority of my friends would either.I also contacted Jones (  August 6, 2014 to Langan with health materials ) and told him of the severe consequences this was having for my family but he did not respond.   Had it not been for the new HIPAA -Privacy rule I would never have obtained these documents and without the record reforms act I would never have obtained the evidence implicating Stoller ( Langan PDF copy )

screen-shot-2016-12-09-at-1-13-52-pmIt is now time to enter phase two of exposing the corruption of PHPs. It is now necessary to necessary to relentlessly contradict the lies and falsehoods and and present the evidence with logic and clarity.    It is necessary to name names, point fingers and demand that direct and specific answers to direct and specific questions.  It is time to shine a bright light on the specific  unethical and illegal acts detailed here. They are the rule not the exception and the diagnostic rigging and forensic fraud make these more murders than suicides. This is a public health emergency.   By my estimates over 80% of those being monitored by PHPs do not even meet the diagnostic criteria for substance use disorder or any other psychiatric disorder.  It is political abuse of psychiatry.

screen-shot-2016-04-26-at-10-58-19-pmLegitimate authority has a responsibility to be truthful to one’s words and deeds and policies need to be enforced in a consistent manner.  State PHPs are engaging in fraud in collusion with their preferred drug and alcohol assessment, testing and treatment centers.   They are giving diagnoses to individuals who do not meet the diagnostic criteria for a given diagnosis to provided unneeded treatment. They are financially exploiting doctors under threat of disciplinary action against there medical licenses.

screen-shot-2016-09-09-at-3-58-30-am

The Board claims no crimes were committed because no one has been charged with any crimes.  No, Dr. Sanchez has committed very serious crimes including multiple felonies. This can no longer be ignored. These crimes can be determined by the documentary evidence alone. They are self-evident.

To settle the matter once and for all I am offering over $25,000.00 in cool prizes to the first person who can disprove my claim that Dr. Sanchez committed multiple felonies.    My claim is that by simply looking at the dates and documents multiple felonies are clear.  They are not equivocal.  The first person to disprove this assertion may collect each and every item pictured below.  You can even write up a legally binding contract and I will sign it. There is something for everyone and if anyone has any questions about any of it feel free to ask.screen-shot-2016-09-09-at-7-26-42-pm

To summarize,  I can find multiple clear  felonies in the documents that need no further inquiry. They are black letter law and involve fraud, concealment, perjury and other crimes.  Policies and laws need to be enforced equally.   The Board cannot play favorites and give allowances to its friends when it comes to criminal activity.  Sanchez is licensed by the medical board just as I am and the screen-shot-2016-09-09-at-9-08-18-pmboard’s position on the fraudulent practice of medicine is quite clear.

One felony would be demand the board address what is seen here.  Multiple felonies make it inexcusable to ignore and if it is ignored it will be relentlessly addressed again and again and again.   As it is so difficult to obtain evidence it is necessary that this be addressed with full measure as a precedent.  People just like this are harming good doctors across the country and unless you are profiting from the drug and alcohol testing and treatment racket you should be disgusted at what is seen here.   The fact that Sanchez pontificates on the behavior of others makes this particularly egregious.  Moreover, Jones also tests newborns and other groups with these same tests.  If he is this unethical who knows what amount of damage has occurred.  Anyone of integrity and conscience should be outraged by what is seen here.  As it is one of the clearest and most specific examples of laboratory fraud I am going to be asking for help getting this out–it should be used to show how this type of drug and alcohol testing can be abused.

Direct and specific questions deserve direct and specific answers. This will need to be addressed directly as it is not going away and neither am I.   If cannot disprove fewer than three felonies than they need to be addressed.   Suspect similar point-people in other agencies protecting them.

If multiple felonies were not committed then  you would think at this very moment there should be people knocking on the door trying to get my attention so they can collect these prizes.    I don’t hear anybody knocking, do you?

screen-shot-2016-02-09-at-3-39-27-am

Prizes as Below

Medscape Article Now Live! Please comment and tell your stories now!

screen-shot-2017-01-27-at-11-34-00-amLink to Medscape article by Pauline Anderson Here:

Link to illegible, post-dated and undated documents submitted as evidence  and mentioned in article can be seen here>  board-records-obtained-june-2016

Link to document written June 6, 2013 but date-stamped as being received in 2012 ( both by hand and apparently by the Board’s Document Imaging Unit (DIU)  > Back to the Future: Massachusetts Board of Registration in Medicine


screen-shot-2017-01-27-at-11-25-36-amscreen-shot-2017-01-27-at-11-23-28-am

Michael Langan, MD, a Boston-based internal medicine specialist who has fought the Massachusetts Physician Health Service (PHS) and Board of Registration in Medicine for years to reinstate his license, has suffered a setback but is bolstered by a new development.

A justice of the Supreme Judicial Court of Massachusetts has denied Dr Langan’s petition to invalidate the 2013 suspension of his medical license for not meeting conditions to have his license reinstated.

However, a new law has enabled Dr Langan to access his records. According to Dr Langan, these documents show that the court did not consider key evidence in his case, as demonstrated by the fact that his hearing occurred after the date of receipt that is stamped on the documents. This may offer an opportunity to reopen his case.

The court decision, which was handed down in December by Associate Justice Geraldine Hines, states that although Dr Langan completed required psychiatric evaluations, he “did not submit a suitable worksite or substance abuse monitoring plan. In combination with his violation of the LoA [Letter of Agreement] meeting requirement, the board’s decision to affirm its prior suspension of petitioner’s license to practice medicine is supported by the record. The board’s decision to deny reinstatement in the absence of an acceptable plan is affirmed.”

“It’s unbelievable; everyone is dumbfounded,” said Dr Langan of the decision.

Dr Langan is appealing the denial of his petition, a process that will take an estimated 6 months.

He maintains that the PHS committed “forensic fraud” and concealed doing so.

“If I couldn’t win with all the direct evidence of felony crimes that you don’t need to be a lawyer to recognize, then I don’t think anyone can,” he told Medscape Medical News.

The PHS is a confidential resource for physicians and medical students seeking help for a variety of physical and behavioral health concerns, which may include difficulties with substance use.

In 2007, Dr Langan was at Massachusetts General Hospital (MGH) and Harvard University when he approached the PHS to help him with his dependence on Vicodin, an opioid analgesic.

He became dependent on Vicodin after a bout of chickenpox during residency, when he developed shingles. He stressed that there were no work-related problems associated with use of this drug.

 He was an inpatient at the Talbott Recovery Center in Georgia for more than 3 months, after which he signed the requisite 5-year contract with the PHS that included regular drug testing.

According to Dr Langan, there were no problems until mid-2011, when a report from the US Drug Testing Laboratories found he was positive for phosphatidylethanol (PEth), a blood marker for chronic alcohol use.

The level detected was 365.4 ng/mL, which “is the equivalent of drinking a half gallon of whisky a day,” or a sign of end-stage alcoholism, said Dr Langan, who insists he has never had an alcohol problem.

“That the test was invalid at this point should have been self-evident,” said Dr Langan.

Lab Fraud?

Suspecting that there had been “lab fraud” and that he would “end up being admitted for 3 months,” Dr Langan said he requested, but was denied, an independent evaluation outside the 12-step PHP-approved list of facilities. Because his request was denied, he attended one of the approved facilities, Hazelden Addiction Treatment Center, in Minnesota, where he “was cleared.”

 “They noted no past or present history of alcohol use or abuse and sent me back after a 4-day evaluation,” he said.

An independent investigation by James G. Flood, PhD, who has been chief of toxicology at MGH for nearly 30 years, concluded in a November 5, 2012, letter to Dr Langan’s lawyer “that there is a purposeful and intentional act by PHS” to show Dr Langan’s test as valid “when in reality this test was invalid and involved both fatal laboratory errors” and inadequate review of the results.

Any confirmatory, positive finding based on the July 2011 test “should be reversed, rectified and remediated,” Dr Flood writes.

 Among the “many errors in sample collection, processing and transportation,” said Dr Flood, was that the documentation that was received with the specimen did not have a date and time of specimen collection. Moreover, the person who collected the specimen was not properly identified, the signature of the sample donor was missing, and there was no tamper-proof seal affixed to the specimen.

Dr Flood claims the sample was directed to the wrong laboratory, where it sat for several days. The storage conditions of the sample while at that laboratory were not documented.

Following an investigation by the College of American Pathologists, in October 2012, Dr Langan’s laboratory test result was corrected from having a positive result to being an invalid test, but he said he did not learn of this change until months later.

 In a letter to the Massachusetts Board of Registration in Medicine, Luis T. Sanchez, MD, who at the time was the director of the Massachusetts PHS, said the amended report indicates that the “external chain of custody protocol [for that sample] was not followed per standard protocol.”

Dr Sanchez noted that, on the basis of the revised report, “PHS will continue to disregard the July 2011 PEth test result.”

Dr Langan requested the record of the chain of custody pertaining to his testing. This document showed that the test was “not only invalid but falsely created,” said Dr Langan. He added that it included a fax from the PHS requesting that his identification number be added to an already positive test and that the chain of custody be updated.

“You can’t update a chain of custody, as it is generated in real time,” said Dr Langan. “This is forensic fraud. It clearly shows collusion between the PHS and the lab.”

In an October 2012 letter, Dr Sanchez alleged that Dr Langan did not attend required peer support group meetings, but according to Dr Langan, this claim is “without fact or support.” Dr Langan maintains that he attended all required meetings. He also maintains that the PHS actions were in “retaliation” for requesting the chain of custody record.

Massachusetts PHS Director Dr Sanchez did not respond to a request from Medscape Medical News for clarification.

 Medscape Medical News also sought comment on recent developments in Dr Langan’s case from the Massachusetts Attorney General’s Office, which declined to comment.

“The AG’s [Attorney General’s] Office often defends state agencies in litigation and we typically do not comment on behalf of our clients, who in this case is the Board of Registration in Medicine,” Emily Snyder, deputy press secretary, Office of Massachusetts Attorney General, told Medscape Medical News in an email.

Intentional Delay?

Dr Langan alleges that the PHS “intentionally delayed” his efforts to undergo a psychiatric evaluation that was necessary to have his license reinstated. He said the PHS insisted he get this evaluation out of state, even though he suggested three Boston-area board-certified experts.

 The Board of Registration in Medicine eventually approved an evaluation by Patricia Recupero, MD, from the Law and Behavioral Health Program at the University of Rhode Island.

Dr Recupero’s November 2013 report determined that Dr Langan “is safe to return to the practice of medicine without further supervision,” that he “has an excellent prognosis and a very low risk of relapse,” and he “has not had an alcohol use, abuse or dependence problem.”

Many of the conflicts between the PHS and Dr Langan revolve around positive test findings, Dr Recupero notes in her letter.

 It is “critical to understand” the inadequacies of such tests for physician monitoring for purposes of relapse, she notes. She added that the source of the alcohol in Dr Langan’s test results cannot be determined and that many products – mouthwash and hand sanitizers among them – can create a false-positive test.

Dr Langan acknowledges he used hand sanitizers in the course of his work as a physician. Owing to severe allergies, he also uses prescribed asthma inhalers, which contain alcohol as a propellant.

Dr Recupero also notes that “almost without exception,” Dr Langan’s test findings have been below the minimum level to declare a test positive and that positive findings “are not a sign of relapse.”

 It was her opinion that, should he require additional treatment and supervision, the PHS should not be involved. A spokesperson for the PHS confirmed that it has not been involved in matters related to Dr Langan for at least 3 years.

Dr Langan said that since it suspended his medical license, the board has “engaged in a persistent pattern of ignoring my every reasonable effort at trying to be reinstated” and has “abused the administrative law process to accomplish this.”

Medscape Medical News contacted the Massachusetts medical board as well as its counsel, Deb Stoller, but received no response.

“Close to Homeless”

A memorandum to the Supreme Judicial Court, filed May 13, 2016, proposed a settlement between Dr Langan and the board. In return for the immediate reinstatement of Dr Langan’s license, he would be monitored for a maximum of 3 months by Dr Recupero and Timothy E. Wilens, MD, codirector of the Center for Addiction Medicine at MGH.

That memorandum was accompanied by letters from Dr Recupero and Dr Wilens agreeing to the terms, but according to Dr Langan, it has been “ignored.”

“The board did not acknowledge or address the proposals in any way,” said Dr Langan.

Dr Langan maintains that he “never ever” had any patient care or malpractice problems during his 15 years at MGH. In fact, his supervisors and colleagues reported that his work performance has been “superlative” on all counts, he said.

Many in the addiction medicine and psychiatric community support Dr Langan. He has letters from high-profile physicians in the field who verify that he is safe to practice medicine.

A first petition was filed in the Supreme Court on October 22, 2014, but the judge dismissed it because it had not been filed within the required 60-day period. Dr Langan’s most recent petition was filed July 3, 2015.

The past few years, he said, have taken a toll on his family. They have lost their home and health insurance because of his inability to practice his profession.

Disheartened by this latest setback, Dr Langan is looking into the possibility of becoming licensed in another state and leaving Massachusetts.

But Dr Langan has renewed hope. Under Massachusetts’ new Public Records Reform Law, which went into effect January 1, 2017, “the board was forced to comply with my request for records within 10 days,” and has done so, he said.

According to Dr Langan, these records show some irregularities that may bolster his case.

“A letter dated December 15, 2011, introducing exculpatory evidence was date-stamped January 17, 2012, almost 1 month after the hearing where it was submitted as evidence. All of the other documents had either illegible or absent date-stamps,” he said.

Forensic Fraud Beyond Annie Dookhan–It’s Time to Wake up to the Reality of Systemic Corruption Between State Physician Health Programs (PHPs) and Drug-Testing Labs.

imgres-23

The attached documents show the Massachusetts physician health program ( PHP), Physician Health Services, inc. (PHS) and a commercial drug testing lab United States Drug Testing Labs, inc. (USDTL) engaging in red-handed flagrant forensic fraud.

This is not lone-nut  Annie Dookhan drug-testing falsification  but misconduct indicative of top-down systemic corruption done via fax and thus appears to be standard operating procedure.

Screen Shot 2015-05-04 at 8.19.51 AMThe documents herein are part of a “litigation packet” (the documented chain-of-custody required for all forensic testing) for an alcohol biomarker test (PEth) drawn July 1, 2011 and reported as a positive on July 19, 2011 to the Massachusetts Board of Registration in Medicine (” Board”).  The “litigation packet”  is considered a legal document and it is generated in real time to document where, and under what conditions a given specimen is at a given time.

The documents here include  a faxed memo from PHS to USDTL 7/19/2011 requesting an identifying ID#  and a “chain of custody” be added to an already positive test.  Seldom is a document available that shows how the perpetrators of laboratory fraud do it–this is complete from start to finish.

A chain of custody is generated in real time. It cannot be done retroactively.

To do so constitutes fraud.

With no compunction, concern, or consternation this sociopathic mercenary subordinates science in order to put coins in his purse and complies with this improper request and adds a unique ID number to an already positive specimen.

Moreover, when the test was questioned the, PHP requested that USDTL support the test as a valid positive. And Joseph Jones did so with full knowledge there was no chain-of-custody and the ID # and date of collection were added.  The alliance is consistent with a civil conspiracy and the crimes are felonious.

The act is also flagrantly antithetical to the process of Medical Review Officer (MRO) review —one of the basic tenets required of all forensic drug tests and requisite to report one as positive.

But like an arsonist firefighter,  Jones does the exact opposite of what he is supposed to.   With complete disregard of the basic codes of conduct and MRO guidelines he reports as positive a test that would not meet the minimum requirements for an at home over-the -counter clinical lab to consumer test let alone let alone one of forensic import.

A test with multiple fatal flaws and no chain of custody, no collection date,and absent any clue of a unique identifier was in fact reported as a positive to please a client.  It is egregious, indefensible, and unconscionable.  It is illegal.  Most importantly it is immoral.

Positive drug and alcohol tests can end lifetime careers, tear apart families, and trigger suicides. And I am hearing of more and more suicides caused by these laboratory tests done by Dr. Jones and corrupt illegitimate authority like Dr. Sanchez.

The consequences are grave and far reaching.  An organizational culture capable of willing participation and continued support of forensic fraud cannot be trusted.

Cognizant that the consequences to the donor are significant and possibly irreversible and catastrophic exhibits a careless disregard for truth that is unconscionable.  That this was done without hesitation or thought is egregious.

It is purposeful and with undeniable malice. It represents institutional and sinister corruption. And it exemplifies the top-down sociopathic, predatory, and uncaring organizational culture that is undermining democracy and eroding civil liberties.

But the most disturbing fact of this is that those who should do something about it blind themselves.

The Board of Registration in Medicine protects Dr. Sanchez. He is apparently allowed to commit any crimes he wants and it is worth reading through all of the documentation as he compounds felonies over time.

The political abuse of psychiatry and false diagnoses are acts that violate the most basic and fundamental medical and social ethical codes. They should be met with zero tolerance by the medical community as well as society at large.

Remarkably the Massachusetts Department of Health and Human Services is also aware of this. Apparently learning nothing from the Annie Dookhan case, certain individuals have hemmed and hawed for over six months without any response in a torpid stasis.  As protectors of the public health one would think there would be some urgency to address the fact that a state contracted agency is engaging in undeniable laboratory misconduct and fraud.

The crimes are many and include state and federal crimes as well as violation of the HIPAA criminal statute as they changed a “forensic” sample to “clinical” in order to bypass chain of custody. They then changed it back to “forensic” and misrepresented it as such up until recently.

This needs to get be addressed outside the medical profession.  As  a society and culture within a society and culture the  prevalence of thinking has become destructive rather than ameliorative under the influence of the “impaired physicians movement.”    The ease with which pernicious ideas and attitudes have pervaded the regulatory and organizational and regulatory culture of medicine is frightening.

The fact that medical boards and public health department are aware of criminal acts being committed  by this “authority” yet do nothing to address its existence will inevitably lead to worse .

If dictatorships can be defined as systems in which there is a prevalence of thinking in destructive rather than ameliorative terms then the “physician wellness” paradigm” shoe fits.    There are multiple warning signs that the profession of medicine is becoming subordinated to the guiding philosophy of the “physician wellness” movement,

One thing is for certain.  There should be zero-tolerance for forensic fraud perpetrated by those in positions of power.   Any intentional laboratory fraud guided by malice is egregious but the scope and severity of what was done here involving collusion to fabricate evidence to coverup the crime, and concealment of the truth when the lab was forced to correct the test by an outside agency is  particularly egregious.    The fact that Dr. Luis Sanchez hid the fact that he was made aware of the corrected test on October 4, 2012 and  reported non-compliance with requirements that directly resulted from that very test for “damage control” under “color of law” is unconscionable.   But the fact that he did these things and lied about it is undeniable.  The facts are self-evident.

This is much worse than Annie Dookhan as her victims were abstractions.  She did not see the damage that resulted from her laboratory misconduct.  These people knew what they were doing, knew it was wrong and did it anyway.   And unlike Annie Dookhan, Sanchez saw the damage he was causing as that was his intent.

As far as I can find, these documents are the most elaborate and complete representation of the mechanics of forensic fraud. They show the sequential steps between the party requesting it and the response of the complicit lab.  The documents illustrate how easy laboratory misconduct is accomplished and the moral detachment of the involved parties.  The fact that it involves top-down corruption cannot be overestimated.

The most obvious crime is the violation of M.G.L 156 (B) section 69 involving reporting false statements.

Screen Shot 2015-05-04 at 10.57.54 AM

Screen Shot 2015-05-04 at 11.02.18 AM

The fact that this was test was ordered as a “forensic” specimen then changed to a “clinical” specimen makes it a HIPPA violation as changing it to “clinical” created  “protected health information” (PHI).     In fact, the only reason I was able to obtain the October 4, 2012 document proving Dr. Sanchez lied was due to a change in the HIPPA-Privacy Rule enabling “patients’ to obtain laboratory results without authorization from the agency that ordered it.   Without this allowance Sanchez would still be maintaining he did not find out about the correction until December.   Well the documentary proof shows he lied.

Moreover, PHS is not a treatment provider and cannot order clinical specimens.  It is an ultra viresact outside of their designated scope of authority as a non-profit organization.

What Sanchez did here is also in violation of the HIPAA criminal statute.

Screen Shot 2015-05-04 at 10.42.58 AM

The elements of a criminal offense under HIPAA are fairly straightforward.  To commit a “criminal offense” under HIPAA, a person must knowingly and in violation of the HIPAA rules do one (or more) of the following three things.:  use or cause to be used a unique health identifier, obtain individually identifiable health information relating to an individual or disclose individually identifiable health information to another  person.   Criminal penalties under HIPAA, tiered in accordance with the seriousness of the offense, range from a fine of up to $50,000 and/or imprisonment up to a year for a simple violation to a fine up to $100,000 and/or imprisonment up to five years for an offense committed under a false pretense and a fine up to $250000 and/or imprisonment up to ten years for an offense committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage , personal gain, or malicious harm.

Requesting the sample be changed to “clinical” created PHI and the fact that it was under false pretense and intended to cause malicious harm is quite evident.

Although PHS is not a covered entity Quest Diagnostics is and as a business associate they can be linked by the conspiracy statute:

Screen Shot 2015-05-04 at 10.48.10 AM

And that is why outside forces need to be involved. These are serious crimes and they have created serious consequences.  I have heard of multiple suicides in doctors caused by these tests.  How many doctors have died as a result of Jones colluding with  individuals just like Sanchez?   The results of these tests can have grave, far reaching and even permanent consequences.  They can ruin careers and destroy families.   Sanchez and Jones know this.  Their moral disengagement here shows an absence of empathy and complete disregard of what consequences may result.

The Board of Registration in Medicine is protecting Dr. Sanchez and the DPH has its head in the sand.

It is my understanding that groups like PHS have led law enforcement to believe that all matters involving doctors should be handled by the medical community.  This has created barriers as doctors reporting crimes have found it difficult to get them investigated or even reported let alone charged.

Law enforcement needs to address this. This needs to be exposed.

.I have been told that in other states where similar situations exist in which the truth is unable to penetrate the proper channels it should go directly to the Governor.

I would like to get these documents to Governor Charlie Baker and any help in making this happen would be appreciated.

IMG_8758 2

Screen Shot 2014-11-04 at 10.47.41 PM

IMG_8757

Screen Shot 2014-11-04 at 10.51.24 PM

Screen Shot 2015-03-12 at 10.43.14 PM

Screen Shot 2014-11-08 at 1.19.44 AM


“A body of men holding themselves accountable to nobody ought not to be trusted by anybody.”
― Thomas Paine 

USDTL drug testing laboratory claims to advance the”Gold Standard in Forensic Toxicology.”  “Integrity: Results that you can trust, based on solid science” is listed as a corporate value. “Unlike other laboratories, our drug and alcohol testing begins and ends with strict chain of custody.” “When people’s lives are on the line, we don’t skip steps.”  Joseph Jones, Vice President of Laboratory Operations explains the importance of chain-of-custody in this USDLT videopresentation.

Dr. Luis Sanchez, M.D. recently published an article entitled Disruptive Behaviors Among Physicians in the Journal of the American Medical Association discussing the importance of  of a “medical culture of safety” with “clear expectations and standards.”  Stressing the importance of values and codes-of-conduct in the practice of medicine, he calls on physician leaders  “commit to professional behavior.”

Sanchez is Past President of the Federation of State Physician Health Programs (FSPHP).  According to their website the FSPHP “serves as an educational resource about physician impairment, provides advocacy for physicians and their health issues at local, state, and national levels, and assists state programs in their quest to protect the public.”  In addition the FSPHP “helps to establish monitoring standards.”  The FSPHP is the umbrella organization of the individual State PHPs.

Sanchez is also the previous Medical Director of the Massachusetts state PHP, Physician Health Services, Inc. (PHS).  According to their website PHS is a “nonprofit corporation that was founded by the Massachusetts Medical Society to address issues of physician health. PHS is designed to help identify, refer to treatment, guide, and monitor the recovery of physicians and medical students with substance use disorders, behavioral health concerns, or mental or physical illness.

PHPs recommend referral of physicians if there are any concerns such as getting behind on medical records.  As PHS Associate DirectorJudith Eaton explains “when something so necessary is not getting done, it is prudent to explore what else might be going on.”  If the PHP feels that doctor needs an assessment they will send that doctor to a “PHP-approved” facility “experienced in the assessment and treatment of health care professionals.” The physician must comply with any and all recommendations of the assessment center.  To assure this the physician must sign a monitoring contract with the PHP (usually five years). USDTL is one of the labs PHPs have contracted with for forensic drug and alcohol testing.


Forensic Drug and Alcohol Tests: The Need For Integrity and Accountability of the Sample

Screen Shot 2013-09-04 at 6.14.30 PM

“Forensic” drug-testing differs from “clinical” drug-testing in how the results are used. “Clinical” tests are used for medical purposes in diagnosing and treating a patient.

A “forensic” test is used for  non-medical purposes.  It is not used for patient care, but for detecting licit and illicit substances in those who should not be using them. Pre-employment and employee assistance and professional monitoring programs are examples.Screen Shot 2014-05-08 at 2.17.18 AM

Forensic testing is held to a higher standards because the consequences of a positive result can be grave and far reaching. A positive forensic test can result in loss of rights of the individual being tested and his or her loved ones. Mistakes are unacceptable.

The Federation of State Medical Boards Policy on Physician Impairment supports this position stating “chain-of-custody forensic testing is critical” (page 14) and the “use of a Medical Review Officer (MRO) for screening samples and confirming sample results” (page 21).

Any and all drug testing requires chain-of-custody. The custody-and-control form is given the status of a legal document because it has the ability to invalidate a test that lacks complete information.  Chain-of-custody provides assures specimen integrity. It provides accountability. 

Screen Shot 2014-11-06 at 7.25.46 PM The job of the MRO is to ensure that the drug testing process is followed to the letter and reviews the Custody and Control form for accuracy.  The MRO also rules out any other possible explanations for a positive test (such as legitimately prescribed medications).  Only then is the test reported as positive.

The legal issues involved in forensic testing mandate MRO review. According to The Medical Review Officer Manual for Federal Workplace Drug Testing ProgramsScreen Shot 2013-12-19 at 12.20.46 PM

the sole responsibility of the MRO is to”ensure that his or her involvement in the review and interpretation of results is consistent with the regulations and will be forensically and scientifically supportable.”

“Fatal flaws” such as lack of chain-of-custody form, missing tamper proof seal, missing signatures, or a mismatch of the sample ID and chain of custody ID invalidate the test.   It is not reported.  Tight chain-of-custody and MRO review is critical for the accountability and integrity of the sample.

The Medical Review Officer Certification Council  provides a certification process for MROs. TheyScreen Shot 2014-04-30 at 12.47.25 PMalso  follow their own Code of Ethics.   In accordance with these standards PHS has an MRO to review all positive tests.  As added assurance the FSPHP guidelines state that all positive tests must be approved by the Medical Director.


Regulation and the Medical Profession–The need for Integrity and Accountability in Physician Leadership and Health Care Policy.

Screen Shot 2014-11-09 at 12.26.14 PM

Good leadership requires correct moral and ethical behavior of both the individual and the organization. .  Integrity is necessary for establishing relationships of trust.  It requires a true heart and an honest soul.  People of integrity instinctively do the “right thing” in any and all circumstances.  The majority of doctors belong to this group.

Adherence to ethical codes of the profession is a universal obligation.  It excludes all exceptions.  Without ethical integrity, falsity will flourish.

The documents below show fraud. It is intentional.  All parties involved knew what they were doing, knew it was wrong but did it anyway.  The schism between pious rhetoric and reality is wide.

Screen Shot 2014-08-20 at 12.01.33 PM

The  July 19th, 2011 fax from PHS seen below is in reference to the lab report from USDTL seen above.  In it PHS requests the report be “updated”to donor ID number “1310” and  to “reflect that the chain of custody was maintained.”

The lab report is a positive test for the alcohol biomarker (Phosphatidyl Ethanol) or PEth, an alcohol biomarker introduced by the Federation of State Physician Health programs and marketed by USDTL and other labs to detect  covert alcohol use..

There is no record of where, when or by whom it was collected.

Screen Shot 2014-11-06 at 11.17.32 PMBoth the donor ID # and chain of custody are listed as 461430.

The purpose of chain-of-custody is to document the location of  a specimen in real time.  “Updating” it is not an option.  It is prohibited.  Updating the “chain of custody to reflect that chain of custody was maintained”  is a clear indicator that it was not maintained.

ID #1310 is the unique identifier I was issued by PHS.  It is used as a unique identifier, just like a name or social security number, to link me to any sample collected for random drug and alcohol screening. #1310 identifies me as me in the chain-of-custody.    On July 1st, 2011 I had a blood test collected at Quest Diagnostics.

IMG_8756 2

The sample was collected at Quest Diagnostics on July 1, 2011 but these documents were not obtained until December 3, 2011 and were included in the “litigation packet” which documents chain-of-custody and is generated on any and all forensic drug testing.   It provides proof that the test was done on who it was supposed to have been done and that all required procedure and protocol was followed. It protects the donor form being falsely accused of illicit substance use.  In most employee drug-testing programs the litigation-packet is provided on request immediately.  It is a transparent process.  This is not the case, however, at PHS.

I requested the litigation packet immediately after the positive test was reported on July 19, 2011.  PHS first refused, then tried to dissuade me.  They finally agreed but warned there would be “unintended consequences.    The entire litigation packet can be seen here:   Litigation Packet 12:3:2011

The positive sample has no chain-of-custody linked to me, no date, and no indication where it was collected or who collected it.   In addition there was no “external” chain of custody for the sample. The custody-and-control form was missing.

With multiple fatal flaws (6/6)  rendering it invalid, USDTL should have rejected it by their own written protocol.

Screen Shot 2013-12-19 at 12.20.46 PM

USDTL did not reject it. The document below shows that USDTL added my ID # 1310 and added a collection date of July 1, 2011–the day I submitted the sample.

Screen Shot 2014-09-15 at 5.27.21 AM

“REVISED REPORT PER CLIENTS REQUEST”  

And in doing so the lab that claims “integrity” and “strict chain of custody” readily, and with no apparent compunction” manufactured a chain-of-custody and added a unique identifier by faxed request.

The litigation packet was signed by Joseph Jones on December 3, 2011.   There was no record of where the sample was from July 1st to July 8, 2011. No external chain-of-custody or custody-and-control form was evident in the litigation packet.

Screen Shot 2014-07-28 at 6.50.01 PM

The V.P. for Laboratory operations for the lab that claims “strict chain of custody” and that “doesn’t skip steps” “when “peoples lives are on the line” verified a positive test as positive with no custody and control form, no external chain of custody and 6/6 fatal flaws.  What is so shocking is that  this was done without compunction or pause.  As a forensic test ordered by a monitoring program Jones knew full well it would result in significant consequences for someone.  He knew that someones “life was on the line,” knew it was wrong, and did it anyway.

A person of conscience would never do this.  It is unethical decision making  that goes against professional and societal norms.  A “moral disengagement” that represents a lack of empathy and a callous disregard for others.  I would not consider doing something like this for any price and here it appears to be standard operating procedure.

PHS reported the positive test to the Medical Board on July 19, 2011 Positive PEth July 19, 2011-1.  It was used as a stepping-stone to request an evaluation at one of three  “PHP-approved” facilities (Marworth, Hazelden and Bradford). The Medical Directors of all three facilities can be seen on this list list called “Like-Minded Docs.”  The MRO for PHS, Dr.Wayne Gavryck,  whose job was to review the chain-of-custody and validate its integrity before reporting it as positive is also on the list.  See this simplified schematic of how it works in Massachusetts.  It shows how this is a rigged game.

Expecting to be diagnosed with a non-existent problem and admitted for non-needed treatment I requested an evaluation at a non-12 step facility with no conflicts-of-interest.  Both PHS and the Medical Board refused this request in one of four violations of the Establishment Clause of the 1st amendment.

Screen Shot 2014-07-27 at 7.55.16 PM copy

I chose Hazelden.  The Medical Director was aware that I had just signed  a patent license agreement for an epinephrine auto-injector and he had a child with a peanut allergy.  We talked about the device and discussed the problems with current management.  I think it was because of this added personal interaction that he did not “tailor my diagnosis” as PHS most certainly requested.  Seeing me as a person rather than an object, I believe,  enabled his conscience to reject it. My discharge diagnosis found no history of alcohol issues but they could not explain the positive test. Unable to rule out that I drank in violation of my PHS contract they recommended I attend AA.

PHS mandated that I attend 3 12-step meetings per week and requested that I obtain names and phone numbers of fellow attendees so they could contact them to verify my attendance.  They also mandated that I discontinue my asthma inhalers (as the propellant contains small amounts of ethanol) that had been controlling my asthma and preventing serious attacks for the previous ten years.  I was threatened that if I had to use the inhalers or one day late on the increased payments I would be reported to the Board and lose my license.

Screen Shot 2014-11-09 at 10.03.16 PM

Screen Shot 2014-11-08 at 11.57.25 PM

Sanchez states that my request for the “litigation packet” was processed on December 5, 2011 (two days after Jones signed off on it) and adds the “testing laboratory is willing to support the test results.”

In the interim I filed a complaint with the College of American Pathologists.  I also requested the missing external chain of custody documents from Quest.

Screen Shot 2014-08-20 at 12.15.52 PM

I never received the chain of custody from Quest.  Instead I received a letter from Nina Tobin, Compliance Manager for Quest documenting all the errors but written to sound as if some sort of protocol was maintained.  Tobin claimed the specimen was inadvertently logged as a clinical specimen but sent on to USDTL a week later.  (See Quest Letter )

Screen Shot 2014-11-09 at 10.06.46 PM

The Chief of Toxicology at MGH wrote a letter to the Board documenting all of the misconduct and irregularities stating that it was an “intentional act” perpetrated by PHS.  MLLv3finalJacob_Hafter_Esq_copy.

This letter, as well as the opinions of everyone outside of PHS was ignored. So too were any opinions of my two former Associate Directors at PHS.   The e-mail below dated October 10th, 2011 is to to Drs. John Knight and J. Wesley Boyd and I am referring to their article Ethical and Managerial Considerations Regarding State Physician Health Programs  that was about to be published. We had hoped that it would draw more attention to the problems with PHPs.

Screen Shot 2014-11-10 at 10.36.13 AM

I was subsequently reported as “non-compliant” with AA meetings.    They could not give any details of where or when.  They then misrepresented a declaration of fact (I stated that I had started going to a specific meeting on a specific date) as an admission of guilt by saying I was referring to a different meeting.     10:23:12 PHS Letter to BORM-noncompliance.

My Chief at MGH, his Chief and others held a  conference with PHS and attempted to remove me from PHS and replace the monitoring contract with one of their own.  They refused.   When confronted with the fabricated test they dismissed it and focused on sending me to Kansas to one of the “disruptive physician” Psikhuskas where they are using polygraphs (despite the AMAs stance that it is junk science) and non-validated neuropsychological instruments that detect “character defects” to pathologize the normal.

I refused. Had I gone to Kansas I would have been given a false diagnosis and my career would be over. This is what they do.

Screen Shot 2014-11-08 at 12.05.52 AM

Screen Shot 2014-09-05 at 7.28.02 PM

Amy Daniels, the investigator for the College of American Pathologists contacted me in December of 2012 to see how things were going since USDTL “amended” the test.  Daniels told me that the College of American Pathologists confirmed my allegations and, as an Accrediting Agency for Forensic Toxicology mandated that USDTL correct it.  (Labs can lose accreditation if they do not comply with CAP  Standards for Forensic Drug Testing). This was done on October 4, 2012.

PHS denied any knowledge of an amended test.  I also wrote an e-mail to Joseph Jones requesting the document but he did not reply.

I contacted CAP.   On December 11, 2012 Dr. Luis Sanchez wrote a letter stating  “Yesterday, December 10 2012, Physician Health Services (PHS) received a revision to a laboratory test result”

 “The amended report indicates that the external chain of custody protocol [for that sample] was not followed per standard protocol]” 

Sanchez dismisses this test as irrelevant, rationalizing neither PHS nor the Board based any actions on the test and they would “continue to disregard” it.

Screen Shot 2014-11-08 at 1.19.44 AM

The  logic is that it was my behavior that resulted in any consequences.  My “non-compliance” in October led to my suspension and the test had nothing to do with it.   The sole reason for reporting me to the Board in 2011 was the positive test.  There is no other pretext to use.  It is misattribution of blame as without the test, now invalidated, there would have been no AA meetings to say I was non-compliant with.

In response to a civil complaint PHS, Quest and USDTL all took the position that the results of the fraudulent testing had absolutely nothing to do with anything.

And in response to the allegations of forensic fraud the labs claimed there was no forensic fraud because this was not a “Forensic” test but a “clinical” test.     The argument was that “clinical” tests do not require chain-of-custody and it was his behavior not these tests that resulted in consequences.   

As a “clinical” test I knew it was considered Protected Health Information (PHI)  under the HIPAA-Privacy Rule.  A patient must give written consent for any outside entities to see it.  Obtaining lab tests previously required the consent of both the patient and the ordering provider.  What PHS and the labs were apparently unaware of was the changes to the HIPAA-Privacy rule giving patients increased rights to access their PHI.   The changes removed the ordering provider requirements.  A patient has a right to obtain lab test results directly from the labs and has 30 days to do it.  CAP agreed.   USDTL sent me all of the documents.  They can be seen below:

August 6, 2014 to Langan with health materials.

The documents sent by USDTL are notable for two things:

1.  The e-mail from me to Joseph Jones dated December 10, 2012.  It can be seen on page 22 of the USDTL documents.  Screen Shot 2014-11-10 at 11.21.18 AM

Screen Shot 2014-11-10 at 11.22.00 AM

2. USDTL document confirming PHS knew the test was amended 67-days before they said they did.Screen Shot 2014-08-06 at 4.50.02 PM

The document shows PHS and Sanchez were aware of the invalidity of the test on October 4, 2012.   Instead of correcting things they initiated machinations to throw me under the bus.  They officially reported me to the Board for non-compliance on October 19, 2012.

The December 11, 2012 letter signed by Sanchez states “Yesterday, December 10, 2012, PHS received a “revised report” regarding the test.  The documents show he knew about it 67-days prior.

Screen Shot 2014-11-04 at 10.51.24 PM

Although USDTL complied with the HIPAA-Privacy Rule and CAP, Quest did not.   Quest Diagnostics refused to send me copies of their lab reports claiming it was confidential and protected information that required PHS consent.  Quest required I sign a consent form with multiple stipulations regarding PHS.  I refused and contacted the Department of Justice -Office of Civil Rights.  The DOJ-OCR agreed with me and I received the Quest documents

Remember a “clinical” test can only be ordered by a physician in the course of medical treatment.  It requires authorization from the patient to obtain a “clinical” specimen and it requires written authorization as to who sees it.  Referring physician was Mary Howard.

image

And below is the fax from PHS to Quest from July 1, 2011 also requested by Mary Howard.  The signature on the front is not mine.  In addition I gave the blood at 9:30 and was in my clinic at MGH at 12:23 so it couldn’t be. The WC 461430 R are dated July 2, 2011.  This is a “clinical” not “forensic” sticker.  The “R” indicates a red top tube.  The other sticker is USDTL and indicates it was logged in on July 8, 2011.

Screen Shot 2014-09-15 at 7.18.25 PM

What does it all mean?    Blood left in a red top tube ferments. This is basic chemistry.  The PEth test needs to be refrigerated and shipped overnight to prevent this.  In addition it needs to be collected with a non-alcohol wipe in a tube that has an anti-coagulant or preservative so that it does not ferment.    It requires strict procedure and protocol.

When I gave my blood on July 1st, 2011 it was as a “forensic” test per my contractual agreement with PHS.

On July 2, 2011 it was changed to “clinical.”   Why?  because “forensic” protocol would have invalidated it.

The only conceivable reason for doing this was to bypass chain-of-custody procedures.  My unique identifier #1310 was removed and the clinical specimen number was used for chain-of-custody.    The R in 461430R indicates a red top tube.

By holding on to it for one week the blood fermented.    As it was July with an average temperature close to 90 they overshot their mark a bit.   My level of 365 is consistent with heavy alcohol use–end stage half-gallon a day type drinking.

Quest then forwarded it to USDTL with specific instructions to process it as a “clinical” sample.  USDTL complied and  processed it as a clinical specimen which was reported it to PHS on July 14, 2011.

Screen Shot 2014-07-28 at 12.41.01 PM

PHS then asked USDTL to add my forensic  ID # 1310 and add a collection date of July 1, 2011 so it would appear “forensic” protocol was followed.    The reason Jones signed the “litigation packet” on December 3, 2011 was because that was when the “litigation packet” was manufactured.  A “clinical” sample does not produce one.

Screen Shot 2014-07-28 at 12.40.13 PM

USDTL willingly complied with this request.

Screen Shot 2014-08-20 at 11.59.24 AM

PHS then reported this as a “forensic” test to the Medical Board on July 19, 2011 and requested a reevaluation.

Screen Shot 2014-11-09 at 1.17.24 PM

The distinction between “forensic” and “clinical” drug and alcohol testing is black and white. PHS is a monitoring program not a treatment provider. The fact that a monitoring agency with an MRO asked the lab to process and report it as a clinical sample and then used it forensically is an extreme outlier in terms of forensic fraud. The fact that they collected it forensically, removed the forensic components and let it sit in a warehouse for a week is  abhorrent.  The fact they then specifically requested it be processed as a clinical sample deepens the malice. The fact that they then reported it to the Board as a forensic sample and maintained it was forensic up until just recently makes it egregious. But the fact that the test was changed from “positive” to “invalid” on October 4th, 2012 and they then reported me to the Board on October 8th,  2012 for “noncompliance,” suppressed it and tried to send me to Kansas where I would be given a non-existent diagnosis to delegitimize me for damage control makes it wantonly egregious.  This is political abuse of psychiatry.

Accountability requires both the provision of information and justification of what was done.

For doctors it is very difficult to obtain the information. As seen here, they put up a gauntlet to prevent the provision of what is immediate in all other drug testing programs.  I now have all of the information. What it shows is clear. This was intentional.  It was no accident.  They knew what they were doing, knew it was wrong but did it anyway.

Accountability also requires that those who commit misconduct suffer consequences. The PHPs have also put up barriers to this.    With no regulation or oversight they have no apparent accountability.

My understanding is that it works this way.   The Medical Board, Medical Society and Departments of Public Health have no oversight.   The MMS has an ethics committee but all they can do is “educate” the person if they feel there was a violation.  The DPH won’t even look at it and the Board is complicit.

My understanding is that they have convinced law enforcement that this is a “parochial” issue that is best kept within the medical community.  They have also created the impression that they are “friends” of law enforcement.  I have heard from many doctors that they have tried to report misconduct, civil rights violations and crimes to the police, AGO, and other law enforcement agencies only to be turned back over to the PHP.     By saying the physician is “impaired” it delegitimizes and invalidates the truth.  “He’s just a sick doctor,  we’ll take care of him.”  That physician then suffers consequences effectively silencing the rest.

PHS uses the Board to enforce punitive measures and temporize.   The Board puts blind faith in PHS.  Blind faith that defies common sense ( mandating phone numbers at anonymous meetings)  and disregards the law (Establishment Clause violations that are clear and well established).    The Board also temporizes to cause damage.

In my case they required a psychiatric behavioral evaluation.  I was given the choice of Kansas and a few other Like-minded assessment centers.

After petitioning for  multiple qualified psychiatrists that were summarily rejected months later for no reason one of the Board Attorneys suggested  Dr. Patricia Recupero, M.D., J.D. who is Board Certified in Forensic Psychiatry and Addiction Psychiatry.   The Board had used her in the past but not recently.  Seeing that she had been used by the Board for fit-for-duty evaluations in the past the Board accepted my petition.

Dr. Recupero wrote an 87-page report. She concluded I was safe to practice medicine without supervision, that I had never had an alcohol use, abuse or dependence problem, and that PHS request for phone numbers was inappropriate. She also documented PHS misconduct throughout my contract and concluded it was PHS actions, not mine, that led to my suspension.   What she describes is consistent with criminal harassment.  She documents the falsification of neuropsychological tests and confirms the forensic fraud.  What did the Board do?  Ignored their very own recommended and approved evaluator.

One measure of integrity is truthfulness to words and deeds.  These people claim professionalism, ethics and integrity.  The documents show otherwise.  The careers and lives of doctors are in these peoples hands.

Similar fraud is occurring across the country.  This is an example of the institutional injustice that is killing physicians.  Finding themselves entrapped with no way out, helpless and hopeless they are feeling themselves bereft of any shade of  justice and killing themselves.  These are nothing more than bullies and accountability is essential.  The “disruptive physician” moral panic has harmed the Medical Profession.

Dr. Clive Body in his book  Corporate Psychopaths   writes that “Unethical leaders create unethical followers, which in turn create unethical companies and society suffers as a result.”  And according to Dr. Robert Hare in  Without Conscience  “If we can’t spot them, we are doomed to be their victims, both as individuals and as a society. ”

Wes Boyd notes that valid complaints from physicians are often dismissed as “bellyaching” by the PHPs.  Complacent that these are just good guys helping doctors and protecting the public the complaints are dismissed, tabled, deflected or otherwise ignored.  Bellyaching??   Is this bellyaching.

It is my opinion that what you see here is indefensible  Procedurally, Ethically, and Legally.

Procedurally it goes beyond negligence and represents fraud.  It violates every procedural guideline, regulation and standard of care including their very own.

Ethically it violates everything from the Hippocratic Oath to  AMA Medical Ethics to the MRO Code of Conduct.

And where was PHS MRO Wayne Gavryck? By my count he violated at least 4 of the 6 Codes of Ethical Conduct.

Screen Shot 2014-11-10 at 1.04.20 PM

What was done here violates the most fundamental ethical principles of Medicine -Autonomy, Beneficence, Nonmaleficence and justice.

Intentionally falsifying a laboratory or diagnostic test to refer for an evaluation or support a diagnosis or give unwarranted “treatment” is unconscionable.  Abuse under the utility of  medical coloration is especially egregious.

The information provided herein should negate any “peer-review” protection or immunity afforded PHS as it is undeniably and egregiously in “bad faith.” Moreover, the ordering a “clinical” test is outside PHS scope, practice, and function of PHS. According to M.G.L. c. 111, § 203 (c):

An individual or institution, including a licensed or public hospital, physician credentialing verification service operated by a society or organization of medical professionals for the purpose of providing credentialing information to health care entities, or licensed nursing home reporting, providing information, opinion, counsel or services to a medical peer review committee, or participation in the procedures required by this section, shall not be liable in a suit for damages by reason of having furnished such information, opinion, counsel or services or by reason of such participation, provided, that such individual or institution acted in good faith and with a reasonable belief that said actions were warranted in connection with or in furtherance of the function of said committee or the procedures required by this section.

Dr. Luis Sanchez and Dr. Wayne Gavryck need to be held to the same professional standards as the rest of us.

If you can support either of them procedurally, ethically, or legally, any one of them, then I will turn in my medical license with a bow on it.  If they did not commit negligent fraud by standards of care and procedural guidelines, egregious moral disengagement in violation of ALL ethical codes for the medical profession and society and break the law then disprove me.  Just one will do.

But you can’t do this then I ask that you speak up and take a stand. Either defend them or help me hold them accountable.  If a crime is committed it needs to be addressed.  Ignoring encourages more of the same.

And if this cannot be supported procedurally, ethically or legally then I want to know what is going to be done about it?

How low does the moral compass have to go before someone takes action?

Doctors are dying across the country because of people just like this.  They have set up a scaffold that removes the usual checks and balances and removed accountability.   It is this institutional justice that is driving many doctors to suicide.

So the evidence is above.  Either defend them or help me draw unwanted attention to this culture of bullying and abuse. So I am asking you to contemplate if  what you see here is ethically, procedurally or legally sound.   If you can show just one of these then I stand corrected. But if you cannot justify this on any level then I want you to help me expose this criminal enterprise. Either defend it or fight it. Silence and obfuscation are not acceptable.

Screen Shot 2014-11-10 at 1.34.48 PM

Screen Shot 2014-11-10 at 1.36.13 PM

Screen Shot 2014-11-10 at 10.24.58 AM

Screen Shot 2013-09-04 at 2.22.36 AM

Screen Shot 2014-11-10 at 9.15.46 PMScreen Shot 2014-11-10 at 9.23.36 PMScreen Shot 2014-11-10 at 9.19.08 PMScreen Shot 2014-11-10 at 8.54.21 PMget-attachment.aspx

Please sign petition for state audit of Massachusetts physician health program (PHP), Physician Health Services, Inc. (PHS)–Evidence of top-down corruption

Screen Shot 2015-08-29 at 2.37.54 PMTo sign the petition please click here.

Why this is important

State Physician Health Programs (PHPs) were originally developed by competent and caring physicians to help colleagues who developed problems with addiction or substance abuse.

As an alternative to disciplinary action by state Medical Boards they provided a safe haven for sick doctors while also protecting the public from impaired physicians.This image as a humanitarian agency with virtuous organizational purpose has created an absence of the need to guard.   Any system can be subverted, but as self-governing organizations with no meaningful transparency, oversight, regulation or accountability these organizations were particularly vulnerable to exploitation.

State PHPs have been gradually taken over by the Federation of State Physician Health Programs (FSPHP). The FSPHP is an offshoot of  the American Society of Addiction Medicine (ASAM), the self-proclaimed “voice of addiction medicine.”

A “self-designated” medical specialty, American Board of Addiction Medicine (ABAM) “board certification” is not recognized by the American Board of Medical Specialties (ABMS).

Through a torrent of propaganda and misinformation, however, combined with strategic and successful lobbying efforts they have gained tremendous sway in the field of addiction medicine. Advancing the 12-step rehab drug testing agenda they have modified and monopolized the field. By cozying up to regulatory boards and politicians they have altered the rules, statutes, and regulations to provide immunity, impunity, and confidentiality. All of this was done without difficulty or any meaningful opposition. They have swayed legal opinion and successfully tinkered with the system to amend rules and policies.

Many consider the ASAM and FSPHP to be corporate front groups, organizations whose agendas match those of corporate interests but who claim no formal relationship. In this case the agenda is 12-step rehabilitation industry and the drug testing industry. Over the past 10 years the ASAM has grown to over 3000 physicians. Within this group there is a subset of recovery fundamentalists who have populated the PHPs. Many have also become medical directors of the rehabilitation facilities to which they refer. By removing dissenting physician who do not agree with the groupthink they have successfully taken over the State PHP system. The evidentiary standard is low. They encourage confidential referral from colleagues and provide immunity to those who refer. If the PHP believes a physician “could benefit” form their services there is no choice. The FSPHP political apparatus exerts a monopoly of force. It selects who will be monitored and dictates every aspect of the evaluation and monitoring process. Conflicts of interest abound.

Control has replaced conduct and ideology has trumped science and reason. It is a system that fosters corruption and impunity. There have been reports of gross misconduct and breaches of standards of care, ethical violations, and civil rights violations. Basic human rights violations and criminal activity has been reported.

In Massachusetts caring and competent physicians such as J. Wesley Boyd and John R. Knight were removed from the State PHP, Physician Health Services, Inc. (PHS). In an article written for the Journal of Addiction Medicine in 2012 they address some of these concerns and suggest the “broader medical community begin to reassess PHPs as a whole.” They recommend independent oversight, transparency, national standards, periodic auditing, and an appeals process. They state:

“Because PHP practices are unknown to most physicians before becoming a client of the PHP, many PHPs operate outside the scrutiny of the medical community at large. Physicians referred to PHPs are often compromised to some degree, have very little power, and are therefore, not in a position to voice what might be legitimate objections to PHP’s practices.”

The FSPHP has introduced junk science such as Ethyl Glucuronide, Ethyl Sulfate, and Phosphatidylethanol as long term alcohol biomarkers with no evidence base. They did this by getting them approved as “Laboratory Developed Tests” (LDTs) to bypass FDA scrutiny. There is no evidence-based support for these tests but the FSPHP convinced Regulatory Agencies (medical boards) that they were valid tests. This “medical sanctification” of these bogus tests resulted in other monitoring programs utilizing them and, unregulated by the FDA, the labs doing the tests could claim they were accurate and reliable with no repercussion. they are claiming the PHP programs as the “new paradigm in addiction treatment” claiming an 80% success rate. They have also created a myth that medical mistakes are the result of a hidden cadre of drug addicted doctors and are behind the recent call to randomly drug test all physicians. Of course who will run such a program? They will. They also want to expand to other organizations such as the DOT.

There is a lot of anecdotal evidence that the marked suicide rate in physicians is because of this.

The propaganda and misinformation is based on a study that is misleading and full of methodological flaws.

In “Ethical and Managerial Considerations Regarding State Physician Health Programs,” published in the Journal of Addiction Medicine in 2012, John Knight, M.D. and J. Wesley Boyd, M.D., PhD recommend ”the broader medical community begin to reassess PHP’s as a whole” and that “consideration be given toward the implementation of independent ethical oversight and establish and appeals process for PHP clients who feel they are being treated unfairly.”

They also recommend the relationship of PHP’s between the evaluation and treatment centers and licensing boards be transparent and that national organizations review PHP practices and recommend national standards “that can be debated by all physicians, not just those who work within PHPs.”

In evaluating a physician this group is not gathering data to form a hypothesis but making data fit a hypothesis that arrived well before the physician did. And this may be part of the explanation for the recent marked increase in physician suicide. With guilt assumed from the start, no due process, no appeal, and no way out physicians are being bullied, demoralized, and dehumanized to the point of hopelessness. This needs to end now.

Medicine is predicated on competence, good-faith, and integrity. Medical ethics necessitates beneficence, respect, and autonomy. The scaffold erected here is designed for coercion and control. Exposure, transparency, and accountability are urgent. An evidence based Cochrane type assessment of their “research” and an Institute of Medicine Conflict of Interest review are long overdue.

In addition it is a “rigged game” as the ASAM makes the public policy and the FSPHP enforces it. Furthermore the FSPHP mandates that physicians be evaluated at a “PHP-approved” facility. All of the medical directors of these facilities (which number around 20) are ASAM physicians “in recovery.” It is essentially self-referral.

A State Audit done in North Carolina found no oversight or regulation of the State PHP from either the state Medical Board or the Medical Society. In addition they found lack of due process for physicians and exposed the conflicts of interest between the PHP and the out of state treatment programs. They concluded abuse could occur but not be detected.  It is the same scaffold present in Massachusetts.

The Medical Director and CEO of the North Carolina Physicians Health Program (NCPHP) Dr. Warren J. Pendergast, M.D. is the immediate past President of the Federation of State Physician Health Programs (FSPHP)  and the audit findings of the NCPHP are standard operational procedure for other state programs fully infiltrated by the FSPHP.

The same infrastructure that exists in North Carolina and Massachusetts exists in other states.   In this system there is absolutely no oversight from the medical board, the medical society, department of health or anyone else for that matter.  They truly have removed all aspects of accountability.

PHS, inc. has been given cart blanche power in the assessment, treatment, monitoring, and disposition of all physicians referred to them.

The previous Medical Director of the Massachusetts PHP, Physicians Health Services, Inc. (PHS) for fourteen years (prior to Dr. Steve Adelman) , Dr. Luis Sanchez, is also a past President of the FSPHP.

And although  PHS did not enter into formal partnership with the FSPHP until 2013, Sanchez and PHS Director of Operations Linda Bresnahan (who was interviewed for the recent Medscape article critical of PHPs) have both had long term involvement in the political hierarchy of the FSPHP and, in fact, helped develop the prototype for other states.

PHS, inc. exclusive use of out of state treatment programs has been challenged. In the past PHS, Inc. has adamantly refused to allow physicians to be evaluated in State despite it being one of the medical hubs of the country. Physicians in Massachusetts who are referred for evaluation in Kansas, Georgia, Alabama, and West Virginia as PHS has convinced the Board that only these facilities are ‘experienced in the assessment and treatment of health care professionals.”

In actual fact the medical directors of all of these preferred facilities are also ASAM physicians with the vast majority being in 12-step “recovery” themselves and close colleagues,  if not friends of the medical directors of other state PHPs.

There is also documentary evidence that PHS, inc. is colluding with third parties (labs and treatment centers) to misrepresent test results and diagnoses in conspiracy to commit fraud.  Documentation shows purposeful and intentional act to commit “confirmatory distortion” which is the deliberate misinterpretation or misrepresentation of facts to support a predetermined hypothesis.

Knight and Boyd note in “Ethical and Managerial Considerations Regarding State Physician Health Programs” “To further complicate matters, many evaluation/ treatment centers depend on state PHP referrals for their financial viability. Because of this, if, in its referral of a physician, the PHP highlights a physician as particularly problematic, the evaluation center might—whether consciously or otherwise— tailor its diagnoses and recommendations in a way that will support the PHP’s impression of that physician.

To consciously “tailor” a diagnosis or recommendation based on the PHPs impression of a physician is fraud.

Documentary evidence shows how PHS, inc. is engaging in fraud by colluding with a “PHP-approved” assessment center to fabricate and falsify neuropsychological tests to show “denial” and “relapse” with normal objective raw data being interpreted as abnormal. (again verified by a third-party oversight agency which resulted in the colluding party being forced to correct the results under threat of disciplinary action).

But without any regulation or meaningful oversight of PHS and no appeal process or avenue for the reporting or investigation for the physician, PHS has been able to get away with this misconduct with impunity and immunity. Complaints are either ignored, dismissed, or justified by sympathizers, apologists and a great deal of “willful ignorance.”

There should be zero tolerance for forensic fraud at all levels but when a person’s career, life and liberty are at stake and the perpetrator is in a position of power this conduct is particularly egregious. The damage done by a positive drug or alcohol test can be severe, far-reaching, and permanent. Intentionally and purposefully misrepresenting drug or alcohol tests by manipulation and fraud is unethical and needs to be addressed in real time. Those who engage in such behavior need to be held accountable for their actions.

For these reasons I petition Suzanne Bump to initiate a performance audit on PHS, inc. to detect fraud and abuse. There is currently no meaningful way to report, investigate, and hold accountable abuse of power in PHS, inc. Transparency, oversight, regulation, and accountability are essential.

The Physicians of the Commonwealth of Massachusetts deserve better than this.

Medscape Medical News—Physician Health Programs: More Harm Than Good? State-Based Programs Under Fire

Screen Shot 2015-07-27 at 9.11.46 AMMedscape Medical News > Psychiatry

Physician Health Programs: More Harm Than Good?
State-Based Programs Under Fire
Pauline Anderson
August 19, 2015

There is growing scrutiny of US physician health programs (PHPs), which are state-based plans for doctors with substance abuse or other mental health problems.

Detractors of the PHP system claim physicians who voluntarily disclose they have mental health or drug problems can be forced into treatment without recourse, face expensive contracts, and are frequently sent out of their home state to receive the prescribed therapy. Some physicians allege that during their interaction with the treatment centers, large amounts of money were demanded up front before any assessment was even conducted.

In addition, critics assert that there is no real oversight and regulation of these programs.

Called by turns coercive, controlling, and secretive, with possible conflicts of interest, some say the PHP experience has led vulnerable physicians to contemplate suicide.
Two states ― North Carolina and Michigan ― have already been asked to step in and investigate many of the issues raised by PHP critics. In North Carolina, the state agreed with many of the concerns raised and recommended “better oversight” by its medical board and society. And in Michigan, litigation in the form of a class action lawsuit has been launched against the Health Professional Recovery Program (HPRP), a program similar to PHPs.

Michael Langan, MD, an internal medicine specialist in Boston, has first-hand experience with a PHP.

Dr Langan was at Massachusetts General and Harvard University in Boston when he approached the Massachusetts state PHP to help him get off an opioid analgesic. He had begun taking the drug to help him sleep after developing shingles and said he spent several months in prescribed PHP treatment after “signing on the dotted line.”

On his first day at the assessment center, Dr Langan said he was asked how he was going to pay $80,000 cash. “This was before they even evaluated me,” he told Medscape Medical News. Subsequently, Dr Langan said he underwent an independent hair and fingernail analysis that turned out to be negative “for all substances of abuse.”

Since then, he has been documenting possible cases of negative interaction with these organizations. The system, he says, leaves physicians “without rights, depersonalized and dehumanized.”
He fears that the role of PHPs has expanded well beyond its original scope, becoming monitoring programs that have the power to refer physicians for evaluation and treatment even on the basis of administrative failings, such as being behind on chart notes, he said.

He has heard reports of “disruptive physicians” being diagnosed with “character defects.” The monitored physician, he added, “is forced to abide by any and all demands of the PHP ― no matter how unreasonable ― under the coloration of medical utility and without any evidentiary standard or right to appeal. Once in, it’s a nightmare.”

Disempowered, Without Recourse

It is estimated that 10% to 12% of physicians will develop a drug or alcohol problem at some point during their careers.

PHPs were initially established to help physicians grappling with a substance abuse or mental health problem and to provide them with access to confidential treatment while avoiding professional investigation and potential disciplinary action.

Often staffed by volunteer physicians and funded by state medical societies, the original intent of these programs was to help health professionals recover while protecting the public from potentially unsafe practitioners.

PHPs assess and monitor the physicians referred to them. In most states, physicians who comply with PHP recommendations can continue to work, provided they undergo regular drug testing and other testing to ensure sobriety.

Some PHPs are run by independent nonprofit corporations, others by state medical societies. Still others receive support from state medical licensing boards. The relationship of each PHP to the state medical board varies. The scope of services offered through PHPs also differs.

Today, such programs exist in every state except California, Nebraska, and Wisconsin and are represented by an umbrella organization known as the Federation of State Physician Health Programs (FSPHP).

According to its mission statement, the FSPHP’s mandate is to “support physician health programs in improving the health of medical professionals, thereby contributing to quality patient care.”

Coercive Process

Concerns about the PHP system have been percolating for a number of years. In 2012, an editorial by J. Wesley Boyd, MD, PhD, Cambridge Health Alliance and Harvard Medical School, and John R Knight, MD, Boston Children’s Hospital and Harvard Medical School, published in the Journal of Addiction Medicine brought many of the issues to the profession’s attention.

In their editorial, Dr Boyd and Dr Knight alleged that once a mental health issue has been disclosed, doctors are “compelled” to enter a PHP and are instructed to comply with any PHP recommendations or face disciplinary action.

“Thus, for most physicians, participation in a PHP evaluation is coercive, and once a PHP recommends monitoring, physicians have little choice but to cooperate with any and all recommendations, if they wish to continue practicing medicine.”

In an interview with Medscape Medical News, Dr Boyd, who was associate director of the Massachusetts PHP for 6 years, elaborated on what he sees as the lack of due process afforded physicians by such programs.

“In general, these programs are given a free pass because it’s doctors helping doctors, and the feeling is that they wouldn’t be doing that if they weren’t generally nice people concerned about the well-being of others.”

Although many PHPs and the individuals running them are well intentioned, “there are generally few avenues for meaningful appeal” for doctors wishing to dispute PHP treatment recommendations, said Dr Boyd.

Approached on this question, the FSPHP’s director of program operations, Linda Bresnahan, maintains in a written response to Medscape Medical News that “options exist for a physician to seek an additional independent evaluation” and to appeal to the medical board or workplace.

Not so, said Dr Boyd, who counters that physicians have been made to feel “disempowered” and without recourse. “People tend to think that if you raise complaints, you’re just bellyaching and your complaint can’t be legitimate.”

Dr Boyd also said he has heard anecdotal reports of a number of doctors whose interactions with a PHP were so difficult they became suicidal.

“It’s not surprising that if you have your licensing board crawling up your rear end, rates of depression go up and rates of suicide go up,” he said.

Regular Audits in Order?

More and more physicians, even those involved in a PHP, feel that regular monitoring of such programs is in order. For example, Dr Boyd said there should be routine audits “to ensure that rampant abuses of power are not happening.”

Asked whether she believes random audits for state PHPs are warranted, the FSPHP’s Bresnahansaid that the federation “supports quality assurance processes, utilizing both internal and external approaches, and is working to develop guidelines for PHPs to promote accountability, consistency, and excellence.”

Michael Myers, MD, professor of clinical psychiatry, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, in New York City, who is on the advisory board of the New York PHP, also favors audits.

Dr Myers has been in practice for 35 years, the last 20 of which have been devoted to caring for physicians and their families. There is no doubt, he told Medscape Medical News, that his state’s PHP program has been “absolutely lifesaving” for some doctors.

However, he acknowledged that there have also been “a lot of unhappy campers” who took issue with the program’s process. At the same time, though, he can recall only one physician who made a formal complaint. Dr Myers noted that the PHP program was initiated on the premise, “if we don’t govern ourselves, then someone else will do it for us.”

“We are trying to have some autonomy, but if a person is unhappy, there isn’t the same mechanism that would exist, say, at a university, where there’s a whole protocol that a professor with a grievance can follow.”

This lack of mechanism for due process was at issue in a recent Michigan class action lawsuit launched by three health care professionals (two registered nurses and one physician assistant), who claim in the statement of complaint to represent the “hundreds, and potentially thousands of licensed health professionals injured by the arbitrary application of summary suspension procedures.”

Although the state program was originally designed to simply monitor the treatment of health professionals recommended by providers, the HPRP has recently “unilaterally expanded its role to include making treatment decisions,” according to the complaints.

They state that “the mandatory requirements of HPRP, coupled with the threat of summary suspension, make involvement in HPRP an involuntary program circumventing the due process rights of licensees referred to the program.”

They also claim the “involuntary” nature of HPRP policies and procedures and the unanimous application of suspension procedures upon HPRP case closure “are clear violations of procedural due process under the Fourteenth Amendment,” the plaintiffs claim.

Initially, the three plaintiffs had their licenses arbitrarily suspended. But in each case, the suspension was promptly overturned by a judge.

For some who have been watching these events, this lawsuit just might be the catalyst to make much needed changes to physician health programs across the country.

“Kafkaesque Nightmare”

Jesse Cavenar, Jr, MD, vice chairman and professor emeritus, Department of Psychiatry, Duke University School of Medicine, Durham, Northcarolina, calls the PHP experience a “Kafkaesque nightmare.” Although he himself has not been referred to a PHP, he said a psychiatrist colleague of his, who was anonymously accused of smelling like alcohol, was evaluated and subsequently diagnosed with alcohol abuse.

According to Dr Cavenar, there was nothing to support the diagnosis. The doctor also claimed that the “thorough” physical examination noted in his record was never conducted. In the end, said Dr Cavenar, the psychiatrist was in treatment for 13 months. His medical and legal bills topped $90,000.

Dr Cavenar, who obtained power of attorney in this case, tried but failed to communicate with the treatment facility on behalf of his colleague. He also failed to obtain the medical record.

“When you have a facility that has made a diagnosis and they refuse to talk to anybody about how they made that diagnosis, you say, ‘Something is wrong here.’ ”

During his brush with the PHP system, Dr Cavenar also discovered that at least one evaluation facility has an “understanding” with the referring PHP that a physician will be diagnosed and spend a minimum 90-day interaction period in the treatment facility.

Medscape Medical News spoke to another knowledgeable, highly placed source, who asked not to be identified. He supported Dr Cavenar’s assertion of a mandatory 90-day assessment period, saying he had heard from two other physicians who had undergone treatment in the PHP system that there was in fact such a mandatory period proscribed for them in advance even of an evaluation to determine their level of need.

“I’m no bleeding heart; if you do the crime, you do the time,” said Dr Cavenar. “That’s not what we’re seeing here. We’re seeing people who didn’t do the crime but who are getting tapped with time.”

Bresnahan told Medscape Medical News via email that FSPHP is not aware of a blanket “90-day minimum interaction period” with treatment centers. Rather, among the many treatment centers familiar to PHPs, there are a variety of “programs” within the treatment centers that vary in length, and a variety of programs such as outpatient, intensive outpatient to residential treatment, and variations of residential treatment.

“Treatment centers often offer a 1- to 5-day multidisciplinary evaluation to determine treatment needs, including length of stay and outpatient vs inpatient treatment options. In general, residential treatment centers offer different programming that vary in length of stay from 30-day treatment programs to 45-day treatment programs to 90-day treatment programs.

“Along with these options, PHPs do utilize treatment centers that will provide clients with a variable number of days of treatment. In these examples, the treatment center determines the recommended length of stay during the course of treatment based on clinical needs,” she notes.

Asked about treatment costs to physicians, Bresnahan responded that she is unaware of reports of large lump sums expected on admission.

“FSPHP is unaware of excessive up-front fees in the $80,000 range,” she writes. “It is our understanding that a treatment phase can range from $5000 to $50,000 depending upon the days and the type of programs.

“A number of healthcare professional programs are now having progress with insurance reimbursement to offset portions of the cost,” she adds. “Some offer financial assistance based on a needs assessments, and some may also offer payment plans,” Bresnahan told Medscape Medical News.

Dr Cavenar felt so strongly about his colleague not having due process that he lobbied for an audit of North Carolina’s PHP.

His initial efforts were ignored by the state medical board, he said, so he approached the state governor’s office. Finally, Dr Cavenar said he and three other concerned psychiatrists successfully secured a state audit of North Carolina’s PHP system, the results of which were released in April 2014.

PHP Originator Speaks Out

According to psychiatrist Nicholas Stratas, MD, one of the problems with the North Caroline PHP is that decisions regarding a referred physician are vetted by a legal team.

Dr Stratas has a unique vantage point. He was the originator of the North Carolina PHP, was the first-ever psychiatrist and president of the North Carolina Medical Board, and still holds numerous affiliations with both Duke University and the University of North Carolina.

“In our state, the PHP has turned into something that was never intended…. [It] has become bureaucratized and legalized,” he told Medscape Medical News. “When I was on the board, we had one attorney; now, they must have six or seven attorneys, and the whole job of triaging physicians is left to the legal department.”

Dr Stratas said that at least until the state audit, the North Carolina PHP left physicians with no legal recourse once they were referred to a treatment facility.

“They have taken the position that because they are a peer review mechanism, they don’t have to comply with the nationally recognized condition that everybody should have access to their own records; they will not provide records to the physician.”

Dr Stratas related the case of a psychiatrist who after a detailed assessment was determined to have no addiction or mental health problems. This psychiatrist got caught up in the PHP system after an anonymous caller complained about “weird” behavior, according to Dr Stratas.

On questionable advice from his attorney, the psychiatrist voluntarily suspended his medical licence, thinking it was temporary and would help sort the situation out, but now he cannot get it back until he undergoes “treatment,” said Dr Stratas. After almost 2 years, said Dr Stratas, this psychiatrist is still without his medical licence.

Auditor’s Report: Potential for Undetected Abuse

The state auditor’s report found no abuse by North Carolina’s PHP. However, there was a caveat ― the report determined that abuse could occur and potentially go undetected.

It also found that the North Carolina PHP created the appearance of conflicts of interest by allowing the centers to provide both patient evaluation and treatments and that procedures did not ensure that physicians receive quality evaluations and treatment because the PHP had no documented criteria for selecting treatment centers and did not adequately monitor them.

“Abuse could occur and not be detected…because physicians were not allowed to effectively represent themselves when disputing evaluations… [and because] the North Carolina Medical Board did not periodically evaluate the Program and the North Carolina Medical Society did not provide adequate oversight,” the auditor’s report noted.

The North Carolina PHP “did not use documented criteria to select treatment centers” and “did not conduct periodic evaluation of the treatment centers to ensure compliance with established operating criteria.”

The auditor added that the program’s “predominant” use of out-of-state treatment centers placed an undue burden on physicians.

Furthermore, according to the report, the North Carolina PHP “created the appearance of conflicts of interest by allowing treatment centers that receive Program referrals to fund its retreats, paying scholarships for physicians who could not afford treatment directly to treatment centers, and allowing the center to provide both patient evaluations and treatments.”

The report recommended that physicians have access to “objective independent due process procedures” developed by the state medical board and medical society and that plans be implemented for “better oversight” of the program.

The report also stated that North Carolina’s PHP was required to make it clear that physicians “may choose separate evaluation and treatment providers” and that the PHP undertake efforts to identify qualified in-state treatment centers for physicians.

Since its release almost a year ago, many of these recommendations have been addressed by the North Carolina Medical Board.

“We absolutely embrace the auditor’s recommendations and are working really hard to implement them,” Thom Mansfield, the board’s chief legal counsel, told Medscape Medical News.

North Carolina’s PHP has undertaken to provide periodic reports to the medical board, and an independent audit of the program will be carried out every 3 years, Mansfield added.

Physicians who disagree with their assessment or treatment can now have their case reviewed by a committee independent of the PHP compliance committee and of the medical board, he said.

Mansfield also noted that the state PHP has established criteria for identifying suitable centers to conduct assessments and offer treatment, with an emphasis on developing more in-state resources. “I know the PHP is now referring people to at least two in-state centers,” he said.

In taking these actions, said Mansfield, the North Carolina Medical Board hopes it is “showing leadership” for other states.

May 3rd, 2013–Dr. Steve Adelman: The Mentality of What’s in Charge and Proof that Stupidity Often Reigns!

As the oldest medical society in the United States the Massachusetts Medical Society can count some of the greatest minds in the history of American medicine as members but this guy is not one of them.  My how far we have fallen!   This same author has also unintelligibly and bizarrely compared the medical profession to  Barbra Streisand’s face and tried to send a medical student who (naively) presented to him with “sleep apnea” for an evaluation in Kansas for “schizophrenia.”  He also opportunistically blamed the Boston Marathon bombing on “marijuana withdrawal” as seen below:

adelman1

adelman2

Screen Shot 2015-07-01 at 1.38.47 AM


images-10
 
The sophomoric mnemonics are neither clever nor illuminating.  Unworthy of  Readers Digest circa 1957, this dumbing down of doctors needs to end.  The very soul and practice  of medicine has been both  castrated and lobotomized with the  same dull and very very blunt instrument. How does one reconcile the fact that the very same medical society that publishes the New England Journal of Medicine is allowing this type of tripe and rabble to get past editorial review?  
In 1969, through an act of the state legislature, the Massachusetts Medical Society updated its mission to read:
“The purposes of the Massachusetts Medical Society shall be to do all things as may be necessary and appropriate to advance medical knowledge, to develop and maintain the highest professional and ethical standards of medical practice and health care, and to promote medical institutions formed on liberal principles for the health, benefit and welfare of citizens of the commonwealth.”
With a foundation and history built and based on of scholarship and critical thought we need to support the highest levels of science, fact, intelligence and reason.  Stupidity tries but it should not rein.    Before the Boston Society for the Diffusion of Useful Knowledge in 1842, Dr. Oliver Wendell Holmes delivered two long lectures entitled “Homeopathy and Its Kindred Delusions.” He characterized one of its popular practitioners, Dr. Robert Wesselhoeft, as one of those:
 “Emperics [quacks], ignorant barbers, and men of that sort…who announce themselves ready to relinquish all the accumulated treasure of our art, to trifle with life upon the strength of these fantastic theories.” That “pretended science” as Holmes called it, was “a mingled mass of perverse ingenuity, of tinsel erudition, of imbecile credulity, and artful misrepresentation, too often mingled in practice…with heartless and shameless imposition.”
 And Holmes words are as apt and appropriate today as they were in  mid 19th Century Boston!   Probably more so.  It’s no different. No different at all.    Be it homeopathy or 1939 quack spirituality, quackery is quackery is quackery.  Silence is definitely not the answer.
Screen Shot 2013-12-22 at 11.45.40 AM

Continue reading

Happy New Year from DisruptedPhysician.Com

ark--38305-g4r49qgw-is-1

Please don’t forget to sign petition to request Massachusetts State Auditor Suzanne Bump investigate the  Massachusetts Board of Registration in Medicine Physician Health and Compliance Unit under the direction of Attorney Deb Stoller  and their unholy alliance with Physician Health Services, Inc. (PHS).

Accountability requires both the provision of information and consequences.  Those who are able to hold PHS accountable have been provided with information that unquestionably shows PHS is engaging in unethical and criminal activity including forensic fraud and collusion with third parties to commit fraud.  It is necessary that these agencies do their job, provide due diligence, investigate and provide the appropriate consequences to those who engage in misconduct and break the law. Anything less is indicative of complicity.

Happy New Year to you and yours.  Let’s end this type of corruption in healthcare in 2015.

5be84913767be62dd5ac5ec9d424416c

 

Please Sign Petition and Call (617-727-6200) MA State Auditor Suzanne Bump to Demand Audit of Corrupt Physician Health Services and the MA BORM Physician Health and Compliance Unit

Please Sign Petition and Call (617-727-6200) MA State Auditor Suzanne Bump to Demand Audit of Corrupt Physician Health Services and the MA BORM Physician Health and Compliance UnitThe Petition can be found here.  Or better yet, sign the petition and call her.  The evidence that Physician Health Services, Inc. (PHS) is committing crimes has been free-floating for the past two years.   It has been posted on Reddit, Twitter, Facebook, Linkedin, blogged, faxed, and phoned.  The response?  Absolute silence.

The procedural, ethical and criminal violations are clear and many.     The incontrovertible evidence has been directly delivered to individuals who should address this but for some reason do not.  This is not a matter of opinion folks but a matter of fact.    Time and time again we hear of  egregious misconduct hidden for decades because of  cognitive dissonance and blinkered apathy.

What evidentiary standard is required for action?   Over the past three years and under a lot of duress I have obtained indefensible documentary prima facie  proof of  crimes committed by individuals that should elicit immediate action but produced nothing but silence.

The crimes are many and they are of significance.  Accountability necessitates both the provision of information and justification for one’s actions.   This group has effectively blocked both of these. With much effort and under threat I have obtained proof of criminal activity with the expectation that the provision of this information would  result in those who should and could do something about it would.   They have not.

The documentary evidence of crimes is self-evident.  It is indefensible.    It is inexcusable that criminal activity is taking place within the walls of the Massachusetts Medical Society.   The fact that PHS is unregulated and without any meaningful accountability is irrelevant.  They are engaging in criminal activity within the walls of an institution whose very foundation is the antithesis of this groups actions and it must be addressed. Either support what the documents show or do something about it.

So please sign this petition and call  Massachusetts State Auditor Suzanne Bump at 617-727-6200

Institutional injustice just like that being committed by Luis Sanchez, Linda Bresnahan and the corrupt MRO Wayne Gavryck is killing doctors across the country.  They need to be held accountable.  Help me hold them accountable.

You do not need to be from Massachusetts to sign this petition. It is to raise public awareness–hopefully enough to elicit more exposure of this problem to prompt audits not only in Massachusetts but in other states as was recently done in North Carolina. The N.C. state auditor conducted an investigation and found poor oversight of the state PHP by both the state Medical Society and the state Medical Board, a lack of due process for physician’s who disputed the PHP’s evaluations and requirements, and multiple instances of potential conflicts-of-interest.

Dr. J. Wesley Boyd, who was previously an Associate Director at Physician Health Services, inc., the Massachusetts PHP is recommending that state government agencies audit their PHPs as well to “ensure that their vast power is wielded judiciously and with oversight.”  He adds that “doctors who are unsafe to practice medicine ought to be prevented from doing so. But every doctor who enters any kind of treatment or monitoring program should be treated respectfully and fairly, monitored appropriately, and have legitimate avenues of appealing decisions about their care.”

The Massachusetts PHP is engaging in unconscionable conduct including forensic fraud and self-evident criminal activity that is indefensible from within the walls of the Massachusetts Medical Society. Most are not aware of this. They need to be. This rigged game is a national problem and how the racket works in Massachusetts can be seen here.

 Please help me expose this and put a stop to it!

IMG_8564

Screen Shot 2014-11-26 at 6.52.55 PM