Massachusetts Governor Charlie Baker Moves to Control Professional Boards

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Baker moves to control professional boards

By Christian M. Wade Statehouse Reporter May 11, 2016

BOSTON — Dozens of independent boards that regulate doctors, barbers, electrical workers and an array of other professionals could soon be pulled under the state’s umbrella — a move that trade groups complain smacks of government overreach.

Lawmakers are considering a bill filed by Gov. Charlie Baker to limit the independence of licensing boards and give the state the power to “review and veto” any action deemed to stifle competition.

The proposal responds to a U.S. Supreme Court opinion last year that boards controlled by members of the profession they regulate are not immune from antitrust lawsuits.

In that case, the court ruled that the state dental board in North Carolina had no protection from antitrust claims when it issued cease-and-desist orders to companies offering teeth-whitening services.

Baker administration officials say the ruling leaves licensing boards in Massachusetts vulnerable.

Even legal actions may be challenged, Mike Kaneb, Baker’s deputy legal counsel, told a legislative committee on Tuesday.

“Individual board members can be sued,” he added.
But exerting authority over the boards is also raising concerns.

Frank Callahan, president of the Massachusetts Building Trades Council, which represents about 75,000 skilled construction workers, said the state needs to address the issue but he’s concerned the governor’s proposal would give the state too much power over the boards.

Boards that oversee electricians and other skilled trades already have state oversight, to varying degrees, he noted, as well as lawyers to ensure their decisions comply with federal anti-trust laws.

 

Baker moves to control professional boards | News | eagletribune.com 13/5/16 11:14 PM

Several representatives of trade groups opposed the proposal at the legislative hearing. Robert Butler, business manager for Sheet Metal Workers Local 17, called it a “solution to a nonexistent problem.”

“This bill would allow the state to make decisions without any public input or recourse,” he said.

Baker, a Republican, has promised to make the state more business- friendly, in part by cutting through red tape. In a statement, he said licensing rules and limits on professionals “have the effect of restraining trade and commerce” and are bad for business.

Donna Kelly-Williams, president of the Massachusetts Nurse’s Association, criticized his plan in comments to lawmakers.

“With this directive, it seems as though the governor would like to turn the Board of Registered Nurses and other similar boards into nothing more than vehicles to spur economic competition at the expense of the public health and safety,” she said.

Baker administration officials said that’s not the intent.

“The only motivation for the governor’s bill is to respond to the changes in law,” Kaneb said Tuesday.

Since the Supreme Court ruling, legislation to exert more control over independent licensing boards has been introduced in least six other states, according to the National Conference on State Legislatures.

In Massachusetts, the Division of Professional Licensure oversees 45 boards, which regulate more than 370,000 individuals and businesses in some 50 trades and professions.

Most board members are volunteers appointed the governor and operate independently from the state.

Baker signed an executive order last year directing the licensing division and other agencies to conduct monthly reviews of recent board decisions to determine if any violate federal laws.

Martin W. Healy, chief counsel for the Massachusetts Bar Association, said the state must act quickly to comply with the Supreme Court ruling to ensure that its boards don’t face legal challenges.

 

Baker moves to control professional boards | News | eagletribune.com 13/5/16 11:14 PM

“This is a major issue for the state that needs to be addressed quickly,” he said. “You would have a very difficult time attracting talented people to these positions if they could held personally liable for the board’s decisions.”

Christian Wade covers the Massachusetts Statehouse for the North of Boston Media Group’s newspapers and websites.

MA – State Oversight of Professional Licensing Boards – annot

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Physician Health Programs:  The Need for Integrity and Accountability of Organizations

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Accountability, or answerability,  is necessary to prevent abuse and corruption.  This requires both the provision of information and justification for actions.  What was done and why?

Professional guidelines and standards of care, ethical codes of conduct and the law are all objective benchmarks that can be used to assess the actions and decisions of others.  In any free society this necessitates the existence of organizations of truly independent opinion capable of standing in this judgment.

State PHPs are Non-Governmental Organizations (NGOs) over which the state health department has no supervisory oversight.  There is no regulation, no transparency and no accountability.  There is no public scrutiny and they police themselves.

In Ethical and Managerial Considerations Regarding State Physician Health Programs Drs. John Knight and J. Wesley Boyd call for greater oversight and scrutiny of PHPs by the medical community at large.   They recommended periodic auditing, national standards and regulation.  They also attempted to convince the Massachusetts Medical Society to implement changes at PHS where they served as Associate Directors with over two decades of collective experience.

These efforts to promote transparency and accountability at both local and national levels, however,  fell on deaf ears.

State PHPs have systematically removed those not conforming to groupthink.  Threatening them with litigation if they breached “peer-review” statutes and confidentiality agreements has effectively silenced them from reporting any misconduct, abuse or even crimes they may have witnessed.

In Massachusetts John Knight was removed in 2009 and J. Wesley Boyd in 2010.  In Ethical and Managerial Considerations Regarding State Physician Health Programs  they comment “if a PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwisetailor its diagnosis and recommendations in a way that will support the PHP’s impression of that physician.”  So too will the clinical laboratories.  

How is this any different from the case of Dr. Farid Fata, the Michigan oncologist who intentionally diagnosed healthy patients with cancer so he could charge them for unneeded chemotherapy?  The U.S. Attorney called it the “most egregious” case of health care fraud ever. His acts may have contributed to one patient death.   The institutional injustice of the PHP system is causing countless deaths of physicians.

To consciously “tailor” a diagnosis is fraud.  To tailor a diagnosis of substance use disorder or any other psychiatric diagnosis is the political abuse of psychiatry.  Misrepresentation, dishonesty, deception, and distortion play no role in the Profession and Guild of Medicine.  To do so violates the basic moral principles of Medical Ethics–Autonomy, Beneficence, Non-Maleficence and Justice.

The “PHP-approved” assessment and treatment centers are all staffed by doctors of “like-mind.”  It is a rigged game.

An audit of the North Carolina PHP found essentially no oversight from the Medical Board or Medical Society.  The audit found that “abuse could occur without being detected,” and this is by design.  By removing and blocking the provision of information necessary for accountability, restricting the liberties and freedoms of physicians, and increasing their power and control they have erected a framework of hidden abuse.

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The situation in North Carolina is standard operating procedure for PHPs under the Federation of State Physician Health Programs (FSPHP).  It is not the exception but the rule.

While outspoken in denouncing what they regard as unethical and unprofessional behavior by other doctors, they are resistant to apply even the most minimal standards to their own activities.

To whom are the PHPs accountable? Whom do they represent? There are legitimate concerns.

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The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control

The Medical Profession, Moral Entrepreneurship, Moral Panics, and Social Control.

As a society governed by organizations, associations,  institutions and regulatory bodies, the medical profession is not immune to “moral panics” and “moral crusades.”

A threat to patient care or the values of the profession can be identified and amplified.   A buildup of public concern fueled by media attention ensues creating a need for governing bodies to act. Medical Professionalism and the Public Health has been assailed.

Unbeknownst to the general population and most members of the medical profession at large, certain groups have gained tremendous sway within organizational and regulatory medicine. Through  moral entrepreneurship they have gained authority and become  the primary definers of the governance of the medical profession and the social control of  doctors.  To benefit their own interests they have fostered and fueled “moral panics.” Exhorting authorities to fight these  threats by any means necessary  they have successfully made and enforced rules and  regulations and introduced new self-serving definitions and tools that neither help doctors nor protect the public.

A Golden Age

BY TIMOTHY STEELE

Even in fortunate times,
The nectar is spiked with woe.
Gods are incorrigibly
Capricious, and the needy
Beg in Nineveh or sleep
In paper-gusting plazas
Of the New World’s shopping malls.
Meantime, the tyrant battens
On conquest, while advisers,
Angling for preferment, seek
Expedient paths. Heartbroken,
The faithful advocate looks
Back on cities of the plain
And trudges into exile.
And if any era thrives,
It’s only because, somewhere,
In a plane tree’s shade, friends sketch
The dust with theorems and proofs,
Or because, instinctively,
A man puts his arm around
The shoulder of grief and walks
It (for an hour or an age)
Through all its tears and telling.

Timothy Steele, “Golden Age” from Sapphics and Uncertainties: Poems 1970-1986. Copyright � 1986, 1995 by Timothy Steele. Reprinted with the permission of the University of Arkansas Press, www.uapress.com.

Source: Sapphics Against Anger and Other Poems (1986)

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Disappointed that his grandiose proposal to test the urine of half the U.S. population for illicit drugs was declined in the 1980’s, Bob realizes such a large swath was too tall an order. Acknowledging that his dream of lifelong urine drops for each and every one of the riffraff at least once a fortnight will take time, he decides to focus his attention on specific subsets of the great unwashed such as school-children, welfare mothers, the unemployed and whatever they are calling Hippies these days.

The Addiction Medicine Control Machine

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In his 1969 novel The Wild Boys, William S. Burroughs writes “Under pretext of drug control suppressive police states have been set up throughout the Western world…. The police states maintain a democratic façade from behind which they denounce as criminals, perverts and drug addicts anyone who opposes the control machine.”

15 years earlier Dr. Ruth Fox formed the New York City Medical Society on Alcoholism. This organization subsequently became the American Medical Society on Alcoholism and eventually the American Society of Addiction Medicine.    The goal has always been to convince the medical establishment that 12-step recovery is the one and only treatment for alcoholism and drug addiction.

Unable to convince the medical establishment of this they decided that a better tactic would be to impose it on them.

And through propaganda, misinformation, lobbying, misleading public relations, and myriad other machinations used to promote a static ideology and suppress anything that contradicts, detracts, or otherwise not fit their world view as a product of themselves, they have admittedly succeeded.

This  includes creating a  “medical specialty” that requires neither knowledge nor competence.  Like Grimm fairy tale number 98, Doktor Allwissend (Doctor know-All) in which a poor peasant becomes a famous medical expert by declaring himself so ( by dressing like an expert, brandishing an ABC book with a rooster on the front, and having a sign painted with the words ‘I am Doctor Know-All’ and nailing it above the door to his house), the ASAM has “faked it til they made it.”

To make this point I sat for the exam with absolutely no preparation in 2010, passed by a respectable margin, and was “board certified” in addiction medicine. ABAM “board certification” is not recognized by the American Board of Medical Specialties (ABMS).  It is a “self-designated” medical specialty which means exactly what it sounds like.  “I hereby declare myself..”

Except for a year of psychopharmacology research, some MRO work, and “moonlighting” at local mental health facilities I have no education or training in addiction yet I was able to join the ASAM fold—–an exercise somewhat like showing how easy it is to buy a gun at Walmart.  The analogy does not end there however as they can both be “licenses” to kill.

Like  an NRA wallet card I never intended to use it.  I let it lapse so there is no need for the ASAM to revoke it.    It was in effect an  “academic exercise” to make a point-and that point being that I am no “expert” in addiction medicine and neither is 4000 of me.

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By proclaiming themselves the cream of the crop, bestowing phony “board certification,” and creating the myth of expertise at the expense of the real experts and lobotomizing evidence based thought and critical thinking they have created a monopoly of despotism in addiction medicine treatment.  The ASAM and FSPHP  have created a tyranny in regulatory medicine that is unsupervised and opaque.  Moreover, they have grand plans for the rest of the population. They have influenced the DSM-V, are trying to gain control of MRO education and regulation, and pose a great danger to all of us.  This front-group for the 12-step assessment and treatment centers and the drug and alcohol testing industry is indeed fulfilling Burrough’s prediction of a police state.

They have money and and a monopoly of force by number (they outnumber Addiction Psychiatrists by 4:1) and the risks of this unqualified authoritarian control and influence involve all of us as a society.  And it impacts freedom, life, and liberty.

Alarmist call to arms about the dangers of drugs and hidden addicts protected by others and posing danger to create untrue hype is propaganda and misinformation to further the ASAM drug-testing 12-step inpatient rehab agenda and gain control. Drug war sloganeering designed to get everyone aboard. Logical fallacy, deceptive facts, pseudoscience, and misinformation is obvious if anyone cares to look a little deeper. The conflicts-of-interest are immense. The ASAM and FSPHP are front-groups that use ends-justifies-the-means coercion and deception to get public recognition of the righteousness of the twelve steps of recovery.

Neither doctors nor US citizens should be subject to the whims of a religion based political group composed of unqualified, inexperienced, paternalistic and biased individuals who are truncheons of dogmatic ideology and refuse to accept evidence based treatment, transparency, and accountability as important. ASAM board certification is not recognized by the ABMS. These are self-proclaimed specialists–great pretenders.   Underneath is a Potemkin village.  The emperor is bereft of all clothes.

The problem is that regulatory agencies, politicians, medical boards, and others have bought into the lie. Most people take them at face value resulting in the perception that they are indeed experts in addiction medicine and they are well on the way to becoming the only experts in addiction medicine. Within the next couple of years this will become a reality. The ASAM will shortly gain ABMS specialty certification. They are well funded.

The addiction psychiatrist subspecialty has already being pushed into a corner. Some have even joined in in rather than fade away–kind of like what happened to the proctologists as the gastroenterologists moved further up. But that analogy doesn’t quite work  as gastroenterology swallowing proctology represents an advancement in science.  Medicine, like all of science is fluid. What they represent is frozen.  Additionally it’s a lucrative gig.

This situation is more like the anti-vacciners parading themselves as experts in immunology and gaining enough support to run out the real McCoy.

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 Pseudoscience, groupthink, deception, and coercion. A framework not built on the scientific method, evidence based decision making, autonomy and benevolence; but based on unproven ideological dogma, righteous inflexible worldview, rigid rules, obedience, and control. Drug testing of all physicians will be done by ASAM, FSPHP physicians. They will demand prohibition, testing, and treatment and will be in complete control. Even with 100% specificity and sensitivity there are valid arguments against this. But if you throw in the corruption and other issues that are obvious if one looks, then medicine as we know it is going to be lobotomized by dabblers and clowns.

It will come in a whimper not a bang and by then it will be too late. The goal of the ASAM has been to be recognized as the “experts” in addiction medicine ever since The American Society of Addiction Medicine (ASAM) was started by Dr. Ruth Fox in the 1950’s to promote AA and the 12-steps to doctors as a treatment for alcoholism.

PHP’s function to monitor and control. . Mandating coercive 12-step ideology onto physicians is SOP. The marked rise in physician suicide over the past decade is directly correlated with the FSPHP taking over state impaired physician programs. And the “kill em all let God sort em out” logical fallacy of saving doctors and protecting patients is propaganda with no evidence base.

This system, that encourages referring doctors confidentially for evaluation, is a nearly foolproof means to silence any physician they feel the need to. An accusation of substance abuse is made relatively easy. Then recommend an evaluation to one of your own people who will confirm the problem and force them into a 5 -year monitoring program where you must abide by the twelve step road to salvation.

By colluding with a short list of inpatient drug treatment centers such as Hazelden, Talbott, Marworth, Farley, and others where co-conspirators there will engage in “confirmatory bias” and “confirmatory distortion” to make the assessment fit the diagnosis they have a nearly perfect system to remove any physician from practice. It is “political abuse of psychiatry.”

 

In the former Soviet Union during the Khrushchev-Brezhnev era, the KGB used its forensic psychiatric institutions to brand, arbitrarily and for political reasons, large numbers of political dissidents as suffering from “schizophrenia” and “paranoid psychosis” and then incarcerated them for long periods in “special psychiatric hospitals.” In 1976, the Soviet Union was severely censured on this account by psychiatrists from all over the world at a conference in Hawaii of the World Psychiatric Association. Only after Gorbachev’s rise to power were these errors rectified. We have now discovered that similar practices have also occurred in certain parts of China.”1– Jia Yicheng (China’s top forensic psychiatrist), 1998

 

 

Well to quote Zoolander “Earth to Mathilda” it’s occurring right here in the U.S. of A. but they have substituted “substance use disorder” for “schizophrenia” to delegitimize, marginalize, and ignore.

The ASAM claims an 80% success rate. If you look at the data they are basing this on it is illusory–sloganeering and propaganda with no substance.

The biggest obstacle is that this system allows them to throw the normal rules of conduct under the imperative of a higher goal assumed to trump all other consideration. Those outside of the FSPHP, ASAM system either defend or ignore the reports of ethical and criminal violations, complacent in their trust of these “experts” claiming they are just helping sick doctors and protecting the public.

The ASAM and FSPHP are gaining power and expanding in scope. They have effectively muscled forth the “war on drugs’ agenda to further their goals by establishing a system that of coercion, control, secrecy, and misinformation. The first wave was substance abusers, they then added any psychiatric diagnoses, then the disruptive physician”, and the next target is the “aging physician”.  Goodbye Dr. Welby.

The testing of physicians will inevitably include EtG and PEth—tests that Alabama PHS Director and ex-felon Greg Skipper introduced, proselytized, and brought to the drug testing industry like a carnival huckster. Introduced as  Laboratory developed tests (LDTs) to bypass FDA approval and regulation this junk science was commercialized, marketed, and paraded as scholarship.  Introduced with an arbitrary cutoff point of 100 it ruined countless lives.  God knows how many suicides were caused by this prohibitionist profiteer.

A 2011 study revealed that hand sanitizer alone can result in EtG levels c lose to 2000 ng/ml.

Dr. Skipper and Robert Dupont, are now recommending PEth as a confirmation test for an elevated EtG.

The evidence base is empty. Anecdotal reports supporting these tests and mostly done with Skipper as a co-author are essentially all that exist.

The June 2013 journal “Alcoholism: Clinical and Experimental Research”contains an article coauthored by Skipper and DuPont , Greg Skipperand Robert Dupont looking at 18“subjects” who tested positive for EtG and concluded that “positive PEth testing following positive EtG/EtS results confirm recent drinking.”Although they were unaware of it, these “subjects” were physicians enrolled in the Physician Health Program.

This is a system that oppresses physicians and is about to enter the domain of individual freedom, destroy the Bill of Rights, force 12-step philosophy and erode freedom of religion, stifle freedom of speech, and take us back decades.. They have convinced medical societies, medical boards, regulatory agencies, parole boards and others to not only accept them as experts, but to write legislation in states to declare them “the” experts in addiction medicine. They did this with a torrent of strategic lobbying efforts on behalf of the 12-step addiction treatment industry towards the AMA (and indirectly through the FSPHP towards the AMA), ABMS, APA, FSMB, ABIM, JCAO, CSAT, consumer groups, presidential candidates, state medical societies, congress, corrections agencies, social service agencies, faith-based community centers, the media and many other targets.

By convincing others of their expertise they have strategically placed themselves in a position of power that includes the ability to remove any doctor from practice.

“With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world.”-Twelve Steps and Twelve Traditions, AA World Services, Inc (1953).

And unless something is done soon, every physician in the US will be at risk of losing everything at the whim of of a 12-step front group that places ideology above evidence base and dogma above virtue.

Claiming success they now want to bring it to you. Take a look at Robert Dupont’s keynote speech before the Drug and Alcohol Testing Industry Association.  Prohibitionist profiteers euphoric about the future bumper crop of clear cups and urine. “Test em all” Dupont wants to include schools and children in the net.  Reminiscent of the Nuremberg rallies he received a a thundering standing ovation.    And for this to happen all you have to do is one thing-nothing.

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