Making the Data fit the Hypothesis is not Science: The American Society of Addiction Medicine (ASAM), “Weasel Phrases,” “Framing” and “Data-Dredging.”

Screen Shot 2014-12-30 at 1.12.01 AMPrinciples of Addiction Medicine devotes a chapter to Physician Health Programs. Written by Paul Earley, M.D., FASAM,1 Earley states that the lifetime prevalence of substance abuse or addiction in physicians found by Hughes2 is “somewhat less than the percentage in the general population reported by Kessler” of 14.6%.3

Although he specifies the numerical percentage “in physicians at 7.9%,”3 he avoids the use of numbers (14.6%) in the general population. He instead uses the qualifier “somewhat less.” Why is this?

My guess is because it understates the statistical fact that the prevalence found by Kessler in the general population was almost twice that found by Hughes in physicians.

You see, “Somewhat less” is a “detensifier.” It creates an impression of a small disparity between doctors and the general population.

In propaganda this is what is known as a “weasel phrase.”   Weasel phrases are used to obfuscate the truth.   Weasel phrases mislead those either without the time, or without the sense to see or look any deeper. The problem is it works.

“Methodologic differences may account for this difference,” Earley states, as the Hughes study “surveyed 9, 600 physicians by mail” and “relied on honest and denial-free reports by the physicians; the Kessler study utilized face-to-face interviews with trained interviewers.”1

This is an example of language framing. Language framing uses words and phrases to direct attention to a point of view to advance a vested interest.

In this case the use of the phrase “honest and denial free” in the context of physician reporting imparts associative meaning to the reader.

As denial is a recurring motif and cardinal attribute of physician addiction according to the paradigm, the connotation is that the reports by physicians may have been influenced by dishonesty and denial while face-to-face interviews done by “trained” interviewers were not.

“Framing” is another propaganda technique designed to tell the audience how to interpret the information given through context.   The message here is that the somewhat less lifetime prevalence of substance abuse and addiction in physicians found by anonymous mail survey may be underreported as a result of both methodology and denial.

But in actual fact there is a large body of research regarding “social desirability bias” that shows the converse to be true.

One of the most consistent findings of studies of this kind is that socially desirable responding is significantly more likely with face-to-face administered data collection compared with self-administered anonymous modes.4-6

Tourangeau et al. reviewed seven studies comparing self-reports of drug use in surveys conducted in different modes. For each estimate obtained in the studies they calculated the ratio of drug use reported in self-reported surveys to the corresponding estimates in interviewer administered surveys and found that 57 of 63 different comparisons showed higher levels of reporting of drug use in the self-reported mode.7

The principal cause of social desirability bias is the level of perceived anonymity of the reporting situation.7

Evidence-based research does not support Earley’s claim that methodological differences in study design explain the difference in reported lifetime prevalence of substance abuse or addiction between physicians and the general population in these two studies.

Evidence based research would, in fact, make the findings more robust.

Moreover, I find it hard to comprehend the psychodynamics, motivation, and logic of denial and dishonesty in influencing an anonymous survey. So too would anyone else who dare peer beneath the veil. It is, in fact, a Potemkin village. In reality the emperor has no clothes.

  1. Earley PE. Physician Health Programs and Addiction among Physicians. In: Ries R, Fiellin D, Miller S, Saitz R, eds. Principles of Addiction Medicine. 4 ed. Baltimore: Lippincott Williams & Wilkens; 2009:531-547.
  2. Hughes PH, Brandenburg N, Baldwin DC, Jr., et al. Prevalence of substance use among US physicians. JAMA : the journal of the American Medical Association. May 6 1992;267(17):2333-2339.
  3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry. Jun 2005;62(6):593-602.
  4. Sudman S, Bradburn NM. Response effects in surveys: A review and synthesis. Chicago: Aldine Publishing; 1974.
  5. Tourangeau R, Smith TW. Collecting sensitive information with different modes of data collection. In: Couper MP, Baker RP, Bethlehem J, et al., eds. Computer assisted survey information collection. New York: John Wiley & Sons, Inc.; 1998.
  6. Dillman DA. Mail and telephone surveys: The total design method. New York: Wiley-Interscience; 1978.
  7. Tourangeau R, Rips LJ, Rasinski KA. The Psychology of Survey Response. Cambridge: Cambridge University Press; 2000.
  8. American Society of Addiction Medicine: Patient Placement Criteria. Chevy Chase, MD: American Society of Addiction Medicine; 2000.
  9. Merlo LJ, Gold MS. Successful Treatment of Physicians With Addictions: Addiction Impairs More Physicians Than Any Other Disease. Psychiatric Times. 2009;26(9):1-8.
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Disrupted Physician 101.2: “Addiction Medicine” is a Self-Designated Practice Specialty Unrecognized by the American Board of Medical Specialties–(An AMA Census Term Indicating Neither Training nor Competence)

Disrupted Physician 101.2: “Addiction Medicine” is a Self-Designated Practice Specialty Unrecognized by the American Board of Medical Specialties–(An AMA Census Term Indicating Neither Training nor Competence)B1A19yWIMAAQf7EThe fraudulent Addiction Medicine drug-testing, assessment and treatment complex is a  charade of prohibitionists and profiteers.  It is time that this be identified and addressed. Addiction Medicine has evolved in a Lord-of-the-Flies manner without regulatory scrutiny or oversight and an absence of the need to guard. They are the Robber barons of Science and Medicine who have bought and boondoggled their way into the Medical Profession and Society  and are poised to ruin both. It is time to take aim at these unsupervised pundits of authoritative opinion with facts, evidence base, and the scientific method. The immense and unconscionable conflicts of interest  must also be addressed. And the blinkered apathy of the masses and willful ignorance of organized medicine needs to end now!   If not the ASAM White Paper on Drug Testing  will come to pass and we will be  faced with a future Police State run by unqualified, illegitimate and irrational zealots and profiteers.

johnnyLawrence

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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.

rushmore-jason-swartzman

 

 

 

Three shells and a pea–ASAM, FSPHP, and LMD

Unknown-3She likes a rigged game, you know what I mean?”

— R.P. Murphy in Ken Kesey’s One Flew Over the Cuckoo’s Nest

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Published  in the March 17, 2014 newsletter Alcoholism and Drug Abuse Weekly, an article  entitled “Physician group urges focus on spiritual and psychosocial” describes a group of doctors who “emphasize that for all addictions, the psychosocial and spiritual interventions, including 12-step interventions must be included in the treatment process and,” according to founding board member Dr. Ken Thompson, M.D., “to not do so falls short of practicing good addiction medicine.”

With a “significant percentage” in 12-step recovery themselves, “they have formed a  group called “Like-Minded Docs,which has more than 150 physicians, many of whom are medical directors of top treatment programs and also members of the American Society of Addiction Medicine (ASAM).” Dr. Thompson is in fact the Medical Director of Caron treatment center in Pennsylvania. The group also includes the medical directors of Hazelden, Talbott, Marworth, Promises, and other assessment and treatment centers used by state regulatory agencies to evaluate and treat referred physicians.    The President of the American Society of Addiction Medicine is a Like-Minded Doc as is former White House Drug Czar (1973-1977) Robert Dupont. In addition, the physician who introduced the long-term alcohol biomarkers Ethyl-glucuronide (EtG),  Ethyl-sulfate (EtS), and Phosphatidylethanol (PEth) is a like-Minded Doc as is  Wayne Gavryck, The Medical Review Officer for the Massachusetts Physician Health Program PHS, Inc.  How does he reconcile his 12-step belief system with fraud and misconduct?   It is either doublethink or the A.A. spirituality persona is just a front.

Although I  applaud the ideal of addressing the psychosocial and spiritual aspects of addiction and acknowledge that 12-step recovery is a treatment tool that can provide great benefit to some people, I do believe there is an inherent conflict-of-interest here. Having no strong feelings for or against A.A, I  view it through the same pluralistic and open-minded lens as I do religion or philosophy;  there are many paths to salvation and none superior. I have referred patients to A.A. myself  and see it as an option and a personal choice, one tool in the toolbox  that can provide great benefit to some people, do absolutely nothing for others and, in fact, harm some.   If it works for you good for you. Knock yourself out.  If not then let’s try something different.Screen Shot 2014-03-15 at 7.33.14 PM

So although the ideals of Like-Minded Docs are ostensibly laudable, the framework is not necessarily so.  What is  most concerning is a confluence of currents that preclude option and choice. It is a scaffold that can be used for coercion, control, and imposition. And this is exactly what is being done in many of the State Physician Health Programs (PHPs).

Originally funded by state medical societies and staffed by volunteer physicians, PHP’s were designed to help sick doctors and protect the public. But over the past decade these programs have undergone a sweeping transformation due to the influence of the American Society of Addiction Medicine (ASAM). Unlike Addiction Psychiatry, ASAM is not recognized by the American Board of Medical Specialties (ABMS). They created their own “board certification” (ABAM)  in 1986 and most physicians do not know that the only requirement is an M.D. in ANY specialty and some sort of experience in substance abuse.

Trumpeting the false dichotomy that addiction is a “brain disease” and not a “moral failing” while portraying themselves as altruistic advocates of the afflicted, the ASAM has cultivated an organization that exudes authority, knowledge, respectability, and advocacy. They have set forth definitions of addiction, shaped diagnostic criteria, dictated assessment protocols, and shaped public policy all under the guise of scholarship and compassion.

They introduced junk science such as the EtG and PEth alcohol biomarkers through Greg Skipper, FSPHP, ASAM, and another Like-Minded Doc.

They created the “moral panic” of a hidden cadre of drug addled and besotted doctors protected by a “culture of silence” disguised as some of the best workers in the hospital and in fact look “just like us.”  They introduced and promulgated the nebulous “disruptive physician” and successfully fostered a moral crusade to attack this huge hidden threat. And if you do a little searching you will find that their  next target is the “aging physician,”  demented doctors causing unseen mayhem and assailing the public good.  They are now  fomenting a call to arms to root out senility in medicine. It is the same tactic they used in the substance abusing and disruptive physician.  Social entrepreneurs.  Moral panic. Moral crusade.   With no evidence base and the use of  propaganda and disinformation they have convinced regulatory and administrative medicine that witches are real, witches are evil,  and they are the authority when it comes to witches and know how to identify and root them out with our witchpricking instruments.  And you know what?. It worked.

And by infiltrating state PHPs they have become the might and main of addiction medicine in the United States. By removing dissenters who disagreed with the groupthink they have taken over most of the state PHPs and organized under the Federation of State Physician Health Programs (FSPHP).

And the State PHPs under the FSPHP are very strict when it comes to choice in rehabilitation facilities for for physicians in need of assessments for substance abuse. In fact there is usually no choice in the matter.  The physician may be given a choice of facilities but that is a ruse as it is a false choice– smoke and mirrors sleight of hand. Deception.

As home to some of the countries top ranked hospitals and most prestigious medical schools Massachusetts is an international healthcare hub with world-class teaching, research, and clinical care. Two of the top three psychiatric hospitals in the United States as rated by U.S. News and World Report are found here in Massachusetts with McLean Hospital earning the top prize and Massachusetts General Hospital ranked number three. However, this medical mecca of learning and research is apparently unable to attract anyone with the competence and skill to assess a physician for addiction or substance abuse.

In Massachusetts if the State PHP, PHS,inc. feels a physician is in need of an assessment the evaluation must be done at “a facility experienced in the assessment and treatment of health care professionals.”  No exceptions. And apparently these esoteric skills are only found in Georgia, Arkansas, Alabama, Kansas, and a half dozen other far-away places.

With over 20 years experience with the Massachusetts PHP, Physicians Health Services, inc., Harvard Medical Schools Dr.’s John Knight and J. Wesley Boyd published an article in the Journal of Addiction Medicine last year concerning Ethical and Managerial Considerations Regarding State Physician Health Programs.

One of the issues they discussed was the conflicts of interest between the state PHPs and the evaluation centers. One comment I was surprised got past editorial review was that the treatment centers may “consciously or otherwise” tailor diagnosis and recommendations to the PHP’s impression of that physician. “consciously” tailoring a diagnosis is fraud. It is political abuse of psychiatry. It is unethical. It is, in fact, a crime.

If you cross-reference the  medical directors of the “PHP-preferred facilities”  with the list of LMD’s it is a perfect match.

Therefore when the PHP refers a physician for an evaluation and gives them a choice of an assessment facility there is no choice. It is three card monte. A shell game. Heads I win tails you lose.

The ASAM has imposed the prohibitionist chronic brain disease spiritual recovery model of addiction on the field of medicine. It is a system of coercion, control, and indoctrination. And another ASAM Like-Minded Doc, Robert Dupont, is calling this the “new paradigm” of addiction medicine and wants to spread it out to other venues including schools.

Like-Minded Docs solves the final piece of the puzzle. It explains why so many doctors across the country are claiming fabrication and manipulation of personality and cognitive tests to support nonexistent diagnoses. 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. The emperor has no clothes and sunshine is the best disinfectant.

She likes a rigged game, you know what I mean?

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