Physician Suicide

mllangan1 45 Comments

Physician Suicide.

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

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

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

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

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

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

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

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

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

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

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

Misconduct, fraud, and even crimes are being reported.

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

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

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

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

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

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

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

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

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

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

45 thoughts on “Physician Suicide”

  2. This doctor has a great site that addresses physician burnout and provides resources: http://www.thehappymd.com

    I believe Wible, and others like her, facilitate wellness retreats for people working in the medical field. It is really important to keep the conversation going. Thanks for your post.

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    • Yes, what we need is doctors like Wible staffing state Physician Health Programs along with honest and conscientious Medical Review Officers who know what they are doing–firm but fair. Institutional injustice is unacceptable in any venue. Why are doctors different? The current system attracts bullies, personality disorders and sociopaths. We need to stop ignoring the obvious. We have been bamboozled but ignoring it and hoping it will go away is not the answer.

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  3. Reblogged this on Inside the Stormy Prison and commented:
    If the stigma of suicide prevents the care of our medical population how can we expect to get any reasonable care for others with the same impairments? Ignoring the situation won’t make it go away. Allowing people who have “good intentions” at best and power and control aspirations at worst instead of professionals who actually have knowledge of the condition and empathy will only continue to punish the suffering and create avoidance in the medical society. Read this blog entry. Educate yourself as to what happens when a group of people are taken advantage of.

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  4. Thanks for re-blogging! I truly appreciate it from the bottom of my heart.

    “Every time we turn our heads the other way when we see the law flouted-when we tolerate what we know to be wrong-when we close our eyes and ears to the corrupt because we are too busy, or too frightened-when we fail to speak up and speak out-we strike a blow against freedom and decency and justice” Robert Kennedy.

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    • Mental illness is a taboo subject. Suicide is even more taboo than mental illness. For a wound to be cleaned the corruption must be exposed and recognized. It was a welcome sight to see your blog post here. Please keep the information coming.
      “Stigma’s power lies in silence. The silence that persists when discussion and action should be taking place. The silence one imposes on another for speaking up on a taboo subject, branding them with a label until they are rendered mute or preferably unheard.”
      ― M.B. Dallocchio

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  8. You are right. Not only is it not talked about but it is not even known about at all. I don;t actually know the reason why this is happening so please educate me. I will read all links and see if I can figure it out but given all the information with questionable integrity–given the reason why these doctors kill themselves–I am not sure I can believe anything unless it comes from the mouth of an MD. So please feel free to share your thoughts. I am reblogging this on my blog at cluelessdoctors.com (thanks for following by the way) where my job as a scientist is to bring to the surface errors on the part of big pharma and try to educate the public to stop drugging themselves. I am hoping my blog is not in conflict with your message and cause! Let talk!!! We are out for the same good. Angela

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  11. I was not aware of the lack of compassion in this country towards those with problems. Very sad and certainly no excuse. These kinds of things happen in America when dealing with tax collectors because that is still an area of government that has no compassion. Good article.

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  15. Reblogged this on Chaos Theory and Human Pharmacology and commented:
    Suicidio en Médicos

    Varios casos de suicidios de colegas aquí en Colombia nunca han sido revisados ni discutidos, a veces quedan dudas en los reportes de medicina legal y notas periodisticas sobre las verdaderas causas de su muerte. Esto es inaceptable, no ayuda a prevenir los problemas reales que llevaron al suicidio, tampoco sirve la situación para que la medicina pueda extrapolar estos conocimientos en la prevención del suicidio en otros profesionales de la salud (enfermería, y otras áreas de la ciencia y de las artes (ej. ingenieria, administración, diseño, física, etc).

    El problema es mayor si se tiene en cuenta que el miedo que despierta el temor al suicidio de un ser querido, algo muchas veces comprensible por todo el oscurantismo que hay sobre el tema, muchas veces lleva a prescripciones irracionales de medicamentos psiquiátricos con serios cuestionamientos en su seguridad y eficacia:

    – Fluozetina
    – Paroxetina
    – Venlafaxina
    – Risperidona
    – Olanzapina
    – Quetiapina
    – Duloxetina
    – Agomelatina
    – Escitalopram
    – Sertralina
    – Trazodone
    – Nefazodone
    – Alprazolam
    – Reboxetine
    – Others (e.g., modafinil, aripiprazole, mirtazapine, methylphenidate — Ritalin)

    Too much medicine: http://www.bmj.com/too-much-medicine

    Demasiada medicina: http://polimedicado.org

    References

    1. Ramirez, Jorge H (2014): Clasificación antidepresivos y antipsicoticos. figshare. http://dx.doi.org/10.6084/m9.figshare.1184484

    2. Ramirez, Jorge H (2014): Database of human studies evaluating antidepressant drugs. figshare.
    http://dx.doi.org/10.6084/m9.figshare.1168926

    3. Re: Putting GlaxoSmithKline to the test over paroxetine. The BMJ. http://www.bmj.com/content/347/bmj.f6754/rr/816737

    4. http://chaoticpharmacology.com/2014/12/12/response-to-full-text-of-cep-members-letter-to-the-lancet-psychiatry-in-response-to-article-by-nutt-et-al-council-for-evidence-based-psychiatry/

    5. Ramirez, Jorge H (2014): Duloxetine database | WHO ICTRP, ClinicalTrials.gov, Embase, PubMed, ISI, others. figshare.
    http://dx.doi.org/10.6084/m9.figshare.1096304

    6. Ramirez, Jorge H (2014): Agomelatine (Valdoxan) – Over 80% registered studies of this antidepressant drug are unpublished. figshare.
    http://dx.doi.org/10.6084/m9.figshare.1126326

    7. Ramirez, Jorge H (2014): Paroxetine: analysis of unpublished human studies (observationals and clinical trials). figshare.
    http://dx.doi.org/10.6084/m9.figshare.1103284

    8. The meta-analysis of published and unpublished studies of agomelatine is misleading. The BMJ.
    http://www.bmj.com/content/348/bmj.g1888/rr/762419

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  18. Your clue is where you mentioned the Clinical Director was an RN..

    and stop and think, why is an RN in authority over a medical doctor?

    The RN program is based on witchcraft. I know, I was part of it back in the 1980s. I quit because I found it so repulsive.

    I went on to graduate school and became a medical biochemist instead.

    All I heard was how the RNs were equal to doctors, and they should have all the rights, power and paychecks that doctors have. I remember my clinical teacher made us sit in the doctor’s eating lounge to boycott the doctors from coming in to eat their lunch. this was to show the nursing students had more privilege than the doctors, and to make the doctors submit to the nursing program.

    I also remember the teacher encouraging nursing students to find “mistakes” in the record so they could embarrass the doctors.

    The push back then was to control the health system by pushing themselves as “health care professionals” with status and power equal to doctors. they were really scary, so I quit the program.

    this is why you see some in “private practice” now, because they refuse to submit to doctors.

    this is a spirit of rebellion and control.

    all RNs are – are technicians with a conspicuously inferior education to doctors.

    I can tell you that the current nursing program is based on usurping the authority of doctors.

    Nurses hate doctors….they want to rule over them in feminist fashion.

    it gives them great satisfaction to rule over a doctor in a therapy program.

    the patient doctor has the right to decent patient care, and he has the right to object to someone who is less qualified than him to make decisions about him.

    every clinic should have a doctor, NOT an nurse, in charge.

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  21. It is refreshing to see doctors, nurses, and healthcare professionals tell what really happens in the BIG BUSINESS of medicine. After studying our healthcare system and those abroad, spending three years in nursing clinicals, and witnessing the miracles doctors and healthcare professionals perform daily, I decided to pursue a different path…counseling. Most people do not understand what the rest of you endure just to treat their illnesses and promote their health. Kudos for making a stand and advocating for the rights of everyone. I had a doctor that was driven out of his local practice. He went back to school and specialized in a different area, only to be hunted down and all files & computers confiscated pending another investigation. He was truly the one of the greatest physicians I ever met…very sad! Advocate & change legislature, get wall street out of healthcare, and mandate “no conflict of interests” allowed in clinical & drug trials, government sectors of healthcare, and in government itself, hold business and non-profits accountable including their accounting and reporting practices…only then will healthcare be real and true, as we see in most other countries.

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  22. This is very moving. All to often those of us outside the medical sector may take for granted the humanity behind those we expect to heal. I am truly grateful for those who sacrifice so much more behind the scenes than I could ever see. I wish the best for your project, an audience deeply moved through awareness, and the signifigance of the message renewed through progressive change~

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  24. Hi; As I have been through a MaPHS eval and part of treatment,I feel like I should comment here. While in the grip of PHS you have no time to think or look for other things. I was panicked and I believe it was intentional. After I recovered from my long surgical illness which bloomed during the enforced treatment phase,they told me to go back to treatment. I offerred to do any monitoring that they wanted and do an outpatient local program. They pretended to consider it but told me no. I retired as a result. I estimated that to do what they required over 3-5 yrs would cost me 120000 -200000. I believe that I(and my husband) were better off keeping our retirement funds. However,who lost by this. I was a very good general internist/geritrician working in an underserved area. Keep in mind that they can send you back to a treatment center to the tune of 50000 whenever they want! Most doctors know nothing about this. Other than for specific treatment,I have never spoken with any physician in the system that I worked in since this happened. No one wants to know. It is very sad.

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  25. In response toMarianne;
    I agree with your statement about what s an R.N. doing running a program for doctors. Period.

    Your blanket demonization of R.N.’s indicates to me that you have personal distain for us. Do you sincerely believe every R.N. is power hungry, practices witchcraft ,and has it out for doctors?
    Making global statements to be read by those in the profession of healthcare is bad enough. That you chose a forum with non-medical readers helps no one and possibly creates further distrust where there is already too much published and misstated derogatory remarks that go unfounded.
    I certainly am grateful you picked another profession rather than Registered Nurse. The probability that you would have spewed more toxic verbiage about R.N.’s is, may I delicately say, more than none.
    I am a R.N. A person of vocation, dedication and advocate for those in need of me or those I can enlist to help them when more than one (read TEAM), is called for. Doctors are worthy of all the praise they can garner in this climate. That you found need to debase my vocation with global cover leaves me sick to my stomach.
    Whatever school you attended should have been made accountable for their reprehensible behavior. Most probably since you seemed to have a plethora of these nasty instructors the task might have best been done by you. Given your generalizations in your posts, perhaps that would be too overwhelming given the number of incidents you encountered personally as noted in your post.

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    • I am glad you consider yourself positive, but even the corrupt ones present themselves that way.

      I have met nice nurses

      the nice ones are usually on the bottom somewhere, and the nasty ones are teaching or are in charge.

      I went to one of the top schools in the country…very liberal and critical of doctors, but the nurses from there would still marry a doctor for the status of it.

      mental health nurses are the worst – control freaks

      ER nurses are the best – no time for foolishness, all business

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  27. I want to challenge everyone here: It has been known now for decades that the entire mental health system is no more than legalized torture. It’s genocide of not just doctors, who comprise a tiny segment of this population, but anyone labeled “mentally ill.” Do you know that shock treatments are still being done? Do you know that they still regularly tie people to beds, give them a shot of something they’ve never had before, and then leave them there for hours on end? this is medically approved “treatment.” Do you know that for decades now, anyone with a “diagnosis” ends up living in terror…of their shrink and his/her power. Any minute now, those cops could come for you. Doctors aren’t the only ones whose lives get ruined by diagnosis and subsequent inhumane care. It’s just that it shocks people to learn that even an all-powerful, all-knowing, next-to-God doctor has to undergo the torture, too. This isn’t only a doctor thing. In fact, doctors that have never been tortured in this manner (they call it “care”) have no clue what it’s like to live with a psych label that’s on your record for life. These doctors participate in the tortures and it’s clear they think very little of their patients. Psych patients die 25 years younger due to labeling and psych meds. I am on the verge of homelessness. Thanks to “care.”

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  28. Incredible stigma, blindness and tragedy. From the same roots, medical discrimination also is rampant against persons in recovery from depression. It reflects the prevailing attitude of the entire academic medical profession. Sadly, doctors, and would be doctors, with those with addiction are actually held in higher esteem within the profession than those with depression (even those in recovery). It is truly tragic and I can attest to this.

    My depression started as far back as I can recall. But while initially it was just an ever present ironic outlook, I became seriously depressed, with suicidal thoughts (which because of therapy, I recognized and reported) in JrHS. It was relentless, despite over 10 years of therapy and every combination of pharmacologic agent, exercise regimens, diet and personal coaching. Those all helped it stay at bay, but I was becoming discouraged at the baseline ubiquitous futility … except after alcohol (which I knew to fear). Finally, 3 years ago, it let up with TMS. The only downside is that currently, I need a one hour treatment every 10 days. The difference has been so watershed dramatic that I changed my career course from wanting to help others via research to clearly seeing myself able to have a clinical practice.

    Coming from a family of physicians and applying to medical schools, the question has come up about “adversity you have overcome.” I wanted to answer this honestly, as I am grateful to have been in recovery for the past 3 years and proud of my own efforts. So I obtained consultation from three online med school application services, my own psychiatrists, psychoanalysts, psychiatrists who are also TMS providers as well as from local academic consultants, physician mentors ( I live in a large city with multiple medical schools) to make sure I wasn’t just caving in to one or two frightened individual physicians. They were unanimous in their advice: say nothing about depression if you want to be admitted – because despite my stats… 3.93 GPA, 34 MCAT, hundreds of hours of shadowing, community service (including overseas), bilinguality, I am stigmatized by being in recovery from major depression.

    I was advised to NOT list this as an adversity overcome, to NOT mention it in any way in any personal interviews or in any written or oral questions or statements. I received that advice (and I believe it is accurate) from every single physician and medical researcher, PhD, I have consulted; I have asked over 20 physicians and advisory persons in faculty positions. I did not want to follow that course and so repeatedly looked for someone who might know how I could “tell the truth.” I heard instead that I should not mention depression or TMS, and have heard this following advice verbatim from at least half of those: “you would be better off saying you’d overcome an addiction.”

    The medical profession exists with a “don’t ask, don’t tell” philosophy about addiction and depression. The profession claims it is now more sympathetic to issues of diversity such as sexuality, gender and economic issues and nationality. It is still in the dark ages about psychiatric disorders and addiction; the ASAM and PHP are proof. I believe I would receive the same discrimination if I said I had another chronic affliction such as diabetes, the admissions professionals would justify that as affecting my longevity of practice. I hope to be admitted and as an MD, after my residency, one day be able to change things from inside.

    As grieving mother, Karen Miday, MD, wrote after her gifted son, Greg Miday, MD’s suicide, “Is there something about medical academia that hails the talent but spurns the vulnerability? As a practicing psychiatric physician of 30 years, I can confidently state that both talent and vulnerability are necessary for the competent and compassionate practice of medicine.

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    • I am sorry to hear another sad story. I had a bout of depression once, which was based on circumstances, not biology, and I ended up getting laid off. it was hard getting another job. I was fine in one month but the “bad” reference followed me for years. I now counsel people from a spiritual perspective, and it seems to help them

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    • Thanks for sharing. This is what happens to doctors who are psych labeled. Imagine how horrific psych labeling is for a non-doctor, such as a musician or writer? Our lives are over, too, once we get labeled. People see physician suicide as tragedy but since when is anyone else’s suicide less tragic simply because they make less money or aren’t seen as prestigious people? That’s why all the talk of physician suicide infuriates me. Why is anyone else’e suicide seen as inconsequential and just shrugged off? It’s a reflection of our caste structure and only leads to more bigotry. I was a talented music student who apparently mattered to no one. Just a statistic.

      Sadly, the worst, most discriminatory sector are doctors. Many of us are terrified to go to emergency rooms even with very obvious physical complaints since it means profiling and poor care if any. You are boxed in for life. And if you make waves it’s very easy to end up locked up again, even for no reason or proof. This profession, the way it is practiced, needs to change! I left the country to get away from my medical records. I suffer from trauma as a result of the psych tortures, which can happen to anyone.

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      • As a talented music student, Julie, you would matter a lot to me. Music is healing beyond description, and I almost chose that career path for myself. Music got me through a lot of tough school and residency times. I hope you live in a more understanding place now, as it seems the US system can be especially callous. As far as physician suicide is concerned, no it is certainly not more important. Few people realize it happens, possibly because some in the profession itself would prefer to sweep it under the rug.

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        • Every single person I have known who has committed suicide did so BECAUSE of mental health care. Not one of them had no prior exposure to a shrink. All suicide is wrongful death. Someone or some institution has played a role. Yes, it is most often swept under the rug, and as far as I know, many families are under gag orders. Some, I never found out for sure for over a decade due to the silence. NOTE: Break it. For the sake of those that have gone before us. For the sake of justice. I am witness to so many wrongful deaths, saw it happen, could do nothing. But I refuse to shut up.

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  30. Good Morning.. Welcome aboard.. it would appear folks are coming to themselves.. or running like hell from their lost illusions.. personally my studies of the ‘living theater’ have spoken a clarity that keeps the cartoons in context.. (not cartoon art).. and the serious, need for simplicity more available to those so suggestible.. thanks again..
    Peace Tony

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  31. For every physician suicide there are many who are pre-suicidal… ( Severe depression, abused and harassed etc..) That is why this is an urgent issue. Discrimination is rampant. Doctors who express their abuse are considered weak and abnormal, weird?? Bullying is the root cause of a lot of health issues including suicides. In my case, the MEC chief is a psychiatrist. From his behavior, I am sure no one would consider him a human being, let alone a psychiatrist. I have repeatedly said, to fix Health Care, one must fix Humanity. Be a good human being first with unlimited kindness and compassion, before you can become a good doctor, administrator, CEO etc…Let us start with basics to build a good foundation of caring doctors. Lack of Unity among physicians is another factor that weakens us. The unhealthy competition and divisive behavior allows administration, nurses etc to haze and harass physicians. So, let us start by each one of us being kind to at least 1 human being per day.

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