Physician Health Programs are not Above the Law
Are Physician Health Programs (PHPs) above the law?
Unable to get law enforcement to take cognizance of reported abuse, many doctors I have spoken with believe that the actors involved are impervious to criminal liability. Complaints of fabrication and fraud involving PHPs and their affiliates to the police, the Attorney General and other law enforcement agencies have been given no credence, tabled or dismissed with little investigation.
Believing these agencies are deliberately ignoring credible complaints and the documentary evidence placed before them, some have concluded that state PHPs have been given the power to commit crimes with impunity and immunity.
PHPs are not above the law. It is by removing themselves from and blocking the usual routes of accountability and absolute operational control of the testing, assessment and treatment process that has enabled misconduct to remain hidden, unrecognized or excused. The crimes exist but they remain undetected, unnoticed and unpunished.
Removing Accountability
The essence of accountability is answerability which means having the obligation to answer questions regarding decisions and actions. This requires the transmission of information when it is requested. The accountable actor provides the information to the overseeing actors in a transparent manner.
Accountability also requires explanation and justification for the information provided. What was done and why? Standards, rules, regulations, codes, laws and other benchmarks are then applied by the overseeing actor to determine if the information provided was appropriate or inappropriate.
The availability and application of sanctions for illegal or inappropriate actions uncovered through answerability is also a necessary component of accountability. This is necessary to impose restraint on authority and power. Lack of enforcement of sanctions contribute to the creation of a culture of impunity.
The usual mechanisms that exist to impose restraint and create incentives for appropriate behavior and actions are absent. No outside oversight exists to limit their power or subject them to a set of rules. No regulation exists to curb abuse.
A Culture of Impunity
The authority accorded PHPs and the power they exercise exist in a culture of impunity.
The key findings of the2014 North Carolina PHP Audit are below:.
No indications of abuse were found, a point brandished by the PHP as redeeming and proving no abuse was occurring. In actual fact it is an ominous finding that also relates to their apparent ability to violate the law.
The audit found no indications of abuse but that abuse could occur and not be detected because of an absence of due process for the complainant, excessive control of the complaint process by the PHP and absence of oversight by either the medical board or medical society. What this means is that a doctor with no power is making a complaint against an unsupervised agency with enough power to influence the investigation of a complaint against itself. The reason no indications of abuse were found is because the system is specifically designed to hide abuse. That is the intent.
Absence of transparency, regulation and oversight coupled with control of information enables both censorship and doctoring of records. Strict Confidentiality is enforced by HIPAA, peer review protection, and drug and alcohol confidentiality law.
PHPs are able to suppress and conceal criminal activity but they are also able to manufacture information designed to hide misconduct.
The North Carolina Audit found no objective selection criteria for the out of state assessment and treatment centers because none exist other than ideological mindset and monetary gain. The same facilities are used by most state PHPS. They are, in fact, mandated as they are the “PHP-preferred” facilities.
In 2011 The American Society of Addiction Medicine (ASAM) issued a public policy statement on coordination between PHPs, regulatory agencies, and treatment providers. recommending only “PHP-approved” treatment centers be used and the statement specifically excludes ‘non-PHP” recognized facilities.
What the Audit diid not discover is the medical directors of all of the “PHP-approved” facilities can all be seen on this list of Like-Minded Docs. It is a rigged game Every aspect of drug-testing, assessment and treatment is kept hidden and secret and within control of the PHP.
It is a rigged game in which they have removed themselves from all aspects of accountability. They have, in effect, manufactured a culture of impunity at our expense.
Disrupted Physician 
I just found out that the former Clinical Director of Samaritan Counseling Center of the Capital Region was on the same licensing board that I complained to when I tried to go above their heads. I had a feeling that the weird treatment I was getting was coming from the higher ups. The twelve step coercion at this place was completely irrational. This ‘faith-based’ counseling network of ‘centers’ is privately funded through Samaritan Institute about $20,000,000 per year to provide their services at ‘sponsor’ churches.
Jenness Clairmont privately told me that she didn’t agree with the 12-steps. I have no idea if that was honest or what, because a week later I got a letter from her and definite 12-stepper Executive Director David Olsen that there would be no follow up and ‘under no circumstances’ was I to have any further contact with anyone at the ‘center’, affiliates or satellite offices. That really set off the alarm for me. Something is fishy here.
I suspect that Samaritan Institute (the accreditation mill) was formed as a 12-step front group in 1972. If so, that would mean they are involved in influencing the state licensing/approval of this kind of treatment across the country for private therapy (licensed by the state). I was not extorted or threatened loss of livelihood the way you were, but there are other ways that they use ‘leverage’…
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Samaritan Institute? “sponsor churches”? This confirms my suspicions: not only do we have medical industrial complex, a financial/banking industrial complex and an educational industrial complex, we have a religious industrial complex as well. Why does the US insist on being the breeding ground for this.
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My friend:
Given all that you have endured, I am truly awed by your ability to construct regularly a coherent, rational declaration of the demands of justice. Keep up the good work!
Brian
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Thanks Brian–I just wish more people would read it!
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It is such an import story to expose. It must be told and we must get it circulated.
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Below is link to Medscape article and several National Associations are monitoring closely-
ASAM Responds to ‘Physician Health Programs: More Harm Than Good?’
The American Society of Addiction Medicine objects to a Medscape news article that examines the current role of physician health programs.
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I read it. I am also awed by your ability to regularly construct a coherent, rational declaration of the demands of justice.
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Thanks
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I was a victim of human rights violations committed by the PHP farmed out the group called Maximus. While in the “Diversion program” with 18 month clean sober, over 130,000 invested to date, I fractured and dislocated my shoulder. When arriving in the ED I told the MD of my circumstances and requested a drug test as part of my in addition to standard radiographs. The ED MD ordered IV pain medication right away seeing my pain. I refused, until I could reach my “diversion nurse counselor”. The ED doc consulted Pain Management and Ortho given the added level of complexity. Ortho advised that they immediately give me dilaudid and place my fractured shoulder back in socket as my hand was numb and my pulses were weak., then I be admitted for surgery. When I finally reached the PHP monitor, her she told me that if I “take anything other than tylenol ( including for surgery)she would have my license” My team of 4 physicians now at this point( a hospitalist, ortho, PM and ED) all agreed that this was ill advised and I must have my shoulder placed back into socket immediately. That assuredly, this nurse knew not what she spoke and as soon as Monday morning came and they could contact the medical board….I would certainly be vindicated”post-procedure”, as even my contract read,that “medical care recommended by a reasonable licensed physician could not be prohibited” by participation in the program. I let the orthopedist, give me dilaudid and reduce my shoulder. I was admitted to the hospital for one week, while the Orthopod tried to induce me to have the surgery. Pain Management managed my acute pain, with full knowledge of my situation. All the doctors tried to contact the medical board to tell them of my unique surgery. That I should not be kicked out of the program. And, I should have the surgery I needed. The medical board took my license. Upon discharge from the hospital, the the medical board detectives came to my door to inform me, that I couldn’t work. I knew I could not even get myself dressed. When the board detectives came to take my license I had my hospital wrist band on one hand, and a wrist band circulating around our beach community of Ladera Ranch, for the little girl whom I was just featured in the newspaper and on TV for saving her life. They told me I was a danger to the public. My life fell apart. It has never been the same. I had already paid some 130-160,000 in fees to the PHP, and related expenses, even though I “had a strong case to fight the board” as one attorney said. I had no more money left. They had taken everything from me. My life was over. Suicide is something I still think about as I try to piece my life together. There were human rights violations occurring. There were anesthesiologist in Diversion forced to have “back alley” surgeries while in the program, at their friends surgery centers, using diprovan, as it wasn’t checked for. If you had a minor surgery or God forbid a situation such as mine….you were kicked out and lost everything.
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This is outrageous – we need to take back American medicine. These people not only need their licenses revoked but criminal charges need to be filed.
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Will you post this on the Medscape article?
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Could you email me please – mllangan1@mac.com
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I’ll try, it looked like the forum was closed. I’ve tried to tell my story. When it initially happened, I went to a convention and California Medical Conference and passed out an article delineating what had happened to many friends and peers, trying to garner support. The general atmosphere was one of fear. We need legal action, a class action of some type I’m just not sure against whom. But, united we stand and divided we fall. One person, at least in my case and all those physician’s stories I have heard…..could not fight the system, even in what seem to be obvious circumstances. Together, maybe there is a chance. Doesn’t anyone know a class action litigation attorney?
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