Milton Friedman (July 31, 1912 – November 16, 2006) was an American economist who received the 1976 Nobel Memorial Prize in Economic Sciences

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In an article written for the March 2015 Physician Health News, the official newsletter of the Federation of State Physician Health Programs (FSPHP) President Doris Gunderson reviews the history of the organization in honor of its 25th anniversary. She writes:

“In 1990 the FSPHP was born out of a need for individual state programs to work together in discussing and promoting best practices and especially to influence national public policy.”

For the last quarter century the FSPHP has pushed a plethora of both practice and policy (legal, regulatory and healthcare) that claims to assist state physician health programs in identifying, managing and monitoring impaired physicians and protect the public from harm.It was recently suggested by the Chief Editor of American Society of Addictions Medicine (ASAM) Weekly News that this same group take the helm in influencing public policy for addiction medicine at large (i.e. not just doctors but everyone from our kids to our pregnant mothers to our elderly) on a national organizational level.

It is time we examined both the authority and the knowledge claims on which they are based.

In her rebuttal to Pauline Anderson’s August 2015 Medscape article ‘Physician Health Programs: More Harm Than Good?  Gunderson dismissed criticisms as “allegations rather than facts” and “second hand anecdotes.”

In response to allegations that PHPs have no oversight Gunderson comments:

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

The list of organizations Gunderson has to “answer” to appears to be many of the  organizations and societies that physician health programs interact with.  She might as well add Blockbuster for getting her videos back on time. This is not meaningful oversight.  Oversight equates with accountability and that requires answerability (the provision of information) and justification for one’s actions. It also requires the presence of an outside organization truly independent of the group that is able to sanction or punish individuals for wrongdoing or misconduct.     No such organization exists for state physician health programs. Period.  There is no organization that exists that is able to investigate a complaint of misconduct and provide sanctions.  The same applies to their primary business associates, the assessment and treatment centers (because they are private pay and out-of-pocket) and drug and alcohol testing labs (because they use non-FDA approved tests).  The entire racket is unaccountable and unexamined.

Kathryn Pyne Addelson  warned that what we should fear most is “unexamined” authority. “Illegitimate politicization and rampant irrationality find their most fruitful soil when our activities are mystified and protected from criticism.”

This group has been protected from criticism for the better part of a generation. They have enjoyed making authoritative pronouncements as unexamined authority. Their power depends entirely on not being questioned as what is behind the curtain is flimsy and dredged,  a Potemkin village.   The recent Medscape and BMJ articles are revealing that confrontation with direct and precise questions results in nothing but logical fallacy, distortions and lies.  They are utterly incapable of responding with a direct and precise answer.   Gunderson’s response to absent oversight  is just another example of this logical fallacy and distortion.  This is not how rational authority responds. This is not how legitimate authority responds.  I kindly invite her to debate this.  I would like a back-and-forth to clarify.  It is a simple question that deserves a simple answer and I know she follows my blog as she used her own name and e-mail address.

The cumulative comments on the articles critical of these programs are revealing a system of oppressions, injustices and illusions.   A more recent article on Medscape,  “One-Man Fight:  MD Takes on State Medical Board, PHP” reports the same pattern of coercion, absence of due process and diagnosis rigging for sham peer review that I am hearing from doctors across the country.   The comments section to this article are also overwhelmingly critical of PHPs.  They are pertinent, articulate and precise and missing from them is any semblance of a rebuttal by the FSPHP, their apologists or anyone else.   The writing is on the wall as they say. And for that reason we call upon all those of good will in both the medical profession and the public at large to join us in this confrontation with illegitimate, irrational and immoral authority.

1. Gunderson D. Message From the President  Twenty-Five Years: A Remarkable Journey. Physician Health News. 2015;20(March).
2. Addelson KP. The Man of Professional Wisdom. In: Fonow MM, Cook JA, eds. Beyone Methodology: Feminist Scholarship as Lived Research. Bloomington: Indiana University Press; 1991:16-35.