Month: March 2017

New Public Records Law revealing MA medical board counsel concealed criminal fraud for years; Major misrepresentations made by defense counsel to court. Falsehoods with no factual basis.

mllangan1 5 Comments
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On June 3, 2016  Governor  Baker signed House Bill 4333 imposing greater accountability on state agencies  when responding to public records requests.  This includes shorter time frames to respond to requests (10-days for most), the provision of complete and legible records and appointing a Primary Records Access Officer to handle such requests.  The new Public Records Law also subjects agencies to sanctions for failure to comply.with the new law.
On  January 9, 2017  I submitted a Public Records Request  through the Executive Office of Health and Human Services (EOHHS) Website  for a dozen or so documents that had been submitted for board hearings but never directly addressed and containing textual content with evidence that was never weighed.   Moreover, many of the documents provided direct evidence of crimes (no other is evidence needed).
All of these documents were provided  to Board counsel Deb Stoller.
Today, Sunday March 12, is the beginning of daylight savings time. It also marks the beginning of  Sunshine Week, a national celebration started in  Florida 15  years ago to promote open government, transparency and accountability.   Transparency is about shedding light.  Transparency can bring accountability, and, often, meaningful reform.
Screen Shot 2017-03-11 at 3.29.35 PMIn response to a request for documents submitted for specific board hearings the board has not provided a single satisfactory response.   They have not been able to  provide a single document that is chronologically consistent with it being considered at the board  hearing for which it was submitted.   I had no expectations they would and this was the precise point of my record request.  These are documents that should exist but do not exist. The vault is empty.    None of the documents are in the records because they were suppressed on arrival and never got to the full board.  They never considered any of it.  The records do not exist.
Screen Shot 2017-03-12 at 5.39.29 PM It has now been over two months and this shows how transparency is not just about shedding light on what is there but what is not there–transparency can also illuminate contrivances and lies.  If these documents existed then they would have provided them long ago and this is all coming to light as a result of Public Records Division staff enforcing new  Public Records Law and they should be applauded for their integrity, honesty and genuine concern.    In a culture of deference, impunity and apathy where giving allowances are the rule rather than the exception this agency deserves an A+ amidst a sea of D’s and F’s.
 
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The majority of documents provided have illegible or missing dates.   Undated documents have no value.   Analyzing any dataset requires  that  data-points be annotated with reliable timestamps that signify when the textual content was created and this is especially important with records that accumulate over time. Documents with message content passed on to others must be annotated with reliable timestamps that signify when the textual content was received and acknowledged by the receiver.
The  Board Records obtained June 2016  provided  pretty clear evidence that the documents were concealed .  The only documents with a decipherable date stamp included a  December 15, 2011 letter requesting an attached  “litigation packet” be provided to the board for consideration at a December 21, 2011 hearing,  The documents are all date stamped  January 17, 2012.  (nearly one month after the hearing).    AAG  Bertram dismissed the timestamp and claimed it did not reflect when it was entered into evidence but when it was scanned into the computerized records.  In truth they should be one and the same and if that is the case then where is the timestamp reflecting when it was  entered into evidence?    Bertram  claimed this occurs  after hearings not before.  It all defies common sense.
The January 9, 2017 request specifically requested a copy of the documents from the “administrative record” compiled for the December 21, 2011  hearing but in response they returned the same documents provided December 15, 2011 but date stamped January 17, 2012  –nearly a month after the hearing.
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The simple and straightforward request was made again and an appeal was filed requesting provision of the documents requested. Thankfully the  Public Records Division staff attorneys have not accepted  the logical fallacies and half-truths presented to deflect and dismiss a simple and straightforward request for documents. Supervisor of Records Rebecca Murray Ordered the  board provide a revised response and we obtained every document related to the December 2011 “litigation packet” that exists and all of the materials that Bertram claims were retrieved from storage.  All of it can be seen here:
It is a dataset with an N of 1. The only document retrieved from storage is the original December 15, 2011 letter requesting the “litigation packet” be submitted for consideration at the December 21, 2011 hearing and all of it is date-stamped  January 17, 2012 and this precludes the existence of any earlier copies.   No other copies exist!
 Take a look at the letter and all of the pages of the “litigation packet” as they are pristine.  No notations, initials, dates, scribbles or signatures.   So how were these documents “considered” at the December 21, 2011 board hearing?  At almost 50-pages did they all huddle around it or pass it around the room.
The simple fact is they were never considered by the board.  They were sitting in a drawer for a month (my guess under a bunch of moon pies and diet cokes) and then put in the system well after the hearing so no one would notice.
 In his cover letter RAO Dolan reiterates the ridiculous claim that  the date-stamp reflects when it was “bulk-scanned ” into the electronic archives and not when it was “presented to the board.”   What would be the purpose of putting timestamps on documents that have no meaning?   This is a bald faced lie and I want to call him on it.   Evidence presented for any hearing must be submitted and entered into the record before not after hearings. This is common sense but to put this to rest we can turn to the  2012  Manual for Conducting Administrative Adjudicatory Proceedings  which outlines how administrative proceedings are conducted  by professional boards.  It was also edited by AAG Quinan, the Managing Attorney of the Administrative Law, Government Bureau–the Department AAG Bertram is part of    The  “administrative record” is listed as one of the “basic principles” in chapter 1  and is second only to  “due process” M.G.L. c. 30A, § 11(8).    An administrative record must be compiled for every board hearing and indexed.   “The record is everything that is properly before the decision maker in rendering the decision.”
The manual makes it crystal clear that evidence must be compiled before hearings and anything not compiled before the hearing must be excluded!  Bertram also claimed that  “board staff”  reviewed its records and minutes and retrieved  from “off-site storage” the “materials”   that were before the Board in December 2011.”

1 The Board’s staff has reviewed its records and confirmed this to be the case.

2 To be sure, and to put this matter to rest for the Court once and for all, the Board has retrieved from off­site storage those materials before the Board in December 2011. The documents that Dr. Langan claims were “suppressed” are in fact there—and this should not be surprising given the Board’s many orders since that time, all of which have disclaimed any reliance on the July 2011 PEth test.

3 The Board’s staff has confirmed this by reviewing its minutes and confirmed this to be the case.

It has now been confirmed that the only “materials”  that exist are the documents themselves  and they are dated January 17, 2012 and this does not confirm but refutes Bertram’s claims.   In sum not a single data-point exists to support this document was before the board on December 21, 2011.   Moreover, the document provides direct evidence of crimes (no other evidence is needed).

I have requested that Bertram either provide documentation to support his footnoted claims or reveal to the court the misrepresentations.   As a government attorney he is obligated to reveal falsehood and perjury and I requested he do so.  But instead of revealing  no materials from off-site exist to support his claims he notified the court of his misrepresentation that by “offsite storage” he meant “basement”

He mentioned nothing about these major misrepresentations and dug his heels in deeper claiming that board staff did indeed   “retrieve and review those documents” and claims his “footnote representation remains uncompromised.”    His footnote representations no longer remain uncompromised.  At this point I’d say they are pretty compromised–the false contrivances are in actual fact shattered.

The off-point Bertram letter can be seen here:   ( Attachment B (6) )   “Uncompromised is a poor choice of words Mr. Bertram as “shattered” or “demolished” would be more appropriate.
Bertram claimed agency level investigation confirmed documents were before the board in December of 2011

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Reviewing Records and Minutes

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Retrieving Materials

The Reality

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These documents provide direct evidence of crimes (no other evidence is needed).

Bertram was also asked to address the “chain-of-custody error” misrepresentation.  The documents show intentional fraud.  This is no error.    The laboratory fraud seen here is similar to that of Annie Dookhan but the documents here show both of the parties involved; a state physician health program and one of the labs contracted by state physician health programs nationwide.   Precise and detailed documentation of forensic fraud was provided to a state attorney in 2011 but she concealed the documents. . I pointed this out to Bertram from the beginning and I also told him of all of the suicides that have occurred because of bogus tests just like this one.  He did not seem to care.   I notified him of another one here in Massachusetts;  a good doctor and a good person who was also subject to falsified testing and injustice involving the same actors.   I am hopeful that the transparency being provided here will lead to accountability.   Both of these attorneys need to be held accountable.

An attorney must have a factual basis for alluding to, offering or relying on evidence and that factual basis may not be wishful thinking.  There are two requirements for a factual basis — an attorney’s subjective belief and objective evidence to support that belief.

It is now established that no objective evidence exists.  Not a shred of evidence exists.

Not a single date-point with  a reliable timestamp is chronologically consistent with these documents being before the board.

Please donate to my Gofundme-  At this point I really need funding to mount a quick and effective response to these new developments.   Exposing these crooked attorneys would be a great step forward for all of PHP reform.  Please help me out.

https://www.gofundme.com/PHPReform

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How Public Records Law can force transparency and hopefully bring accountability- Root out the rats!

mllangan1 Leave a comment

screen-shot-2016-09-30-at-1-30-53-pmAn attorney must have a factual basis for alluding to, offering, or relying on evidence at trial. That factual basis may not be wishful thinking. There are two requirements for a factual basis — an attorney’s subjective belief, and objective evidence to support that belief.

But none exist here   Not one  document, reference, record, or any other materials exist that are chronologically consistent with these documents being before the board in 2012.

The only document that exists is the litigation packet date-stamped a month after the hearing

I asked Bertram to either provide the factual basis or admit to the false statements.  He’s been ignoring me and will not answer.

The whole picture depicts the respondent as an attorney who, when it serves his advantage, is willing to violate clear norms of professional responsibility and to engage in purposeful deceit which harms others.“

The privilege of practicing law does not come without the concomitant responsibility of truth, candor, and honesty. Because no single transgression reflects more negatively on the legal profession than a lie, attorney misconduct involving dishonesty justifies disbarment.” Id. (quoting In re Young’s Case, 913 A.2d 727 (N.H. 2006)).

No matter what it takes I am going to make sure that is a certainty in this case

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Source: How Public Records Law can force transparency and hopefully bring accountability. Root out the rats!

How Public Records Law can force transparency and hopefully bring accountability. Root out the rats!

mllangan1 2 Comments

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This Sunday marks the beginning of  Sunshine Week, a national celebration started in  Florida 15  years ago to promote open government. Transparency is about shedding light.  Transparency brings accountability, and, often, meaningful reform.

On June 3, 2016 Governor Charlie Baker signed into law the first update to Massachusetts public records law since 1973.  House Bill 4333  imposes shorter time frames for agencies to respond to records requests.  Most agencies need to respond within 10-days but can be granted a 20-day extension provided they show good cause for it.  Those who believe a state agency  has violated its legal obligations can petition the Supervisor of Records and agencies are also subject to punitive damages for failure to comply with the requirements.

Massachusetts has historically ranked at the bottom of the barrel in terms of giving its citizens  access to public records.  A 2015 assessment by  a non-profit investigative news organization gave the state a grade of F and ranked it below Mississippi and Arkansas in the category of public records access (40th in the nation).

Under the new law documents previously provided with missing or illegible date-stamps were requested from the board.  The sole reason for this request was to  determine if these documents were submitted as evidence and forwarded to the tribunal for consideration at the hearing for which they were considered to be heard a, heretofore impossible task due to toothless public records law in Massachusetts.  This matter should be a given.  If I mail a letter I do not question or fret over whether or not it was received by the person I sent it to and  the same dynamic applies here.  It is a given assumption  that documents submitted as evidence for at hearing reaches those individuals who are supposed to hear that evidence at that hearing.    That is how the system is supposed to work and, like a lost letter, exceptions should be rare as there are safeguards in place to assure it.   Here we have a group that has removed those safeguards.  The Physician Health and Compliance Unit (PHCU) is part of the medical board but independent of the medical board and exist as a self-contained unit with no oversight, auditing of or accountability.   The PHCU was created to serve as a liaison between the state PHP and medical board to handle board cases involving doctors being monitored under PHP contract.  Ostensibly they are an objective go-between and these individuals are assumed to seek, follow and tell the truth.  Their job is to review the evidence and let the chips fall where they may.  They do not.  Given the power to act as their own hearing officers and present cases to the board they hold all the chips.  All evidence supporting any doctors case before the board in a physician health case must be submitted to the PHCU, not directly to the board and if that evidence contradicts the PHP then it never ever gets to the board.  This has been suspected for years but when these documents are later requested to see if they had been reviewed board has been able to  delay, withhold and censor them.  There has previously been no way to determine these matters and they could get away with whatever they wanted by gaming the system under toothless laws.

Not anymore (hopefully).

The Commonwealth of Massachusetts Public Records Division has been a breath of fresh air. Those I have interacted with have integrity and empathy as well as zeal.   Although limited in scope they can hold agencies to account by demanding the provision of complete, legible and accurate records and not backing down.

Pam Wilmot, executive director of Common Cause Massachusetts stated:

“As the cradle of liberty, Massachusetts should lead the way on openness and transparency, not lag behind the rest of the nation. The law Governor Baker just signed will help us catch up and begin to take our rightful place among those states that highly value and promote transparency.”

Document Submitted as Evidence for Hearings Date-Stamped  Long After

In response to a June 2016 request the board provided  just one with a legible date-stamp; a December 15, 2011 letter requesting  an attached “litigation packet”be   considered at an upcoming December 21, 2011 hearing .  The documents are all date-stamped January 17 2012 (nearly one month after ).. All of the other documents where  illegible or missing dates rendering it impossible to determine if and when they were entered into evidence  as required by law under  M.G.L. c. 30A§ 11(4) which states:

All evidence, including any records, investigation reports, and documents in the possession of the agency of which it desires to avail itself as evidence in making a decision, shall be offered and made a part of the record in the proceeding, and no other factual information or evidence shall be considered, except as provided in paragraph (5) of this section. Documentary evidence may be received in evidence in the form of copies or excerpts, or by incorporation by reference.

Board Defense counsel Bryan Bertram dismissed the date-stamp as irrelevant and claimed it did reflect when it was entered into evidence but when it was scanned into the  Document Imaging Unit (DIU) . He claimed this occurs  after hearings not before. See  logical fallacy and lies. .  We filed a Motion to Produce Documents (SJC-2015-0267, # 44) with legible dates which Bertram opposed in his  Response to Motion to Produce Documents

Bertram claimed “board staff” had reviewed its records and minutes and retrieved  from “off-site storage” those “materials before the Board in December 2011.”  The documents I claimed were suppressed, he claims , “are in fact there.”  and provides footnotes:

1 The Board’s staff has reviewed its records and confirmed this to be the case.

2 To be sure, and to put this matter to rest for the Court once and for all, the Board has retrieved from off­site storage those materials before the Board in December 2011. The documents that Dr. Langan claims were “suppressed” are in fact there—and this should not be surprising given the Board’s many orders since that time, all of which have disclaimed any reliance on the July 2011 PEth test.

3 The Board’s staff has confirmed this by reviewing its minutes.

He claimed my request was :

“……nothing more than an attempt to impose upon the Board a duty–absent from any statute, regulation or rule to search for and produce documents to him that are outside of that record.  Dr. Langan’s  Motion tellingly directs this Court to no authority to support such a request. Because it is devoid any basis in the law, the Motion should be denied.”

As of January 1, 2o17 my request for  legible documents does have a basis in the law. Authority does now exist to support such a request.

I filed a Public Records Request under the new law on January 9, 2017.   I received a response from Board counsel Robert Harvey  ( January 20, 2017 documents provided by board).   Most are still illegible or missing dates.  The same document date-stamped nearly one -month after the hearing for which it was submitted was provided.   One other had legible dates.   A document written June 6, 2013  is stamped both electronically and by hand with dates sometime in 2012, before it was ever written.

And in response to an Order from the Supervisor of Records  I was  provided the very same document date-stamped January 17, 2012.   But it is not a copy but original as indicated by the “blue-ink.    This original document precludes the existence of any others date-stamped earlier than January 17, 2012.    This documents no earlier dated copies could have been submitted as evidence before the hearing. This document was never admitted into evidence and may not be relied upon by the board in its decision M.G.L. c. 30A, § 11(4).

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The records, minutes, and materials  reviewed and retrieved by “board staff” constitute public records. I requested them. I also requested the board “reports” that would have resulted from “board staff” confirming  it was before the board in 2012.

“ABA Model Rule 3.3, Candor Toward The Tribunal, declares that ‘a lawyer shall not knowingly make a false statement of fact or law to a tribunal or fail to correct a false statement of material fact or law previously made to the tribunal by the lawyer.’ If a lawyer ‘has offered material evidence and the lawyer comes to know of its falsity, the lawyer shall take reasonable remedial measures, including, if necessary, disclosure to the tribunal.’

An attorney must have a factual basis for alluding to, offering, or relying on evidence at trial. That factual basis may not be wishful thinking. There are two requirements for a factual basis — an attorney’s subjective belief, and objective evidence to support that belief.

But none exist.  Not one  document, reference, record, or any other materials exist that are chronologically consistent with the documents being before the board in 2012. The only document that exists is the litigation packet date-stamped a month after the hearing.

I asked Bertram to either provide the factual basis or admit to the false statements.  He’s been ignoring me and will not answer.

The whole picture depicts the respondent as an attorney who, when it serves his advantage, is willing to violate clear norms of professional responsibility and to engage in purposeful deceit which harms others.

“The privilege of practicing law does not come without the concomitant responsibility of truth, candor, and honesty. Because no single transgression reflects more negatively on the legal profession than a lie, attorney misconduct involving dishonesty justifies disbarment.” Id. (quoting In re Young’s Case, 913 A.2d 727 (N.H. 2006)).

No matter what it takes I am going to make sure that is a certainty in this case.

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Make Medicine Great Again!   Please Donate and Help Drain this Swamp!

https://www.gofundme.com/PHPReform

Related Posts

  MA Board Attorney Deb Stoller’s Fraud Upon the Court

Defending MA BORM Deb Stoller’s Five-Year Concealment of Fraud–Nothing left but logical fallacy and lies

Physician Health Programs (PHPs) are not above the law; They just think they are

mllangan1 1 Comment

mllangan1's avatarDisrupted Physician

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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.

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Physician Health Programs (PHPs): The Ford Granada of Employee Assistance Programs (EAPs) and Stuntman Mike is at the wheel.

mllangan1 2 Comments

Screen Shot 2017-03-08 at 8.50.56 PMWhat is being touted as “gold standard” and “cream of the crop” is on closer inspection iron pyrite and curdled spit up.  I am reminded of the commercials comparing a Granada to a Mercedes when I was a kid.  I remember these commercials  well as I couldn’t wrap my head around them.  In one, as I remember it, two couples arrive at their parked adjacent cars with keys in hand. The Mercedes tries to open the door of the Granada and vice versa.  “How is this scenario even possible?” I remember thinking. Had they been drinking?    Is this related to “this is your brain on drugs or that old guy in the miracle ear commercial who looks confused when the waiter asks his salad dressing preference and his companion yells at him “he said do you want Italian, thousand island or vinaigrette?”  How could anyone in a right state of mind  confuse a Ford Granada with a Mercedes 450SE?

PHPs are not the Mercedes of EAPs but the jalopy with no breaks and broken steering of EAPs with Stuntman Mike from Quentin Tarantino’s Death Proof at the wheel.

Like smoke alarms and air bags,  EAPs are not in the forefront most peoples minds until they need them and like smoke alarms and air bags they usually work just fine for most people. Discerning and scrutinizing one’s EAP is not a common thing.  If your EAP was replaced by the PHP model you probably wouldn’t even know it. That is why this needs to be on your radar. Caveat emptor.  Forewarned is forearmed.

Source: Physician Health Programs (PHPs): The Ford Granada of Employee Assistance Programs (EAPs) and Stuntman Mike is at the wheel.

 

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Make Medicine Great Again!   Please Donate and Help Drain this Swamp!

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Physician Health Programs (PHPs): The Ford Granada of Employee Assistance Programs (EAPs) and Stuntman Mike is at the wheel.

mllangan1 4 Comments

PHPs are essentially Employee Assistance Programs (EAPs)  for doctors, nurses and other health care professionals.    The vast majority of people know little or nothing about Physician Health Programs (PHPs) but they should. The grand plan is expansion to other occupations under what they are calling the “New Paradigm.”  Deemed “professional health programs”they don’t even have to change the acronym.

Physician Health Programs (PHPs) are being called  the “gold-standard” for EAPs.   Claims of unparalleled success are being used to promote PHPs to other populations as a “replicable model of recovery.”  Drs. Robert Dupont and Gregory Skipper are promoting PHPs as “A New Paradigm for Long-Term Recovery”  claiming an 80% success rate in doctors.   An article entitled “What Might Have Saved Philip Seymour Hoffman” claims the actor may still be alive today if he had access to one of these programs  and comments they “ought to be considered models for our citizenry” and the “best evidence-based addiction treatment system we have going.”

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Mercedes 450 SE

Such is not the case.  What is being touted as “gold standard” and “cream of the crop” is on closer inspection iron pyrite and curdled spit up.  I am reminded of the commercials comparing a Granada to a Mercedes when I was a kid.  I remember these commercials  well as I couldn’t wrap my head around them.  In one, as I remember it, two couples arrive at their parked adjacent cars with keys in hand. The Mercedes tries to open the door of the Granada and vice versa.  How is this scenario even possible I remember thinking. Was it a bar they just came out of  and they are drunk?     Is this related to “this is your brain on drugs?  Do they have some sort of memory problem like that old guy in the miracle ear commercial who looks confused when the waiter asks his preference for salad dressing and his companion yells “he said do you want Italian, thousand island or vinaigrette?”  How could anyone in a right state of mind  confuse a Ford Granada with a Mercedes 450SE?

 

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Granada

 

PHPs are not the Mercedes of EAPs but the jalopy with no breaks and broken steering of EAPs with Stuntman Mike from Quentin Tarantino’s Death Proof at the wheel.

Like smoke alarms and air bags,  EAPs are not in the forefront most peoples minds until they need them and like smoke alarms and air bags they usually work just fine for most people. Discerning and scrutinizing one’s EAP is not a common thing.  If your EAP was replaced by the PHP model you probably wouldn’t even know it. That is why this needs to be on your radar. Caveat emptor.  Forewarned is forearmed.

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Stuntman Mike

The dark underbelly of these programs are just beginning to be exposed in the general medical community.  See Pauline Anderson’s  Physician Health Programs- More Harm Than Good?  published on Medscape and  BMJ Editor Jeanne Lenzer’s “Physician health programs under fire” for an overview.  Look in the comments section for the horror stories.

Physician Health Programs  (PHPs) claimed “gold standard” for addiction treatment. “80% success rate” being used to promote “new paradigm” to other populations. 

1. National Physician Health Program Blueprint Study Publications List

2.  Setting the Standard for Recovery: Physicians’ Health Programs

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The claim of an 80% success rate is a 2009 study published in the Journal of Substance Abuse Treatment entitled  Setting the Standard for Recovery: Physicians’ Health Programs and authored by Robert Dupont,  A. Thomas McLellan,  William White, Lisa Merlo and Mark Gold.  This  study is the cornerstone of the “PHP-blueprint.” It is the very  foundation on which everything else is based, a Magnum opus used to lay claim to supremacy that has been endlessly repeated and rehashed in a plethora of self-promotion and treatment community blandishment.

To date there has been no academic analysis of the “PHP-Blueprint.”    There has been no Cochrane type analysis or critical review.    There has been no opposition to its findings or conclusions which are paraded as fact and truth without challenge or question and there is a general lack of concern from those both within and outside the medical profession.

One major problem with this claim of an 80% success rate is that close to 80% of those coercively enrolled in these programs do not fit the diagnostic criteria for substance use disorder or any other psychiatric diagnosis. In reality these programs cause far more harm and if we really looked at the impact of these programs and compared them to traditional EAPs the success rate would be abysmally low.

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The Expansion of Physician Health Programs (PHPs) to Other Populations

1.  Although these programs claim to help doctors they may actually be harming many and contributing to suicide.

2.  The plan is to greatly expand these programs to other populations and you could be next.

In 2012 Robert Dupont delivered the keynote speech at the Drug and Alcohol Testing Industry Association annual conference and described a “new paradigm” for addiction and substance abuse treatment and proposed expansion of this paradigm to other populations including workplace, healthcare, and schools.

It is therefore critical that the “PHP-blueprint” be examined using critical reasoning and evidence base.   All of this needs to be assessed in terms of legitimacy and intent.

Lack of Evidence-Base and Conflicts of Interest

A  cursory  analysis of the study on which this success rate is based reveals very little evidence base.

The claim of 80% success rate in physicians is based on Setting the Standard for Recovery: Physicians’ Health Programs is unfounded.  The study is a poorly designed using a single data set (a sample of 904 physician patients consecutively admitted to 16 state PHP’s).

It  is non-randomized and non-blinded rendering the evidence for effectiveness of the PHP treatment model over any other treatment model (including no treatment) poor from a scientific perspective.  The study contains multiple flaws in both reasoning (type I and type II errors) and statistical analysis that render its conclusions invalid.

In addition the impact of undeclared but substantial financial conflicts-of-interest (including funding by drug testing and addiction treatment industries) and personal ideological biases (including personal 12-step recovery from addictions) in the authors of this study also needs to be considered.

Moreover the misdiagnosis and over-diagnosis of addiction in physicians in this paradigm  incentivized by lucrative self-referral dollars for expensive 90-day treatment programs is a significant factor.

False Endpoints and High Mortality Rate

The mean age of the 904 physicians was 44.1 years. They report that 24 of 102 physicians were transferred and lost to follow “left care with no apparent referral.”

What happened to them? These are physicians with multiple identifiers (state license, DEA, UPIN, etc) not transient drifters.

More importantly what happened to those 48 who were reported to the Medical Board for noncompliance and had their licenses revoked–that would be the critical time when this population would be at most risk for completing a suicide. That would be when hope was lost and the coerced physician, knowing that the fight was over, would take that step.

The outcomes they used were the last reported status of the PHP participant enrolled in the program.   Measuring success of program completion in doctors compared to the general population is meaningless as the short-term outcomes are quite different in terms of the external consequences imposed.   The consequence of not completing a PHP is the invariably career ending.    So what happened to the 24 of who “left care with no apparent referral,” the 85 who “voluntarily stopped or retired,” and the 48 who “involuntarily stopped or license revoked.”

Whether you leave a PHP voluntarily, involuntarily, or with no apparent referral it is the end game and your career is over.  Comparing this to other populations where the consequences of failing to complete the program are not so final is inappropriate.     Claiming superiority over programs with a 40% success rate is unfounded because for most of those people the consequences are not so final and may mean nothing more than an increase in testing frequency.

The big question is what happened to the 157 physicians who left or stopped?  How many of them killed themselves. With an average age of 44 there were  6 reported suicides 22 deaths, and another 157 no longer doctors.  I would venture to say the number of suicides is a lot higher than they claim.  But using the last recorded PHP status as the final outcome obfuscates this.

Due to the severity of the consequences a 20% failure rate is quite concerning. This is of particular concern because many doctors (if not most) monitored by PHPs are not addicts.

As noted above, PHPs are essentially Employee Assistance Programs (EAPs)  for doctors. Most EAPs, however, were developed in the presence of trade unions and other organizations working on behalf of the best interests of the employee. This collaborative effort led to EAPs that were more or less “organizationally just” with procedural fairness and transparency.

Imposed 12-step ideology and use of non-FDA Approved Drug and Alcohol Testing

No such organizations exist for doctors.   Due to the absence of oversight and accountability  PHPs have been able to use non-FDA approved laboratory developed tests of unknown validity on doctors without any opposition.

The distinction between professional and private life as a fundamental value of our society  and the importance of this boundary was also upheld by these groups.

In the PHP paradigm no procedural fairness or transparency exists and the boundary between professional and private life has eroded.

PHPs impose 12-step ideology on all doctors referred to these programs.   State Medical Boards  enforce this in violation of the Establishment Clause of the 1st Amendment yet there is little recourse for doctors as they are threatened with non-compliance and loss of licensure.

Selling the PHP Paradigm

The use of 12-step  is most likely not ideologically driven but profit driven.

Abstinence based 12-step programs justify the use of frequent drug and alcohol testing with ongoing lifelong assessment and treatment.    As with drug-courts,  PHPs provide a lucrative model to the drug and alcohol testing, assessment and treatment industry.

The plan to expand this to other populations is outlined in the ASAM White Paper.

Screen Shot 2017-03-08 at 7.29.21 PMThis concerns all of us.  The first step needs to be a critical appraisal of  Setting the Standard for Recovery: Physicians’ Health Programs,  the foundation of their claims of an 80% success rate and a conflict-of-interest analysis of its authors.  The legitimacy of the study and its claims needs to be questioned.

It does not take a Cochrane review to see that the emperor has no clothes.  This is not difficult. It is straightforward and simple.

As an illegitimate and irrational authority it is necessary that this opinion remain unchallenged. We need to challenge it.

Historical, political, economic and social analysis reveals that the “PHP-blueprint” is a false-construct built on circumnavigation and obfuscation.  An evidence-based scrutiny of the literature would reveal it to be invalid and of little probative value.

But if  nobody speaks up it is inevitable that they will expand the “PHP blueprint”  to other employee assistance programs and schools.

This is not just about doctors.  You too are at risk for coercion, control, conformity and forced adherence to a  lifetime of abstinence and 12-step indoctrination and if you do not speak up now it won’t be a risk but a certainty.

PHYSICIAN OR PROFESSIONAL HEALTH PROGRAM SURVEY

Professional Health Program (PHP) Survey

Please click on the link below and complete the following survey if you have been monitored or are being monitored by a PHP.

Professional Health Program (PHP) Survey

This is a confidential survey. If you have concerns about anonymity please create an alternative alias email address (this video shows you how to create an alias G-mail address), then use the alias email address as your “name” for future correlation.

scotty

Competent, Ethical and Fair Legal Representation for Doctors —A Possible New Niche area for Lawyers.

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The attorney pool is currently over-served by those serving two clients and most of those outside simply do not know enough about the “physician health”  legal issues related to doctors.  When they appear before the board it is as if they are a deer in the headlights.  It is a new terrain where all due process and familiar protocol have been removed.  Of course this was all facilitated by changes in administrative and medical practice acts orchestrated by the physician health movement “in the interests of protecting the public.  This must be recognized and addressed.Skilled negotiators and lawyers with administrative law experience would do well to consider representation for doctors before medical boards regarding “physician health” matters.It is not that esoteric, complicated or difficult.   As with the rest of the population, most have just not critically analyzed the issues behind the curtain.

Source: Competent, Ethical and Fair Legal Representation for Doctors —A Possible New Niche area for Lawyers.

American Medical Association (AMA) Seeks to Test Older Physicians: The Aging Physician–Goodbye Dr. Welby!

mllangan1 1 Comment

America, this is serious. The brightest minds in this country are running away from careers in health care. Many of our best doctors are being forced out of business. We must start an open dialogue with doctors ― the individuals who are the most influential in advancing our health care system. The success of our health care system absolutely depends on the caliber of talent we attract to become and remain our nation’s physicians. Short-changing the individuals who are sacrificing everything to save lives will lead to the biggest threat to our nation’s health care system.

Want to make health care great again? We must all reach out to doctors and do everything in our power to demonstrate that we value our country’s physicians before it’s too late.

The AMA is seeking to test older physicians.  This is no doubt due to the influence and lobbying of the “impaired physicians movement” and the “addiction medicine”…

Source: American Medical Association (AMA) Seeks to Test Older Physicians: The Aging Physician–Goodbye Dr. Welby!

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Please donate here!

https://www.gofundme.com/PHPReform

American Medical Association (AMA) Seeks to Test Older Physicians: The Aging Physician–Goodbye Dr. Welby!

mllangan1 Leave a comment

America, this is serious. The brightest minds in this country are running away from careers in health care. Many of our best doctors are being forced out of business. We must start an open dialogue with doctors ― the individuals who are the most influential in advancing our health care system. The success of our health care system absolutely depends on the caliber of talent we attract to become and remain our nation’s physicians. Short-changing the individuals who are sacrificing everything to save lives will lead to the biggest threat to our nation’s health care system.

cropped-screen-shot-2016-10-10-at-9-32-40-pm11

Please donate here!

https://www.gofundme.com/PHPReform

Want to make health care great again? We must all reach out to doctors and do everything in our power to demonstrate that we value our country’s physicians before it’s too late.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

mllangan1's avatarDisrupted Physician

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The AMA is seeking to test older physicians. This is no doubt due to the influence and lobbying of the “impaired physicians movement”and the “addiction medicine” specialists who brought us the “impaired” and “disruptive” physician constructs. As do all groups of this ilk, they want to expand. It is predictable and that is what we are seeing here.

Originally posted on Disrupted Physician:

The Aging Physician—Goodbye Dr.Welby!

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As a specialist in geriatric medicine I have experience in taking care of a number of doctors who were referred to me for suspected memory problems. Still operating and teaching residents in his 70s, myfirstwas a well-respected surgeon, a pioneer or Maverick who had made advances in his particular subspecialty. Known for hisdetailed knowledge of the history of medicine and sharp clinical acumen, he had not seemed himself for a while. His colleagues notedhe appeared slower,fatigued and forgetful at times (not…

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The Alienation Of America’s Best Doctors | Melinda Hakim MD

mllangan1 Leave a comment

America, this is serious. The brightest minds in this country are running away from careers in health care. Many of our best doctors are being forced out of business. We must start an open dialogue with doctors ― the individuals who are the most influential in advancing our health care system. The success of our health care system absolutely depends on the caliber of talent we attract to become and remain our nation’s physicians. Short-changing the individuals who are sacrificing everything to save lives will lead to the biggest threat to our nation’s health care system.

Want to make health care great again? We must all reach out to doctors and do everything in our power to demonstrate that we value our country’s physicians before it’s too late.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

The Alienation Of America’s Best Doctors | The Huffington Post  Doctors are hurting and they don’t have the time to reach out. Melinda Hakim MD—CEO of DoctorCPR.com—a medical career site that…

Source: The Alienation Of America’s Best Doctors | Melinda Hakim MD

cropped-screen-shot-2016-10-10-at-9-32-40-pm11

Please donate here!

https://www.gofundme.com/PHPReform