In Mechanics and Mentality the Physician Health Program “Blueprint” is Essentially Straight, Inc. for Doctors.

The Physician Health Program “Blueprint” is Essentially Straight, Inc. in both Mechanics and Mentality.

In 2012 former Nixon Drug Czar Robert Dupont, MD delivered the keynote speech at the Drug and Alcohol Testing Industry Association (DATIA) annual conference and described a “new paradigm” for addiction and substance abuse treatment. He advocated zero tolerance for alcohol and drug use enforced by monitoring with frequent random drug and alcohol tests. Detection of any substances is met with “swift and certain consequences.”

And then he proposed expansion of this paradigm to other populations including workplace, healthcare, and schools.

Letters from those Abused and Afraid

Screen Shot 2015-03-27 at 1.24.08 AMLetters From Those Abused and Afraid

images-2I get many e-mails, letters and phone calls from doctors, nurses and others who have been abused by  “professional health programs” (PHPs).

Most are anonymous.  Afraid of being identified and punished by the PHP, very few leave comments on my blog revealing their names or potentially identifiable information.

This is understandable.   By simply reporting “noncompliance” to the medical boards a state PHP can end their careers. As it was with the Inquisition this system relies above all else on silence and secrecy.   Speaking out can result in “swift and certain consequences.”

They are afraid.  Some are undoubtedly suffering from PTSD.  Most have developed a “learned-helplessness”   Many have reported abuse and even crimes to their medical societies, medical boards, law enforcement, the media and others only to have the door slammed in their faces.-myself included..   They have no advocacy or support and feel no one cares.   Their locus of control, identify and self-worth have been suddenly ripped from them without recourse. There is no lifeline.

PHPs are ostensibly  Employee Assistance Programs (EAPs) for doctors in both mechanics and mentality.   EAPs assist employees with substance abuse, personal problems and other issues.    They do not diagnose or treat “patients” but refer to outside professionals who do.  The critical difference between EAPs and PHPs is PHPs have mandated all assessment and treatment be done by their own.  These “PHP-approved” facilities are economically and ideologically intertwined with the PHP.  The conflicts of interest are serious and many.

PHPs also use non-FDA approved junk-science drug and alcohol testing they introduced.  The procedural safeguards most EAPs use to  protect the donor ( certified labs, FDA-approved validated tests, split-specimen, strict chain-of-custody, MRO review) have been reviewed.  Unvalidated “personality” assessments they also introduces are being used in “disruptive” physician evaluations guaranteed to find “character defects” to justify monitoring contracts. They implement polygraphs despite the AMAs previous conclusion they are scientifically unsupportable.

It is an institutionally unjust system of coercion, control and abuse that is unregulated, opaque and protected.  There is no answerability and they are accountable to no one.

But regulatory agencies have readily adopted policies not only unsupported by science and evidence-based research but outside the normative principles and practice of medicine.

Granting PHPs authority to limit assessments and treatment to their own facilities  offends the fundamental rights of the individual.

Informed consent (or refusal)  constitutes a basic rule of the lawfulness of medical practice according to national and state medical practice acts governing the profession.  It is a basic principle  of all published principles of medical ethics.

Involuntary treatment is motivated by either potential harm to others (for the good of society) or by need for treatment and/or potential self harm.

Involuntary treatment should be a confined to those gravely disabled by psychiatric disorders or substance abuse.  It necessitates reflection under the ethical principles of autonomy and beneficence.

A single DUI,  transient psychological issue such as grief or anxiety, and even sham peer-review can easily land a doctor into forced assessment and involuntary treatment at a “PHP-approved” facility.

Involuntary assessment and treatment involves legal, clinical ethical, and deontological consideration in its demarcation.

The economic and ideological aspects need to be considered here.

How is it this paradoxical assessment and treatment paradigm legitimized and justified within a profession that emphasizes evidenced based decision making and beneficence and autonomy as two of the basic principles of medical ethics?

  To sell the “PHP Blueprint” to other EAPs it is necessary to prevent doctors from speaking the truth.  Very few want their names, states or other unique identifiers published for fear of  consequences and retaliation.

The letters below have only been posted after being approved by their  authors-MLL


Dear Michael Langan

I love your writings analysing the power relations and psychopathy that is running rampant in every sphere of life, including sadly, medicine…

Your logo of the the two serpents represents the fight between good and evil, to me…

It was encouraging that you ‘liked’ the post from the blog as writing in relative isolation is very hard.

So thanks a bunch !

Take good care of yourself – truth tellers are precious and rarer than gold dust !


Comment: I am Board Certified in Internal medicine. I have endured years of emotional, psychological and spiritual abuse at the hands of the Washington Physician’s Health Program. I have suffered through a long list of injustices without recourse. They include, but are not limited to discrimination, abuse of power, breach of contract and repeated and WILLFUL medical negligence.

Because the actions of the WPHP have been SO egregious, I assumed what was happening to me must be extraordinarily rare.

I have nothing to hide. And I have shared my story with any and all who would listen. To date, my voice, my rights and now my life have been dismissed as unimportant. MY LIFE!! It’s apparently better that I die than my tormentors be questioned and compelled to defend their indefensible and evil behavior.

I am meeting with one last attorney tomorrow. I fully expect him to ignore the basic, indisputable and well documented facts of my case. Namely, there is massive and systematic malfeasance being committed by a tax payer funded agency in the State of Washington who act with omnipotence and without oversight. I have no reason to believe he will respond any differently than the others with whom I have met. HE WON’T CARE! HE WILL NOT BE MOVED. He will make statements that suggest I DESERVE this treatment. And that my life, as well as my imminent death, is unworthy of his time or efforts.

Once my assumptions about this last meeting are officially confirmed, I am committed to the only course of action available to me. The only thing which will put an end to this nightmare.

Today I stumbled upon your website. And today, for the first time, I have learned that my case is not rare. I suspect the other physician victims in this matter have occasionally allowed themselves to dream wistfully of justice. Justice which they have seen thwarted at every turn. Perhaps they, like me, have dreamily imagined the relief and joy and LIFE they would experience if the truth were simply presented and the perpetrators held accountable. I have imagined standing up in court and triumphantly affecting justice for myself as well as all of the other current and future victims. I deliver a powerful defense of justice. My ‘dream speech’. I have imagined that I might still live. And then I wake up.

And so today, imagine my shock, when I found my ‘dream speech’ here. My speech. Reasonable. Honest. Consistent. And based firmly in truth, justice and defense of the powerless against the (arbitrarily) powerful. My speech, it seemed, but authored by another.

Thank you, Dr. Langan.  You have given a voice to my struggles. Please never stop speaking for me, and people like me, many of whom, I fear, will not survive to see justice.

Despite my intention to die, I actually WANT TO LIVE! And I will live and fight on if I ever believe that there is even a small chance of justice for me and the other innocent victims of PHP’s and the ‘treatment’ centers with whom they contract (Talbott in my case. Purely evil and loathsome human beings, for the record).

So, because I do WANT to live…PLEASE HELP ME, SIR!

Can you refer me to attorneys, individuals or groups who might advocate for me and the other victims? Do you have any specific words of hope or encouragement?

Please note my name. Please add me to the list of innocent victims of these power hungry, narcissistic BULLIES.

I don’t expect to live through this. And in a way, the PHP, Talbott and the addiction ‘experts’ with whom I have been tragically acquainted are correct…My life is worth very little. But this issue is so much larger than I. I can die with some serenity if I believe there will be meaningful justice for others like me. And that those responsible will be held to account.

Thank you Dr. Langan. Thanks to all of those involved in the creation and maintenance of this website. Although your shining beacon is barely perceivable through the darkness of injustice which surrounds and seeks to extinguish it…it is the only glimmer of hope I have found during my slow death by PHP.


Dr. Langan:

Thank you for your articles and research regarding PHPs and “impaired” physicians.  I have become involved in this issue after someone close to me struggled with depression during residency.  Sadly, they lacked the resources, support and coping skills and ended up committing a crime with a misdemeanor charge.  Despite their treatment and rehabilitation, they were dismissed from residency.  Not sure if they will ever get to practice clinical medicine.  It is very sad. they are very smart, great doctor and very empathetic towards patients. 

After their situation, I started looking on blogs and found that many residents had shared similar instances.  Many reported struggling with depression and the stresses of residency put them over the edge– like the perfect storm of stress, fatigue, and loneliness that could exploit anyone’s weaknesses.   It seems like during residency, we are emotionally as well as legally vulnerable.  Many of these residents have never been able to resume training at their institutions despite their demonstration of clinical competence and emotional maturation.  According to that medscape article, that is a huge loss to society, socially and financially.

Sadly, there still so much stigma surrounding mental health, and I think it may be worse in our profession. 

I am very concerned regarding the future of our profession.  We are becoming robots in a health care factory.  Our own personal lives are being compromised as well as quality patient care. 

I appreciate all you are doing to shed light on this very important issue.

Thank you for your time and consideration


Dear Dr. Langan:

Thank you for your insight, eloquence, and concern for all of us. These Boards and other administrative bodies claim that they are “protecting the public,” but healthcare providers are the public too. And they’re killing us. 

The problem is not unique to physicians. I am a nurse practitioner, and we share some of the same burdens. Although the numbers are growing, there are so few NPs nobody has studied suicidality among our profession. There is still the same fear of malpractice, professional bullying (nurses “eat their young,”) and the taboo of asking for help. 

A trivial, third-party complaint to the State Board didn’t cost me my license, but it did cost me my job and my mental health. The pain I endured: the relentless questions about my personal life… it was jarringly intrusive. All of this was conducted by a bullying investigator: a man who had no medical training.  The Board took it upon itself to ask detailed questions about my personal life and relationships, as if they would somehow psychoanalyze me. The investigator started his conversation by advising me that the Board does not honor the Fifth Amendment.

I’ve heard others—physicians—tell me of similarly murky complaints that dragged on. A cardiologist I know was instantly fired and rendered unemployable for year under similar circumstances. He struggled to feed his kids. Nobody died. Nobody got hurt. He didn’t have a substance abuse problem or divert drugs. He practiced within his scope. The case was eventually dismissed, and he’s back in business. But he has never totally recovered.

A simple, free email to the Board can cost a physician or nurse practitioner his or her livelihood in a split second.

All of this detracts from the dangers posed by inept or otherwise dangerous clinicians. We’ve all met them, seen them in practice, seen their charts, or heard stories. I think everyone I know can name a clinician who showed up drunk to work, billed fraudulently, or who was so incompetent that he or she should not be practicing.

It has been ten months. The Board hasn’t had any further questions, but they never dismissed the case, claiming that they have a massive backlog. My health and livelihood are inconsequential to them. I’m still being prescribed scheduled benzos and z-drugs just so I can make it day to day.

I came very close to suicide more than once, but I evaded psychiatric admission because then I’d lose my license without a doubt. Again, “protecting the public?” I deliberately avoided emergent medical care because of the Board.

I chose another path: I left the profession, and I have lost my sense of self. Twelve years of school, $350,000 in tuition, and four degrees were rendered worthless by a single third-party email. Above all, my pride in my  clinical acumen, passion for learning, anal retentive charts, sensitivity, and professionalism also went down the drain.

The Board’s notion of “protecting the public” also means kicking good providers out of the business. Our emotional lives are destroyed, our finances wrecked, and we live in fear. There is no “speedy and public trial,” no “jury of our peers.” Although Conrad Murray MD fled to Trinidad, where he is working as a cardiologist (hopefully not prescribing propofol for insomnia), an open complaint renders me ineligible for licensure in all fifty states, all Canadian provinces, the Netherlands, and Australia. 

Assuming that the Board dismisses the case, I don’t know if I could ever return to practice. It’s too hard to live in fear of a backstabbing patient or family member, and the ineptitude and glacial pace of a medical board. I want to clobber anyone who says, “and this too shall pass.” It’s not quite like that.

I am trying to re-establish myself in some second career, but that is hard to face. I cringe every time I open my email and mailbox in fear of a letter from the Board. I know I did nothing wrong, but that’s not how the system works.  

I still fight the urge to take my own life.


Great website. Presents an alternate view I have never seen in action and I have had to report a number of MDs to our state’s PHP. Thanks for the insights.


I am an RN in a monitored program in PA which includes forced AA attendance. I have 22 years as an RN with 10 years of military service which includes a one year deployment to Iraq. I am willing to speak out. Too many are afraid of losing their licenses to practice.


A review of 14 studies found that the relative risk of suicide in physicians compared with the general population is between 1.1 and 3.4 for men and 2.5 to 5.7 for women,[tt_news]=175910, furthermore, studies have indicated higher rates of suicide among psychiatrists and anesthesiologists.

There are a variety of theories on why physicians commit suicide.  Depression is the most common explanation given.  Certainly, there’s a lot of stress involved in our profession.  We deal with death and dying.  We’re held to impossible standards.  Managed/mangled care and the restrictions of government plans/laws/policies on the  one hand restrict what we can do for our patients.  On the other hand however, are the viscous  packs of attorneys waiting to cull the herd.  Let’s not forget the State Medical Boards, out there striving to “protect the patients”, generally done in cahoots with the “Physicians Health Programs”.  These two entities form a deadly collusion that is inescapable—and of course, linked to the packs of predators circling to ensure that we will suffer the consequences for actions that we may have little if any control over.

I am one of the unfortunates.

I haven’t committed suicide (obviously), nor made an attempt at it.  Certainly I’ve had thoughts about it—who among us hasn’t?  My strong religious convictions prevent any serious consideration of this “permanent solution to a temporary problem”.

I am also one of the fortunates.

This is largely due to the foundation of faith that I have.   Years ago I made what may have been a mistake.  I prayed for patience & humility.  We tend to be an impatient and yes, at times an arrogant lot.  I recognized those character flaws in myself and asked Him for help.

 I should have asked for the grace to overcome these shortcomings.  Grace is a gift, a “freebie” if you will.

Patience is gained through trials.  Humility generally through humiliation.

I have learned that where there is pain in life, there is often a lesson—look for it, learn from it.  Running from it merely guarantees that it’ll be presented again, and again and again until it’s learned, often with a few extra presentations after the initial effort to dodge the trial.

The study of theology has lead to the interesting concept that suicide is actually a sin of pride.  Yes, depression is involved, but the pride plays it’s role with the thought that;  “I don’t deserve this trial so I’m choosing to take myself out of the game”.

My personal belief is that only God has the power to give and take life.  The reader is certainly entitled to their own belief.  Mine has evolved by study and prayer over decades.

There is a growing movement afoot across all 50 states for attorneys employed by State Medical Boards to direct their investigators to report possible transgressions directly to the attorneys instead of to the physician board members  The attorneys have thus usurped the role of a professional board; to ensure that we’re held accountable by our peers.  These attorneys then draft their own perspective of what happened, often putting “spin” or “slant” to the report to prejudice the board members to carry out the actions that these attorneys deem to be appropriate.  The Board Members have unwittingly abdicated their responsibilities.  This leaves physicians at the mercy of Board attorneys.  These attorneys were initially tasked with ensuring that the Board members didn’t violate any laws in their disciplinary actions against wayward licensees.  Board members are busy physicians in their own rights.  They have their practices and with the attendant problems associated with them, as do the rest of us.  Typically, they go to their state capital for a couple of days a month to do their “official duties”.  The attorneys present the information for the “rubber stamp” of the Board’s approval.  

Worse still are the “consent orders” drafted by the State Board attorneys.  A key part of such an order is the “findings of fact” describing the (alleged) transgressions.  The hapless licensee is often coerced to signing these flagrantly fictitious documents with threats that the attorney-derived discipline will be much lighter than what the Board will mete out.  It’s actually not uncommon for “defense” attorneys to collude with the Board attorneys, urging the clients that they are supposed to be defending into signing the consent order.  Signing the order will have many grave consequences  As a hapless victim, I had no concept of such unethical yet commonplace activities.  

There is documentation of an extremely arbitrary nature of punishments on ; A physician and his mid-level go out to a dinner presentation by the local pharmaceutical representative.  Driving home afterwards, the physician crashes the vehicle.  Both are intoxicated.  The mid-level spends 2 weeks recuperating in the hospital.  The physician/driver gets a “Public Letter of Concern”.

Another physician is out of state on vacation, gets a DUI, truthfully reports it during his annual license renewal and is taken out of practice for four years.  Some practitioners NEVER return to practice.  Substance abuse issues are treated extremely harshly.

Killed somebody with negligence?  Oh, no problem, that will only get you a “Public Letter of Concern” in North Carolina.

You were seduced by a patient?  Big problem!  There’s to much of a “power imbalance” since you’re a medical practitioner, mid-level or otherwise.  You may possibly NEVER practice medicine again.  There’s documentation of a psychiatrist who married a patient, the State Board found out about it and took her license away; she was to much of a risk for sexually assaulting other patients.  Ultimately she was allowed to have her license back on the condition that she never practice psychiatry again!

I was also unaware that state boards are incentivized to discipline as many physicians as possible, as harshly as possible, for as long as possible.

I was indeed one of the innocents.

Knowledge is indisputably power.  The site quoted above provides a wealth of information of the workings of the “system” in North Carolina.  The “Great North State” is hardly alone in their approach.

The Physician Health Programs (PHP’s) are another area of concern.  It’s a shame that the stated purpose of the PHP’s is to help return impaired practitioners to active practice.  These groups throw the very physicians who need help the most the furthest under the bus in full collusion with the Board.  They’re typically staffed by psychiatrists who are members of “addiction societies” that aren’t much more than diploma mills.  The PHP’s often claim to be performing “peer review” while disregarding the legal requirements for peer review.  The PHP’s/Medical Societies/State Boards are parasitic symbionts that prey upon those of us who have been used up and burnt out by the non-system of healthcare that exists.

 Does this sound like a pattern is developing? “Disregarding the legal requirements…”

In North Carolina, the complaints were of such a volume that the NCPHP was audited and found to have numerous deficiencies.  Next, all 57 of their licensing and professional boards were audited.  All of them showed problems—the most common that they did not report to anybody for supervision!  These are routine violations of the General Statutes of the state.

Every state has a state auditor whose function is to ensure that state agencies fulfill their assigned duties efficiently and honestly.  Most State Medical Boards and PHP’s have NEVER been audited.  Anybody can report their concerns to their state auditor.

Attorneys are supposed to uphold the law; isn’t this ironic?

There is ample evidence of collusion among the players; Defense attorneys who should be defending their clients against their Board (sometimes the Boards actually recommend individual attorneys that they “work well together” with to wayward licensees).  Board Attorneys are clearly involved as are the PHP’s.

State Medical Societies are also generally in the same bed with the Boards & PHP’s.  Governor’s generally rely on the Societies to recommend prospective Board members.  It’s not uncommon for the first question at an “investigative hearing” to request information on whether the licensee is a member of the local state society.  What would the purpose of such a question be?  Simple.  It’s well-documented that membership has a “protective” function.  It’s not absolute, but exists nonetheless.

In one case, the Board remanded a full mental health evaluation.   The result was that the licensee had a mild autism spectrum syndrome (something a good many of us have), an autism spectrum disorder that is characterized by difficulties with social skills and non-verbal communication—but with benefits such as intense interest and expertise in certain areas (like medicine!).  

 The function of a Board is to maintain scope of practice.  Family physicians don’t do craniotomies.  Yet, despite the absence of a single mental health professional on the Board, the recommendations of 3 independent professional organizations, all recommending immediate return to practice for the licensee were ignored.

The Board posted the practitioners protected health information, including mental health information on their website.  The most basic rights to privacy were clearly violated.  The licensee never gave permission for such an intrusion!

The ADA covered disability was dealt with by an indefinite suspension—all with the full collusion of the NCPHP.  The ADA requires “reasonable accommodations”.  Indefinite suspension is punitive—certainly not a reasonable accommodation!  Again, it cannot be over-emphasized that Board attorneys have a strong desire to punish whenever, wherever, for as long as possible.

The licensee signed the contract with the NCPHP.  The licensee was held to the terms, but the advocacy mandated by the contract was never delivered; “the Board attorney said he wasn’t interested in anything I have to say in your favor, his mind is made up, there’s nothing I can do to help…” was the limit of advocacy received.


Collusion is a more accurate description.

The theme song from the hit movie and TV show M*A*S*H* is “Suicide is Painless” by Johnny Mandell.  This epidemic is more of an endemic among our profession.  We can’t keep “looking the other way”.  

 There are two major forms of suicide.

Active suicide would best be described as a former colleague who went into the recovery room one Sunday afternoon when it was deserted, took a scalpel and did a full-length carotidotomy on himself.  He made a posthumous statement.  Another ran out in front of a box truck on the interstate.  It took his head off.

Passive suicide is best shown by 5 of the NC Medical Board victims.  This Board tends to pursue physicians from their mid-40’s to mid-60’s, the top income-producing time of our careers.  They usually have assets to poach.  Usually by that age, we’re taking some form of medications for our own health issues.  A diabetic who purposely forgoes his insulin…   Suicide?  It won’t be reported as such.  What do YOU think?

We will never eliminate all of our stressors.  There will always be the “less fit members of the herd”, which is sad.  This is more appropriate for other animals at other positions on the evolutionary tree.  Why should the most noble of professions be relegated to those branches of that tree?

We need to reach out to each other.  We need to reach out to our state auditors.  Another resource that surprised me is a different agency.  There is an agency whose primary function is “to deal with corruption in public officials both appointed and elected”.

Does this sound like an appropriate agency to engage against our Boards & PHP’s?  It’s the Federal Bureau of Investigation, commonly known as the FBI!

All that it takes for evil to triumph is for good men to do nothing.  When we organize we change from individual targets to a formidable force.  State Medical Societies, unfortunately, are not the answer.  Typically state governor’s turn to them for nominations to staff the boards.  In North Carolina, lawsuits have been settled out of court that involve the alliance between the Board, Medical Society & PHP.

 Perhaps the best solution would be to revamp the system.  Maybe it’s time for a Federal Medical Board.  At the very least, State Boards should be restructured so that investigators do not report to the attorneys, but directly to the Board Members.  It will mean more work for the Boards, but they’ll at least resume functioning in the manner originally intended.

–Wounded Healer


This whole lack of accountability and oversight within the PHP’s makes me sick. I was sent to PHP for evaluation and suspicion of drug abuse by my employer hospital. I was only suffering from side effects of Paxil causing a SSRI Discontinuation Syndrome. The diagnosis was completely missed because the PHP sent me to a rehab center in Los Angeles. I am sure you know this one very well.  

I was coming there for IDE, Intensive Diagnostic Evaluation not recovery and rehab. After arrival I was forced to enter their rehab program completely against my will. I was on my way out the door and about to call a cab when the program director threatened me with absolute coercion.

He said if I left he would assume I had drugs in my possession and that this would negatively affect my evaluation and would be reported to the PHP and state medical board as a form of noncompliance, and that my career and license would be in jeopardy. How is that possible when I was not sent there by any state board or regulatory agency as I was there voluntarily.

The only incentive to force me into admission rather than having my workup done as an outpatient was purely financial. Employer was paying the bill, so it was in their best financial interest to force me into admission at $1800/day and $1400/urine sample and charge for all the transportation to and from all the outsourced facilities for my “evaluation”.

The facility was run by the most inept, unethical group of charlatans I have ever encountered in any field of service not just healthcare. I could not understand how they were qualified to provide medical evaluations when they are not legally allowed to provide any form of treatment for anything. These people were nothing more than middle-management screw ups. They have to outsource everything. They did not even have a crash cart on site.  One of their clients had a tonic-clonic seizure during group therapy as a result of a brilliant PA who decided to withhold the clients chronic benzodiazepine therapy because of her personal beliefs that benzos are horrible medications for anyone.  Where is the physician co-signature and oversight on this brilliant therapeutic decision? No one except the doctors in rehab even knew how to react. It was a total fiasco and state of panic for all the rehab employees. Luckily the client didn’t dislocate something, die or worse, suffer anoxic encephalopathy. I was in fear for my life after witnessing this my first day.

What’s even more concerning is that this rehab center is supposedly one of the best and has exclusive referral from every state PHP.

They had me stay with recidivist junkies and participate in 12 step when I had no substance abuse issues at all, in fact my social life was so boring, that my hair test wasn’t even positive for alcohol. I had to recite scriptures in group therapy, admit that I was helpless, and powerless, and a weakling. Admit that I had to submit to a higher power since I was an addict. I had to submit to random urine drug tests which costs $1400 each 3-5 times per week.

Then when I cannot produce a sample on the spot (paruresis) I am threatened to be reported to the State Medical Board for noncompliance.  A college dropout working as a technician at a rehab does not even have the authority to make this type of threat. I was also forced to shave in front of a female technician with the bathroom door open; she stated that this was policy and I had to relinquish my razor after every shave because I could use it to inflict harm on myself. I then asked why is there a whole drawer full of sharp cutlery in the kitchen that me and my junkie roommates have access to 24/7??? 

I saw a psychiatrist and handed him my diagnosis on a silver platter from my history , i.e. Paxil withdrawal yet SSRI Discontinuation Syndrome was not even on his differential. I was in a state of constant agitation, sleep deprivation from insomnia, severe depersonalization. Ended up in the ER at UCLA for intractable Migraine HA, Sleep deprivation, Dehydration, mild AKI and had to be medicated with IV crystalloid, Phenergan to combat emesis and finally induce sleep (going on 4th day of insomnia at that point). 

Less than 24 hours after the ER visit I am sent for Neuropsychological testing extensively, which violated just about every code of conduct and ethics under the American Psychological Association in regards to testing validity. I was then labeled “disabled” based on the results. the treatment center was then going to recommend that I stay and additional extended period so they could “rehabilitate” me. They realized now that they did not have my credit card on file because I refused to provide them with it at admission as my employer, was paying for everything for the first month. Next they discover that I do not have disability insurance, and now know that they have just ruined my life.  It will take a minimum of 6 months before I can be retested to prove that I have no cognitive impairment and am not disabled. Now my chances of getting disability insurance in the future are ruined.

The treatment center then released me and I returned home to the PHP.  I then had to sign a five year contract, enlist in a drug monitoring contact with “RecoveryTrek” which I had to perjure myself and illegally claim that I was a substance abuser and was in “recovery.” I immediately sought legal counsel because of this nonsense. Shortly into my so called recovery I had to take my Maintenance of Certification Board Exam in Internal Medicine. Passed exceptionally and with ease. How could I be cognitively impaired?

Go figure! The neuropsychological test was readministered locally by a different provider as I told the PHP there was no way I would ever consent to going back to the treatment center.  The neuropsychologist was pretty pissed off about everyone’s mismanagement of my case starting with my employer.  I tested fine, and then the PHP released me from the program and cleared me to return to work. The entire experience has jaded my enthusiasm in medicine. I had to take almost a year off to reflect on how I was used as a pawn in everyone’s game.

I experienced coercion, collusion, fraud, incompetence, and saw a part of evil in this world that I never new existed. I was a prisoner, starting my day by having to call a monitoring center to see if I had to be drug tested for that day, every  day of the week.  I was not allowed to leave the state; how can a PHP legally restrict my civil rights this way when I was not under a court order, and not even under state medical board referral? I was not allowed to have a sip of alcohol during my monitoring, even though I had tested negative for any evidence of drug use. I had to meet with board of directors every month and discuss my case, which no one had clue about regarding why I was even in a PHP.  This violated all of my rights to privacy regarding my medical condition. The contract that I initially had to sign with the PHP had statements within claiming they could report any information about me to any regulatory agency without even substantiating any facts or validity. This is just a clever way of saying they can lie about you and there is nothing you can do about it legally.  There is complete lack of due process. Your civil rights are stripped. You are beaten down into despair and desperation. You are told if you don’t comply your license would be in jeopardy and your career will be over. This cost me thousands of dollars in legal fees, thousands of dollars to be retested and prove I was not impaired, hundreds of dollars each month for PHP dues and random urine drug screening.

I put up with this B.S. for six months, and honestly could not have fulfilled a 5 year contract. If I had not been released (since there was no condition to monitor) I would probably be dead today. I would not be surprised that PHPs have actually caused in increase in physician suicide rate.  I cannot fathom the degree of humility physicians experience having to do this for five years. And the only reason these rehab centers claim such a high success rate for recovery is that they hold a gun to your head and threaten you to be in compliance with everything they recommend. So yeah, doctors have a lot more to lose.  I now understand how these PHP’s are in collusion with rehab centers. What they are doing is a violation of fair trade acts and would fall under the RICO act. The problem is nobody is investigating them for conspiracy and fraud. They all fly under the radar because they believe they are providing a service that ensures public safety. Its a multi-billion dollar scam industry. What’s more sad is that nobody really cares what physicians are subjected to. In fact the public likely finds joy in fact that docs are treated this way. The state of California hates doctors, so the rest of the country probably does too. People probably enjoy knowing doctors are held to higher standards than the rest. That they are usually required to stay 90 days in rehab while all other professionals stay 28 days, that they are financially ruined by rehab centers. That they have been stripped of all their rights while in a PHP monitoring program. That they are more subject to discrimination based on age or coexisting medical problems like diabetes and hypertension. I have actually seen cases of MDs sent to PHPs for monitoring of hypertension and regardless of why you are sent there you must comply with drug monitoring.

The rehab centers are now tapping into other territory that further identify this as a conspiracy. Department of Transportation, Aviation, and Law Enforcement are going to be their next victims. I can’t wait to see how the police officers are going to respond to this nonsense.

This was an eye opening experience. There is no profession that is worth going through this amount of humility. PHP’s will likely remain above the law, continue to have no accountability and oversight, which is a travesty of justice.  I hope you will share my experience.  My case is rather unique in my opinion.  It’s evidence that no physician should ever voluntarily enter a PHP at an employer’s request. You would be much better off to simply quit/resign.


I know of pharmacist who are forced into the program and held hostage by their license. They are also required to do “inpatient” treatments of at least three months and continued random monitoring for five years as well.

Once they have you by the proverbial ball, they milk you till you are dry. It is nothing but a scam. The funny thing is that for healthcare professionals who relapse while in the program, they are sent back to “rehab”(inpatient) again once more for milking while they feed you the same b.s. they did the first time.

What is becoming even more alarming is that at least in one case, Texas, if you call PHP for help or to inquire about help, even though nothing has been reported at work or to the board, and you identify yourself and spill your guts about your issue/s asking for your options you are automatically signing up for a trip to rehab and five years of monitoring.

If you decided that you are not interested what they have to offer, they will tell you they would report you to the board at that stage (of course at the beginning of the conversation they tell you it is confidential, but it is confidential as long as you voluntarily start their program since you spilled the beans.

I would be very careful calling the state PHPs asking for information. I would do it from a blocked phone and use an alias before talking to them.

Maybe others who information about other states can also shed some light on this.


It is really tragic that so many valuable doctors are lost without reason.  That State Medical Boards can strip a physician of his hard earned license without due process. That there is no oversite of these boards. That boards and PHPs bully and harass physicians, even to the point of suicide. About 400 physician commit suicide every year. That’s a loss of an entire medical school every year! A colleague of mine committed suicide after facing medical board charges that had no signifigance anyway. This is occurring in the face of a physician shortage as baby boomers age.


Turns out, I am one of those recovering alcoholics (9+ years) with a lot of experience in AA. It was a large part, though not all, of my treatment. I found it personally helped me a lot. And I also agree with your position.

Based on my experience in AA, things I heard at AA meetings and things I read in AA literature:

– the AA message should be spread via “attraction, rather than promotion”

– AA does not claim to be any kind monopoly in the field of addiction treatment

– AA is fully self-supporting, declining outside contributions

– AA is not professional and not organized

And so having a large body of physicians outside of AA promoting AA is, in my opinion, contrary to multiple AA traditions – particularly if this situation creates controversy. I personally find AA needs no extra promotion, and alternative treatment programs ought to be encouraged just as well as further scientific research into the addiction problem.

The whole thing was meant as a very open, welcoming, non-judgemental, informal gathering of alcoholics talking to each other. Extremism, government coercion, public promotion, money – all those things do a lot more harm than good.

At any rate, thanks for your thoughts, Dr. Langan. Best of luck in the future, I’ll keep following along.


As an airline pilot who made the monumental mistake of believing that the “E” in EAP (Employee Assistance Program) really meant “assistance”, I can only nod my head in sad agreement to everything above. Between “treatment” (indoctrination in AA dogma) and monitoring my decision to ask for assistance in dealing with a series of health and personal issues that I (for the first and so far only time in my life) tried to use alcohol to numb has changed my life forever. I have lost 7 years of my life. My faith in the rule of law in our society is completely gone. The stress and humiliation of having my career depend on my ability to convince people in this program that I have been “converted” (let’s call it what it is: living a lie) have been indescribably painful. It has affected every aspect of my life. My physical and mental health has suffered as has my personal relationships. My only hope is that court decisions like the recent one in the Hazle trial will once and for all end this damaging and unconstitutional practice.


Comment: Excellent research. What is astounding is that some (if not all) PHPs are using EtGs and EtSs and PEths DESPITE explicit advisories by SAMHSA over a span of 6 years! These advisories noted that a) they were not FDA approved; b) there was insufficient research; c) that there were too many false positives; and d) using such tests in such a setting as the forensic environment where someone’s career and reputation could be put at risk was highly dangerous. Further, as I discovered only recently, NCPHP not only runs these tests on new evaluations it conducts on involuntary (and unsuspecting) physicians who have been ordered (under specious circumstances) to be evaluated by NCPHP, NCPHP adamantly refused to release the results of the tests to the physician, though you can be assured the results were used to “make their case” for a pre-determined diagnosis.

I think it is fair to say that their use of these tests is not simply unethical; it constitutes highly risky human experimentation conducted with neither the subject’s consent nor with approval of an IRB.

One can also presume that PHPs have sold this junk science to their associated medical boards in giving them what appears to be substantial evidence to bolster their case. And one can also presume that medical boards have simply accepted it as though it were valid, essentially doing nothing to challenge the invalidity of the test and the violation of due process and thus virtually rubber-stamping the annihilation of a physician’s career.

When you engage these research epidemiologists in this endeavor (is there yet a group called “Epidemiologists for Social Responsibility?”), you may also ask them to review data form board and PHP actions in which this data was – in any way – involved in the assessment of their case, whether playing a major role or only an incidental one. The introduction of this misleading – and therefore fraudulent – laboratory data into these physicians’ adjudication would seem to serve as a solid basis for invalidating their fraudulent assessment and ensuing “conviction.”

Personally, I believe this is of such immense importance that it ranks up there with the flawed hair and fiber analysis assessments that were done by the FBI which my courageous colleague Dr. Fred Whitehurst called attention to in the late ’90’s (and lost his job over, via a massive campaign of discrediting and innuendo of “mental illness.”) It took nearly 15 years but finally, the DOJ saw the immensity and breadth of the false prosecution based on flawed “evidence” and ordered the FBI to reopen over 21,000 cases of potentially flawed hair and fiber analysis!

I truly believe the same outcome is going to materialize here – it has to! Physicians (and soon many other seemingly well-paid professionals who are judged able to afford the “private addictions treatment for professionals” scam) have been falsely assessed and compelled into costly (and embarrassing) treatment programs and prolonged monitoring (with extra time for balking – i.e. “being disruptive”) by the PHP prison-industrial complex. All with no chance of fair hearing, no chance to challenge the validity of the evidence, and high likelihood of reprisal if one doesn’t “go along.” This pervasive abuse of authority and process must be aggressively confronted.


Great site!  There is so much corruption in medical boards & PHP’s.  We need to take it upon ourselves to evaluate what our agencies are doing and turn them into the state auditor of every sight for performance and forensic auditing.  Auditors DO listen and DO investigate, but they need to be led to the need for an audit.  The best way to do this is for those of us who have been assaulted and battered by these agencies to document what has been done to ourselves and our peers and let the auditors know what is going on!


I have enjoyed reading your web log.  I have empathy for your plight.  I am involved in a parallel organization known as the HIMS program (Human Intervention and Motivational Study)  

I can’t help but notice that several of the names you have listed under ‘like-minded docs’, are ‘professionals’ I have also encountered.  Namely, Joe Garbely who did my initial psychiatric evaluation, Lynn Hankes, a urologist who advises HIMS and the FAA, and William Green, my current psychiatrist.  I am told a component of my $1500 dollar meeting with Dr Green (Physical and Psychiatric) will be composed of inquisitions into my involvement in Alcoholics Anonymous and progress in my step work. This is the man who told me I must attend three AA meetings weekly and my aftercare group therapy must involve AA in order to be approved for FAA Special Issuance (the FAA Gold Standard). I was also informed that non compliance would mean a rejection of my application by the Feds. All of this after I informed Dr. Green that there simply was ‘no correlation’ between Alcoholics Anonymous involvement and my sobriety and that I found the program to be psychologically harmful to my well being.

If you have any further information on the three ‘like-minded docs’ I have encountered in my journey kindly point this out to me.  I am sure there are more but I must thank you for providing the missing pieces of the puzzle from the medical perspective. Its eye opening to say the least. Have you spoken with the same attorneys the pilots have? I am sympathetic with your plight.  The worst mistake I ever made was asking for help and the process of psychological hazing, indoctrination, and coercion did nothing but steepen my situational depression.


Thank you for your earnest work on this subject.  We are not alone in this.


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Moving the Goalpost–Criminal Violations of HIPAA by PHS, Quest and USDTL


Information obtained under HIPAA Privacy Rule

1.August 6, 2014 to Langan with health materials   2. Quest-Clinical


The elements of a criminal offense under HIPAA are fairly straightforward.  To commit a “criminal offense” under HIPAA, a person must knowingly and in violation of the HIPAA rules do one (or more) of the following three things.:  use or cause to be used a unique health identifier, obtain individually identifiable health information relating to an individual or disclose individually identifiable health information to another  person.   Criminal penalties under HIPAA, tiered in accordance with the seriousness of the offense, range from a fine of up to $50,000 and/or imprisonment up to a year for a simple violation to a fine up to $100,000 and/or imprisonment up to five years for an offense committed under a false pretense and a fine up to $250000 and/or imprisonment up to ten years for an offense committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage , personal gain, or malicious harm.

One of the ways physician health programs are engaging in forensic fraud  using laboratory developed tests (LDTs) is by changing them from “forensic” to “clinical” samples in order to bypass chain-of-custody.  As there is no regulation or oversight of the entire testing process it is easy to do.  PHPs have no oversight or regulation.  Neither do the commercial drug testing labs using these tests.  They are non-FDA approved and CLIA exempt so the only avenue of complaint is the College of American Pathologists (CAP) which is an accreditation agency that does not have the power to sanction.

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In terms of criminal penalties  I would aim for the $25000 and 10 year mark as the cumulative documentation of HIPAA breaches committed by PHS, Quest and USDTL under false pretense are many and severe.

The Department of Health and Human Services Office for Civil Rights confirmed that my blood test from July 1, 2011 was intentionally changed to a clinical specimen and sent to USDTL with specific instructions to process it as a clinical specimen.  Under the updated HIPAA-Privacy Rule “patients’ have the right to request their records directly from labs without authorization of the ordering provider.

It is important to recognize that all three parties had misrepresented this test as “forensic” since 2011. I have been requesting the “external chain-of-custody” from Quest since December of 2011 and the “appended test” from V.P. of Laboratory Operations Joseph Jones since December of 2012 when I was informed that it was changed from positive to invalid on October 4, 2012.

The new documents provided by USDTL include the October 4, 2012 revised test contradicting Dr. Luis Sanchez letter that he “just found out about” the revised test 67-days later.

The importance of this cannot be overstated as I filed a complaint with the College of American Pathologists in January of 2012. The  investigation confirmed my suspicion that the test was fraudulent and as a result CAP mandated that USDTL revise the test.

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USDTL did so and reported it to Dr. Sanchez but both concealed it and Sanchez took action against my license the following week.

“Moving the Goalpost” is a frequent tactic of PHPs whereby they make a new allegation and disregard the original.   By controlling the information that is provided they are able to suppress and conceal whatever they want by misusing existing health care confidentiality law.

The October 19, 2012 report for noncompliance with my contract was done  under “color of law” and resulted in suspension of my medical license.   The new documentation shows that all three parties were involved in the fraud and the coverup.

The information USDTL provided even contains an email from me to Joseph Jones  from December of 2012 requesting that he provide a copy of the October 4, 2012 revision which he ignored.

In response to demand letters from my attorney all three defended themselves by claiming the July 1, 2011 test had absolutely nothing to do with my suspension and blamed it on my non-compliance.  The new documentation shows that I was reported for noncompliance after Dr. Sanchez was made aware of the revised test.

As the three parties colluded to produce PHI and used it with malice in a conspiracy to commit fraud and I am therefore requesting that charges be filed against these parties under the HIPAA criminal statute:

The HIPAA criminal statute, 42 U.S.C.A. § 1320d-6, reads in pertinent part:

”A person who knowingly and in violation of this part—

•   uses or causes to be used a unique health identifier;
•   obtains individually identifiable health information relating to an individual; or
discloses individual identifiable health information to another person, shall be punished as provided in subsection (b) of this section.”

”Whoever willfully causes an act to be done which if directly performed by him or another would be an offense against the United States, is punishable as a principal.” 18 U.S.C. § 2(b).

 All three parties knew this was intentionally changed from a forensic to a clinical sample and PHI. Instead of correcting an error both Quest and USDTL took steps to conceal this information.   In fact, the complicity of the three parties, cover-up and extent of damages caused by it make this the worst HIPAA-criminal violation to date. I can find nothing comparable and the damages have still not been corrected.

Luis Sanchez was notified  of the invalidity of the test on October 4, 2012 but suppressed it for 67-days.    This was a result of my complaint to the College of American Pathologists (CAP) that launched an investigation which revealed no external chain-of-custody existed for the specimen rendering it invalid.  This was revealed to PHS on October 4th, 2012 but instead of disclosing this and correcting things Dr. Luis Sanchez reported me to the Board  for “noncompliance” less than 2 weeks after it was revealed to him that the test was invalid.     He then wrote a letter on December 11, 2012 stating that he “just found out” about the invalid test.

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Sanchez violates M.G.L. (B) Section 69 on 3 separate occasions 1. July 28, 2011 when he reports the fabricated test to the Board of Registration in Medicine (BORM) 2. October 19, 2012 when he reports non-compliance with my contract leading to my suspension. 3. December 11, 2012 when he reports PHS was made aware of the invalidity of the test the day prior when it was actually 67-days prior (and 2 weeks prior to the report of non-compliance). His attempt at “moving the goal-post” was made clear with the August 2014 provision of the October 4, 2012 report from USDTL to Sanchez. Both USDTL and Sanchez suppressed this information to conceal the crime.

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The additional evidence was provided in December of 2011 with the litigation packet. Since that time Ms. Stoller has received exculpatory evidence that undeniably refutes the test including an investigation by the College of American Pathologists. In addition Ms. Stoller has been made aware point by point the crimes involved. She is aware that this is not only “invalid” but the product of forensic fraud. Her stance has been to ignore each and every point and support PHS regardless of facts and truth while professing to serve the public interest.

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Letter from USDTL to Sanchez reporting the absence of external chain-of-custody and invalidating the positive test. This was concealed until August of 2014.

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While concealing the October 4th test correction Sanchez reports “non-compliance” with A.A. meetings. The positive test was the sole justification for the A.A. meetings.

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Sanchez claims that he just found out about the revised test 67-days after he actually did. Note he makes it a point to state that the test did not cause any consequences confident that the October 4, 2012 document will remain concealed.

A  Request to Inspect and Copy Protected Health Information and  Authorization for Use or Disclosure of Patient’s Protected Health Information was sent to USDTL in July and August of 2014.

The July 1, 2011 PEth test was drawn as a forensic specimen and subsequently changed to “clinical” (rendering it PHI) at the request of Quest’s client, PHS, Inc on July 7th, 2011.  USDTL sent the materials within the 30 day deadline.

Quest Diagnostics, however, refused to comply with my request for the authorization and release of information forms required for them to draw a clinical specimen (which I knew did not exist) as well as any documentation related to the request by PHS that Quest  (in violation of all regulations, professional standards, and clinical laboratory law) changed a “forensic” to a “clinical” specimen.  The Quest attorney insisted that I sign a “release” from PHS.

PHS and the colluding labs were apparently unaware  of the updated HIPAA regulations removing the need to obtain a signed release from a “provider” to obtain PHI.

 I only received it because the DOJ-OCR agreed that this was PHI and forced Quest to send it.    

PHS manipulated the test, set up a system in which they could claim me non-compliant , then did so immediately after the test was amended and hoped I would never find out.

On 10/4/2012 USDTL amended the test noting “external chain of custody was not followed per standard protocol” invalidating the test (this was the result of the initial CAP investigation under the assumption it was a forensic test).  This was faxed to PHS but they withheld this information from me and the Board of Registration in Medicine.

The very next week they deemed me  “non-compliant.” 

PHS then officially reported me to the BORM as “noncompliant” on 10/19/2012.

On 12/10/2012 I found out from Amy Daniels of CAP that the test had been amended. I then called PHS and they issued a letter the very next day 12/11/2012 stating “Yesterday, December 10, 2012 Physician Health Services (PHS) received a revision to a laboratory test” referring to the July 1, 2011 PEthstat.  They  then try to cover themselves by claiming they were not aware of any action taken by the board as a result of this test.

The documents reveal that PHS is violating multiple state and federal criminal laws including clinical laboratory laws.  It not only involves forensic manipulation but sending laboratory specimens as “clinical” samples when they are not authorized to do so and misrepresenting them as “forensic.” 

Joseph  Jones goes on record as a strict advocate of quality control and chain-of-custody with his “Defense in Depth Strategy” video and multiple written documents proclaiming how USDTL follows strict and rigid protocol.  Well the ” litigation packet”  contradicts and even negates this.  How can any of USDTLs testing be trusted in light of what is seen here.

 There is nothing that correlates that test with me and for all intents and purposes it could be a positive template used specifically for this type of misconduct.    They pointed out that it does not pass the  common sense factor (i.e. what would an average person think under normal circumstances about this?)

What it shows is that Mary Howard of PHS changed a test that was drawn as a “forensic” test to “clinical.”    She is listed as the ordering “physician.”  None of the required information exists to obtain a clinical sample. There are no authorization forms signed by me or to whom the information can be disclosed–clear violations of “Prohibited Activities” under Massachusetts law governing clinical laboratories.

Quest and USDTL representation has already clarified that PHS requested this test be sent by Quest to  USDTL as a “clinical sample” with specific instructions to process it as a “clinical” sample.  PHS is a monitoring agency not a treatment provider.

A “clinical” laboratory specimen is defined (CLIA, DPH, HHS, state laboratory law, essentially everyone) by its use in the diagnosis and treatment of a patient in a  doctor-patient relationship. It necessitates patient “care” which PHS is unable to legally provide as a “non-profit” charitable organization. 

As this is both “bad-faith” and ultra vires “confidentiality agreements” and “peer review” protection should no longer be an issue.  Just one removes it.

 PHS is an agency that utilizes drug and alcohol screens to detect if doctors are using substances they are prohibited to use.  It is not a clinical provider.  I am sure Bresnahan has spun some sort of logical-fallacy argument to say it is, but the documentary facts negate this.  Organizational purpose is clear. As a monitoring agency their drug and alcohol testing is forensic.    This brings in to question their “charitable organization” non-profit status.

Accountability requires both the provision of information and justification for actions

Accountability also requires consequences for violations of professional standards-of-care, ethical codes of conduct and the law

PHS is able to do what they do by both blocking information and relying on others to overlook, table or otherwise dismiss valid complaints–complacent that these are good people helping doctors and protecting the public.  The current incarnation does neither

There should be zero tolerance.  PHS has been unaccountable for this type of behavior but this needs to be addressed. 

Accountability requires both answerability, justification and consequences.     There is no conceivable procedural, ethical or legal justification for what is shown here.   The compounding of crimes over time is self-evident and therefore it is the responsibility of the state to hold him accountable for his crimes. The fact that he pontificates on professionalism and stands in judgment of others makes it even more important.    There are no exceptions to the rules or the law..

 And we now know why Quest was so reluctant to provide the records.  Quest was complicit in this and obtained and processed a known forensic sample as “clinical” without any of the required documents.  The test lists “ordering physician” as Mary Howard (who is a secretary at PHS).  There are no signed release of information forms or authorization forms indicating who my PHI could be distributed to.

This is in violation of the HIPAA criminal statute.  As a business associate  It is my understanding  PHS can be tied to it by the conspiracy statute.

There should be zero-tolerance for this type of criminal activity.   There is no excuse for forensic manipulation and this must be addressed.  The people who are engaging in this should be in jail yet they remain unscathed.  This is a systemic problem that is best met with head on and in real time.  It makes Annie Dookhan look like a girl scout.

7/1/2011—PHS requests blood test at Quest Diagnostics.  No outside factors are involved in  PHP requesting this.   There is no outside complaint or concern behind it.  I provide blood sample using my PHS unique identifier #1310

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7/28/2011—verbal report that test was positive to the Board of Registration in medicine and requests I have a “reevaluation.”

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I request test results in form of “litigation packet” but PHS tries to dissuade me and eventually threatens me with “unintended consequences.”

11/29/2011—PHS agrees to provide “litigation packet. Check dated 11/29/2011 is given for payment.

12/5/2011—Receive USDTL Litigation Packet   Sole document from Quest is a fax that is time stamped and arrived 3 hours after the specimen was collected when I was in clinic at MGH rendering this impossible.  In addition it is not my signature:

Signature on Quest document

Signature on Quest document


A fax from PHS to USDTL is also included requesting that my ID # 1310 and a “chain-of-custody” be added to an already positive specimen with no unique identifier connecting it to me.

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PHS asking that my ID # 1310 be added to this sample and

PHS asking that my ID # 1310 be added to this sample and “chain-of-custody” be updated

A report dated 7/20/11 from USDTL “revised report per clients request” and “corrected donor ID from 46130 to 1310 and “corrected collection date to 7/1/2011”

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USDTL adds my ID # 1310 to an already positive sample and adds collection date of July 1, 2011

Note this backdating of chain of custody and addition of my ID # is on 7/20/11  (one day after Dr. Luis Sanchez reported the test as positive to the Board of Registration in Medicine. )

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Joseph Jones certifies that the specimen was processed with laboratory SOP. This is signed on 12/3/2011

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Note that Dr. Luis Sanchez “explained that the testing laboratory is willing to support the test results and provide the litigation packet’ December 5, 2011

Note- the “PHP-referred” attorneys are an essential part of this racket.   Although ostensibly representing your interests they are also serving the PHP as they will not go beyond certain boundaries.  They will not address the forensic fraud facilitated by the labs or the “tailoring” of assessments to fit the diagnosis.  Their other job is 12-step facilitation.  They enforce mandated 12-step and essentially threaten you that the medical board will suspend you if you do not show them you accept it.   My attorney would not even contact the labs involved.    Although discovery of the fraud would have been exculpatory my attorney felt a better approach would be to blame the positive test on my asthma inhalers and referred me to an “expert witness” who for $3000..00 would write a letter supporting this.   I even write a letter for him to USDTL.  He will not contact the labs but offers to do so if Linda Bresnahan “wants him to.”  The deferential almost sycophantic exchange is seen below.Screen Shot 2015-05-07 at 10.32.33 AM Screen Shot 2015-05-07 at 10.31.17 AM

12/14/2011—Bresnahan replies that the one page document with my forged signature is sufficient external chain of custody.

Screen Shot 2015-05-07 at 9.26.53 AM12/19/2011–I try to do everything I can to  get my attorney to address the lab issue.  In any other profession this would have been immediately resolved.  The lab fraud would have been exculpatory. but in this rigged system it is avoided.    The fact that the attorney who is supposedly working for you is actually working against you is a very significant breach of trust It is an essential part of the racket.

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12/29/12—As I  am determined to get the truth about the test I request that when that happens the board allow me to repetition for reconsideration.  Confident that the College of American Pathologists will confirm the fraud this letter is written to Board Attorney Deb Stoller.

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Letter to Board Attorney Deborah Stoller. My contract with PHS was extended for 2 years because I asked for an evaluation at an independent facility not affiliated with PHS and the Like-minded docs. This letter is important as it shows the import of the PEth test which PHS will later say is irrelevant as they “move the goalpost.

1/12/2012—I send “litigation packet” to the College of American Pathologists (an accreditation agency that does not have power to sanction but can investigate and force lab to correct errors under threat of loss of accreditation)

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3/22/2012 – Quest New England Compliance Manager, Nina Tobin in response to my persistence in obtaining the absent Quest “chain-of-custody” provides letter documenting all of the errors in collection and process in a letter that seems to try to give the impression some sort of protocol was followed. She notes it was “ logged as a clinical sample.” Note no indication of the validity of the sample and that this was processed as a clinical sample.

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10/8 2012 –I am called by my attorney and told PHS is deeming me “noncompliant’ with my contract.

10/19/2012—I am verbally reported to the Board of Registration in Medicine for noncompliance with my contract.  This is followed by a written letter:  10:23:12 PHS Letter to BORM-noncompliance

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11/5/2012—Inquisition_10_Pushing_Off_Bridgen appears to be “a purposeful and intentional act by PHS to show MLL’s 7/1/11 test as valid when in reality this test was invalid, and involved both fatal laboratory errors and lack of adequate MRO review of results. Anything based on MLL’s 7/1/11 test as a confirmatory positive should be reversed, rectified and remediated.”   This letter remains unacknowledged by Board Attorney Deborah Stoller.

12/5/2012 – Contacted by Amy Daniels (investigator for CAP) to follow up on the “appended lab.” She tells me that the July 1, 2011 lab was amended on 10/4/2012 and reported to PHS. I contact PHS and they deny it.

12/11/2012– Dr. Sanchez issues a letter stating “Yesterday, December 10, 2012 Physician Health Services (PHS) received a revision to a laboratory test” referring to the July 1, 2011 test. He claims the test had no consequences.

2/6/2013—I am suspended by Board of Registration in Medicine for the “non-compliance” reported by Dr. Luis Sanchez.

6/23/2014-Letter from PHS attorney Paul W. Shaw claiming PHS immune from damages and documenting that the lab draw was performed by PHS ‘in its capacity as a charitable corporation.” He states “you should be aware that the suspension of Dr. Langan’s license had absolutely nothing to do with the blood test referenced in your letter or any actions on the part of PHS, as detailed in the Board of Registration in Medicine’s {Board Order} dated February 6, 2011” referring to my suspension for the “noncompliance reported by Dr. Luis Sanchez.

6/27/2014—Letter from USDTL attorney William F. Burke stating that “the blood sample was tested clinically at the request of Quest Diagnostics” and that “Dr. Langan’s blood sample was provided to USDTL by Quest Diagnostics on behalf of Physician Health Services as part of medical treatment..”   He states “Dr. Langan’s suspension was the result of his inability to comply with the terms of his contract.”

8/6/2014—in response to my request for PHI USDTL provides record. This includes documentation that Dr. Luis Sanchez was made aware of the revised test on 10/4/2012.   Note the very next week on 10/8/12 my attorney informed me that he was reporting me to the Board of Registration in Medicine for “noncompliance’ and officially did so on 10/19/12.

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Also included in the record is an e-mail from me to Dr. Jones December 10, 2012 with subject “please provide amended lab report.” I request a copy of the amended lab report ASAP specifically to “clarify the truth about this test as explicitly as possible before this goes any further.” I state “PHS has used this test to cause, and continue to cause, a significant amount of harm.” He does not respond to this request for what is now documented PHI.   I am suspended 2 months later for non-compliance.

Joseph Jones had already corrected the test 10/4/2012 but both he and PHS concealed it while PHS “moved the goalpost” by deeming me non-compliant.

10/9/14—Receive documents from Quest Attorney Fay Caldwell.   No release of information forms or other HIPAA required documentation is found.

Ordering Physician is listed as Mary Howard.  (secretary at PHS).   Documents reveal no custody and control form information only that it was changed to a clinical specimen by Ms. Howard on July 5, 2011 and sent to USDTL on July 7,2011.


Request that Massachusetts Medical Society acknowledge or refute professional, ethical and criminal misconduct by Physician Health Services (PHS, Inc.)

Oliver Wendell Holmes, the Massachusetts Medical Society, Tinsel Erudition and Pretended Science Redux

images-10As the oldest medical society in the United States the Massachusetts Medical Society can count some of the greatest minds in the history of American medicine as members.  My how far we have fallen.  This same author has previously unintelligibly compared the field of medicine to Barbra Streisand’s face and shamelessly and opportunistically blamed the Boston Marathon bombing on “marijuana withdrawal.” 
The sophomoric mnemonics are neither clever nor illuminating.  Unworthy of  Readers Digest circa 1957, this dumbing down of doctors needs to end.  The very soul and practice  of medicine is being castrated and lobotomized by the same dull and very very blunt instrument. 
How does one reconcile the fact that the very same medical society that publishes the New England Journal of Medicine is allowing this type of tripe and rabble to get past editorial review?  In 1969, through an act of the state legislature, the Massachusetts Medical Society updated its mission to read:
“The purposes of the Massachusetts Medical Society shall be to do all things as may be necessary and appropriate to advance medical knowledge, to develop and maintain the highest professional and ethical standards of medical practice and health care, and to promote medical institutions formed on liberal principles for the health, benefit and welfare of citizens of the commonwealth.”
With a foundation and history built and based on of scholarship and critical thought we need to support the highest levels of science, fact, intelligence and reason.  Stupidity tries but it should not win.  Before the Boston Society for the Diffusion of Useful Knowledge in 1842, Dr. Oliver Wendell Holmes delivered two long lectures entitled “Homeopathy and Its Kindred Delusions.” He characterized one of its popular practitioners, Dr. Robert Wesselhoeft, as one of those:  
“Emperics [quacks], ignorant barbers, and men of that sort…who announce themselves ready to relinquish all the accumulated treasure of our art, to trifle with life upon the strength of these fantastic theories.” That “pretended science” as Holmes called it, was “a mingled mass of perverse ingenuity, of tinsel erudition, of imbecile credulity, and artful misrepresentation, too often mingled in practice…with heartless and shameless imposition.”
And Holmes words are as apt and appropriate today as they were in mid 19th Century Boston!   Probably more so. History has recurrently proved that false constructs and groundless concepts allow for endless error. The Massachusetts Medical Society and all of its members need to come to the realization that Physician Health Services (PHS) has paradoxically become a reservoir of bad medicine beset by corruption. The documentary evidence of  professional, ethical and legal misconduct must be specifically and precisely addressed.

Accountability. Answerability and Justification Required. Accountability, or answerability,  is necessary to prevent abuse and corruption.  This requires both the provision of information and justification for actions.  What was done and why?  Professional guidelines and standards of care, ethical codes of conduct and the law are all objective benchmarks that can be used to assess the actions and decisions of others.  In any free society this necessitates the existence of organizations of truly independent opinion capable of standing in this judgment.State PHPs are Non-Governmental Organizations (NGOs) over which the state health department has no supervisory oversight.  There is no regulation, no transparency and no accountability.  There is no public scrutiny and they police themselves. In Ethical and Managerial Considerations Regarding State Physician Health Programs Drs. John Knight and J. Wesley Boyd called for greater oversight and scrutiny of PHPs by the medical community at large.   They recommended periodic auditing, national standards and regulation.  They also attempted to convince the Massachusetts Medical Society to implement changes at PHS where they served as Associate Directors with over two decades of collective experience.  These efforts to promote transparency and accountability at both local and national levels, however,  fell on deaf ears.State PHPs have systematically removed doctors of academic integrity and moral compass.  Those not conforming to groupthink were threatened with litigation if they breached “peer-review” statutes or confidentiality agreements and this has effectively silenced many from reporting misconduct, abuse or even crimes they may have witnessed.

Massachusetts PHP engaging in Procedural, Ethical and Criminal Misconduct In Massachusetts John Knight was removed in 2009 and J. Wesley Boyd in 2010. In Ethical and Managerial Considerations Regarding State Physician Health Programs  they comment “if a PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwise—tailor its diagnosis and recommendations in a way that will support the PHP’s impression of that physician.”  So too will the clinical laboratories.  Of course “tailoring” a diagnosis to support anything other than the real diagnosis is fraud.    The “PHP-approved” assessment centers are willing to fabricate and misrepresent neuropsychological and cognitive testing to support “denial” and “cognitive-impairment.”   Detailed examples can be seen here and here.  The evidence is clear that past medical director Dr. Luis Sanchez and Director of operations Linda Bresnahan have engaged in not only unethical but criminal activity. Egregious misconduct including forensic fraud and political abuse of psychiatry can be seen in detail here, here and here. This type of inverse morality is antithetical to the history and organizational purpose of not only the MMS but the entire Profession of Medicine.  Institutional injustice can have grave and far reaching consequences.   Increasing reports suggest that programs just like PHS are contributing to the suicide epidemic in doctors.  The patterns are the same and the same scaffold is being used.  PHPs are colluding with the same drug-testing companies and “PHP-approved” assessment facilities.  It is, in fact, a rigged game.

Sunshine is the best disinfectant. Very few doctors are speaking out. Most are vey afraid and remain silent.Few have obtained documentary evidence of misconduct. I have. To ignore the problem or suggest that it does not exist will only cause more damage to other doctors. The suicides will continue.  Nothing will change.  The majority of Massachusetts Medical Society members (as are the majority of doctors) are honest, thoughtful and responsible. Most are completely unaware of the ethical and criminal allegations concerning PHS. This is, after all, a system that depends on secrecy and silence. Most doctors are also probably unaware that the MMS has no regulatory, supervisory or investigatory oversight of PHS.  They have removed themselves from scrutiny by design.  The only avenue of complaint, I have been told, is by filing an ethical complaint with the MMS grievance committee and that any investigation is private, non-disciplinary, and final.   This is irrespective of the severity and scope of the complaint.   What this means is that any complaint against a member of PHS is behind closed doors, if the complaint is substantiated it results in “education” not “discipline,” and the decision cannot be further addressed, appealed or revisited.

Moreover, I have been hearing that ethics and grievance committees in many states have been intentionally populated by PHP apologists, supporters and friends.  As with the other “point-people” they have positioned at medical boards, public health departments and law enforcement, these friends of like-mind are used to deflect, block, delay, suppress and minimize valid complaints.   I do not know if this is the case in Massachusetts.   However, the bottom line is that only two results are possible from any complaint 1) complaint dismissed–final answer, or 2) complaint substantiated–member educated on matter-final answer.  Although this system  may be applicable to some of the common ethical conundrums encountered in the medical profession it is not applicable to criminal activity and fraud.

The character of those involved in PHS can be seen in my post “Integrity and Accountability the Declining State of Physician Health and the Urgent  Need for Ethical and Evidence Based Leadership.”    Wayne Gavryck’s moral compass and adherence to professional and ethical standards can be seen here.  My request is simple, straightforward and should be easy to answer.   So to any of the  apologists, supporters or defenders of PHS I have a simple request.  Just answer the questions here.   No reframing the question, moving the goalpost or redirecting the focus.  Just register and respond. Simple request and litmus test.  Ascertain or refute what you see.  Can the actions of actions of Dr. Luis Sanchez, Dr. Wayne Gavryck or Linda Bresnahan procedurally, ethically or legally.  Yes or No.

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Accountability Requires Answerability and Justification for Actions. Accountability necessitates both the provision of information and justification for actions; what was done and why?    The other defining factor of accountability is the ability of outside actors to punish and sanction those who commit misconduct or wrongdoing.    Without these constraints corruption is inevitable.  State PHPs such as PHS have not only removed answerability and justification but have taken steps to prevent any interference by outside actors including medical societies, medical boards, law enforcement and departments of public health. The most crucial step in solving any problem is admitting it exists. This exists.  There is a solution to this.  Sunshine is the best disinfectant.    If the actions of Sanchez, Gavryck and Bresnahan cannot be justified or defended then it must be concluded that these individuals have violated procedure, ethics and the law.  And if that is the case it is the responsibility of the MMS to acknowledge the individual and specific issues as well as the reality that there is no current avenue to address these issues.   That, in and of itself, is a problem. The documents show significant and severe wrongdoing that constitute crimes committed within the walls of MMS.   How far down would the moral compass have to go before the significance of this is recognized?   This necessitates acknowledging the  problem exists, defining the problem and addressing it directly.

Zero-Tolerance for Forensic Fraud and Political Abuse of Psychiatry Necessary. Any and all forensic fraud should be met with Zero-tolerance. State PHPs are colluding  with commercial drug testing labs and “PHP-approved” assessment and treatment centers this same scaffold is being used in many states. Doctors are dying because of it.  State Physician Health Programs (PHPs) are organized under the Federation of State Physician Health Programs (FSPHP). The FSPHP arose from the American Society of Addiction Medicine and the history can be seen here.

Dr. Luis Sanchez is past President and Linda Bresnahan is the current Secretary.   The FSPHP does not represent doctors but the multibillion dollar drug and alcohol testing, assessment and treatment industry.  This will all come out in due time.   The states of North Carolina and Michigan have taken the lead in starting to expose this. Others will follow.   State Auditor Suzanne Bump is currently looking into a Massachusetts Audit of PHS.  But because of the scope and severity of the forensic and rehab fraud it is morally imperative that the MMS address this.   Those engaging in forensic fraud must be removed.  This needs to be done state by state and I am providing Massachusetts with documentary proof.of forensic fraud.  This is not isolated but systemic.  There are plenty of doctors of intellectual and moral integrity to take the place of those who do not. The criminal and ethical violations shown do not comport with any codes of conduct including those of the medical society.    It is paradoxical here that in my battle against PHS that I am the one supporting truth and fact,medical and  professional ethics, evidence-based medicine and physician rights.   It is I who am fighting for the preservation of and adherence to historical ideals and moral codes of the medical profession.   This is easily seen by looking at rhetoric versus actions and deeds. Those of Sanchez, Gavryck and Bresnahan are irreconcilable.  As the oldest medical society in the United States whose stated purpose is to “…do all things as may be necessary and appropriate to advance medical knowledge, to develop and maintain the highest professional and ethical standards of medical practice and health care, and to promote medical institutions formed on liberal principles for the health, benefit and welfare of citizens of the commonwealth” it is morally imperative that the  Massachusetts Medical Society address this urgently, directly and with full-measure.  Massachusetts needs to take the lead in exposing this national problem.

-Michael Langan, M..D.

Neuropsychological Misconduct –Making the Data fit the Diagnosis Part 2: Cognitive Impairment


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Doctored Wechsler IQ–Boilerplate subtraction of subsets -diagnsosis = cognitive impairment

In May 1999, Dr. G. Douglas Talbott stepped down as president of the American Society of Addiction Medicine (ASAM) down as a jury awarded  Dr. Leonard Masters a judgment of $1.3 million in actual damages and an undisclosed sum in punitive damages for malpractice, fraud, and false imprisonment.  The fraud finding required that the errors in the diagnosis were intentional.

The lawsuit apparently resulted in some changes in the evaluation process.  The errors were deemed intentional in the Masters case as the charts lacked sufficient data for the false diagnosis. Judging by what we see here they are generating intentionally erroneous tests to support an intentionally erroneous diagnosis.

In 2008 I went to Talbott Recovery Center in Atlanta for a 96-hour evaluation due to a positive urine test reported for a substance closely related to a medication I was prescribed.  Despite obtaining a letter from the pharmaceutical manufacturer stating that the drug found in my urine was, in fact, the parent compound of the drug I was prescribed and despite a negative forensic fingernail test  (done by USDTL) I was forced by Linda Bresnahan to have an “assessment.”

I arrived with 4500.00 which was about 500 dollars short for the evaluation. I had requested a forensic hair test  and did not realize they were so expensive.   The primary concern for most of the morning I arrived was when the remaining 500 dollars would arrive. In fact I was told that I would not be able to be admitted until I paid in full.

I had an appointment with an internist, Dr George MacNabb that he cancelled when he found out  I had not  yet paid in full. I have to admit that I, nor anybody I know at MGH, has refused care to a patient based on pre-payment.

The 96-hour assessment included the physical exam, neuropsychological and cognitive testing in addition to drug and alcohol testing by urine and hair.  After finding out my hair test and toxicology screens were negative and in light of my supporting negative nail tests and letter from the pharmaceutical manufacturer I was pretty confident I was good to go but ended up wishing they would have told me the hair test didn’t count before I paid the extra cash.

At the completion of the  96-hour assessment I was brought to their conference room and  told by Dr. Paul Earley and his his assessment team that I needed to stay for treatment.   “I don’t understand,” I said..”I have negative hair (3 months) and nails (6 months), an explanation for the positive test and have never had any problems at work.   I was then told that based on my neuropsychological and cognitive testing I was in denial and “cognitively impaired”  and that they could not advocate for my safely practicing medicine.

I was then taken to accounting to see how I would come up with the 18-25K for treatment. On the last page of my assessment report it states that “Dr Langan agreed with this assessment and recommendations and requested to return home to collect his funds to return for treatment at the Talbott Recovery Campus.”

It is well documented that Talbott will “keep you until the money runs out.”

I had given them a list of people to contact who could verify my work performance was excellent and there were no concerns from anyone including nurses, patients and students.  I asked why they had not contacted my Chief, nurse practitioner or any of my coworkers and was told they had enough information from the PHP Besides, one of them told me “they might cover for you so we can’t put much weight in their opinions.”

My first impression when I started reading the report was that it was another persons assessment given to me by mistake.  The neuropsychology report indicating “denial” I knew was wrong as I recognized the language reporting an elevated L-scale.  Thinking at the time it was an unintentional mistake I asked it be looked at as it was impossible. The L-scale or “Lie-scale” is a “validity” scale that picks up someone trying to portray himself in a positive light so you have to take the rest of the results with a grain of salt. It only works in unsophisticated naive individuals who answer blanket questions related to essentially good an bad behaviors or traits (such as “have you ever lied?”)  believing that is what the audience is looking for.   As a result,  only people bereft of enough common sense to understand that concrete blanket statements are implausible.

Dr. Snook wrote an interpretation of my L-scale as if it were positive ( > 65).  It was later confirmed to be 49 (as normal as normal can be on this) after obtaining the scoring sheet and raw data but even confronted with this he refused to correct it and only did so after the Georgia Psychological Association forced him to.  He engaged in intentional fraud at the request of PHS to show pathology where there is none and in terms of medical ethics there should be zero tolerance for this.  Zero!  Political abuse of psychiatry to give a false diagnosis for economic or political gain is antithetical to both medical and societal ethics.    It is unconscionable in light of all of the doctors who have killed themselves after being evaluated by these programs.

And although I can’t prove it, the  IQ test above was also doctored as I have taken it before and “comprehension” was my best score.   The computer shaves off points to lower comprehension and reasoning subscales and they give a diagnosis of “cognitive impairment.”    I subsequently took it in Boston two weeks later and went back up again!  I wonder what happened in Atlanta?   I could not disprove this one however as there is no raw data generated to prove whether I incorrectly interpreted a proverb or couldn’t tell him what I would do if I found a stamped envelope on the street.

Neuropsychological Misconduct –Making the Data fit the Diagnosis Part 1:  Denial

To further complicate matters, many evaluation/treatment centers are dependent on state PHP referrals for their financial viability. Because of this if, in its referral of a physician, the PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwise–tailor its diagnoses and recommendations in a way that will support the PHP’s impression of the physician.”  -John Knight and J. Wesley Boyd.  in “Ethical and Managerial Considerations Regarding State Physician Health Programs,”  Journal of Addiction Medicine  2012


Dr. Stephen Snook, PhD

Confirmatory Distortion

“Confirmatory distortion” is the process by which an evaluator, motivated by the desire to bolster a favored hypothesis, intentionally engages in selective reporting or skewed interpretations of data thereby producing a distorted picture. It is an “indisputable conscious endeavor to find and report information that is supportive of one’s favored hypothesis.10

In other words it is a conscious decision and not an unconscious bias..

I requested Talbot and Dr. Snook address the fraud and rewrite the interpretation and recommendations.  I then complained to PHS not knowing at the time that they were the ones who requested it.  The requests were ignored.

I then filed a complaint with the Georgia Psychological Association. They confirmed the fraud and forced Dr. Snook to correct the test. Below is his apology. An apology received only because his back was to the wall. “Profound apologies”–Give me a break.  There would not be one if the Georgia Psychological Association did not force him to.

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I have since spoken to a couple dozen doctors who have the same template on their evaluations.   An elevated L-scale would be unusual in any doctor even if he were an alcoholic or addict. It is only the very naïve and unsophisticated who would think they can show themselves in a positive light by answering questions of obvious attempt such as “I never lie.” And if a class action lawsuit comes about this is one of the items that could be used to prove the systemic fraud. Obtain the score sheets from the facilities on anyone with this same interpretation and it will most likely show fabrication in the same manner.

Next up is the cognitive impairment piece.  Just like the MMPI they manipulate the IQ tests to show cognitive impairment by shaving off points in the executive function subcategories.

Snook is one cog in this system of fraud. He and others like him should have their licenses revoked permanently. There is no excuse. How many careers have ended because of his contribution to this scam? How many have died?

As always with my posts, if he cares to contest it and can disprove the fraud I’ll take the post down. As with all the others they can’t. If they could’ve they would’ve.

And this is the reason I was targeted by Linda Bresnahan.  Upset that I got one of their own in trouble she threatened retribution.   “You won’t be a doctor in five years” she said.   “Dead, relapsed or in jail  I don’t care.”  “Dead?” I said.

“Either that or you’ll wish you were”.   And when Drs. John Knight  and J. Wesley Boyd were removed from PHS and were no longer there to protect me she made good on her threat.  She and Luis Sanchez fabricated an alcohol test in retribution for calling out one of their own.

Backfire Step 1: Expose the Injustice–Forensic Fraud being committed by PHPs in Collusion with Corrupt Labs

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I will be putting up a survey shortly and want to hear your stories.  One of the recurrent themes I keep hearing from those victimized by PHPs is falsified drug and alcohol tests.   Attached is an example of what they are capable of.

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Quote by Dr. Greg Skipper, MD, FASAM, FSPHP

Remember, this group has essentially removed themselves from accountability in drug and alcohol testing via the use of Laboratory Developed Tests (LDTs), a loophole which avoids FDA approval and oversight.   Whereas most drug testing is transparent and held accountable, the PHPs use testing that is opaque, unregulated and accountable to no one.  Accountability demands both the provision of information and justification for ones actions. PHPs block both.  While most drug-testing requires the immediate provision of information if the test is questioned (as it should be), PHPs have put forth the logical fallacy that doctors have some sort of inherent expertise in toxicology and pharmacology and can “figure out” how to circumvent the testing process if they were to get copies of their lab results.  They block this provision of information.  And even if this information is ultimately provided, as seen below,  no outside organizations exist to hold them to account.  They do not have to justify their actions to anyone.  No safeguards exist to assure integrity and honesty of the sample.   No safeguards exist to assure the integrity and honesty of those ordering the sample either.

The documents below show forensic fraud.  This is undeniable and indefensible. It does not take a toxicologist or Medical Review Officer to understand what “chain-of-custody” is and that “updating” one constitutes misconduct, fraud and (as seen here) criminal activity.   These documents were obtained 5 months after a falsified test was ordered by Linda Bresnahan, Director of Operations at Physician Health Services, Inc. (PHS, inc.) the Massachusetts PHP via fax no less.  The blood test was drawn on July 1, 2011.  On July 19th, 2011 Ms Bresnahan requests (through the PHP secretary Mary Howard) that an already positive test for the alcohol biomarker phosphatidylethanol be “updated” with  ID # 1310 and a “chain-of-custody. (which is an oxymoron-a “chain-of-custody” by definition cannot be “updated.”  Unveleivably the lab does it without hesitation or any apparent compunction.   The documents speak for themselves.  ID # 1310 just happens to be my ID number.  When I complained that no one ever accused me of ever having an alcohol problem she replied:

“You have an Irish last name-good luck finding anyone who will believe you!” 

For a more detailed analysis see here, here and here.  And where was the Medical Review Officer during all of this?  Good question and one he will not answer!  And no one else is holding him to account.   This needs to change.

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1. Supression of Dissent: Basic Information

2. The keys to backfire

• “Reveal: expose the injustice, challenge cover-up

• Redeem: validate the target, challenge devaluation

• Reframe: emphasize the injustice, counter reinterpretation

• Redirect: mobilize support, be wary of official channels• Resist: stand up to intimidation and bribery”

via Helpful resources for those abused and afraid — via .

When Dentists Go Too Far: North Carolina Board of Dental Examiners v. Federal Trade Commission

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The recent strike down of anticompetitive regulation in N.C. dental case opens the door to antitrust litigation against other state Regulatory Agencies such as Medical Boards.

The Federation of State Physician Health Programs has set up a “hidden” system of coercion and control using various methods (policy and moral entrepreneurship, changes in state medical practice acts and administrative procedure, misuse of health law, etc.) to create a system that lacks oversight and regulation. As a power unto themselves they are accountable to no one.

Although originally funded by medical societies and staffed by volunteer doctors in order to help sick colleagues and protect the public, any system can be subverted for profit and power, and these programs have been taken over by groups representing the multi-billion dollar drug and alcohol testing, assessment and treatment industry and become reservoirs of bad medicine and fraud. All manner of abuse can be hidden under a veil of benevolence. Although most are afraid to speak publicly under fear of punishment and retaliation (“swift and certain” consequences, summary suspension) I have herd from many many doctors in multiple states. Their stories are all the same.

In addition to misconduct related to the non-FDA laboratory developed tests (they themselves introduced into the market using a loophole that bypasses FDA approval) there are reports of coercion into unneeded evaluation and treatment at a couple dozen or so “PHP-approved” facilities under threat of loss of licensure.

Reports to a state PHP can be done anonymously with confidentiality guaranteed to the reporter. Any report will result in a meeting with the state PHP and if they feel a licensee is in need of an assessment they require it be done at a “PHP-approved” assessment center.

As non-profit tax exempt corporations, PHPs do not provide clinical assessments. They can only recommend assessments.  State Regulatory Agencies (Medical Boards, Nursing Boards, etc.) have accepted the PHPs requirements of limiting assessments to those approved by the PHP.   In fact many states mandate assessments to solely  “PHP-approved” assessment centers under threat of summary suspension of a professional license.

An Audit of the North Carolina PHP by State Auditor Beth Woods, however,  found financial conflicts-of-interest in the use of these predominantly out-of-state assessment facilities to which the N.C. PHP was referring and the state Medical Board was requiring.  Woods requested the qualitative indicators and quantitative measures used to  “approve” these assessment centers from the N.C. PHP but they were unable to produce any documentation showing any quality indicators or objective criteria existed!  The best response they could come up with was “informal” methods and “reputation.” The full audit can be seen here.

Imagine if the FDA gave this reply if  asked to provide the criteria used to “approve” medications or medical devices in the “FDA-approval” process!

Making matters even worse, the Medical Director of the N.C. PHP, Dr. Warren Pendergast was serving as President of their national organization, the FSPHP at the time of the audit.

The simple fact is no criteria exist.

A recent class action lawsuit in Eastern Michigan found this same pattern of referral to out-of-state assessment and treatment centers ( Marworth, Talbott, Hazelden. Promises,etc.)

State referrals to “PHP-approved” facilities has become a matter of public policy. Both the American Society of Addiction Medicine and the Federation of State Medical Boards have issued public policy statements stating that only “PHP-approved” centers be utilized by Regulatory Agencies in the assessment and treatment of their licensees.  Moreover, these policies specifically exclude “non-PHP-approved facilities and often involve a limited time-frame.  No choice, no appeal and no bartering.  Do it. Do it now and if you don’t suffer the consequences.

These public policy statements can be seen in the 2011 ASAM “Public Policy Statement on Coordination between Treatment Providers, Professionals Health Programs and Regulatory Agencies” and the 2011 FSMB “updated Policy on Physician Impairment.”  Many state Regulatory Agencies have strictly adhered to these policy recommendations.

What this means is that  states are mandating evaluations at  “PHP-approved” facilities even though there is no documentable or plausible reason for doing so.  No measurable criteria exist as to how the list of “approved” facilities were “approved” yet they have “cornered the market,” removed choice and created an imposed monopoly under threat of loss of professional licensure.

In reality no official “PHP-approved” list exists.  Neither does any objective published criteria for approving them.  At the same time state Regulatory Agencies and Boards are forcing evaluations on licensed professionals at these couple-dozen or so facilities.  They are excluding patient autonomy and choice violating the fundamental freedoms of the individual and informed consent.

All semblance of due process has been removed.  If  a plausible reason existed (i.e. they met some minimum standard of credentialing, quality or patient outcome) for referring to a proscribed list of assessment centers it could be arguably justified.  Without such criteria, and in light of the economic and ideological conflicts of interest involved, it is patently unjustifiable.

Even more disturbing is, as Drs. John Knight and J. Wesley Boyd (who collectively have more than 20 years experience as Associate Directors at the Massachusetts PHP, PHS, Inc.) pointed out in their 2012 paper published in the Journal of the American Society of Addiction Medicine,  many of these facilities are willing to “tailor” the diagnosis and recommendations of an evaluation to fit the wishes of the PHP.    “Tailoring” an assessment and recommendations to anything other than what the true data show is healthcare fraud.  It is, in fact,  the political abuse of psychiatry.

PHPs started out as “Physicians Health Programs” but many are transitioning to “Professionals Health Programs”  to widen the net.  For example in Michigan  and Florida the state PHP covers all health care practitioners from Acupuncturists to Veterinarians. PHPs have also entered non -healthcare employee assistance programs (EAPs) such as the aviation industry and the grand plan is expansion to  non-healthcare professions. They are doing this by claiming remarkable success rates and brandishing themselves as the “gold-standard” of substance abuse treatment.   Interestingly, the same individuals claiming how successful PHP programs are are the same individuals profiting from the drug and alcohol testing they introduced.  Anyone with any sort of license is at risk.

So whether you cut hair, teach, take care of patients or even drive a car they could be coming after you next and they don’t have to convince you of the validity and reliability of their services–they only need to convince those who regulate your license and, as we have seen, they are very accomplished at persuasion in this department.

And that is why we need more state audits of PHPs and Medical Boards.  The starting point is simple. Request from the state PHP and Board  a  list of “PHP-approved” facilities and the criteria by which they were approved. What should be a simple reply will undoubtedly not be as they will not be able to provide either.

Article 8

Antitrust litigation hasn’t disappeared, but rather changed its focus. Instead of targeting the great railroad empires of the late 19th century, today’s antitrust efforts focus on more minute industries, like dentistry.

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An Open Letter to Senator Elizabeth Warren Regarding Laboratory Developed Tests, Physician Health Programs and Institutional Injustice

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—There is no place in science for consensus or opinion, only evidence.-Claude Bernard

Dear Senator Warren,

Thank you for your reply regarding laboratory developed tests (LDTs) and the need for regulatory oversight.   As you mention, LDTs are developed without FDA approval—a pathway in which is not even necessary to prove validity of a test (that it is actually testing what it claims to be testing for) to bring it to market. With no FDA oversight or regulation a commercial lab can claim any validity they want in marketing these tests. The regulation debate has focused on the reliability and validity of a number of clinical tests marketed with unverified claims of accuracy such as prenatal screening and Lyme disease and this lack of oversight is a direct threat to patient safety.

I am sure you would agree with me that the importance of tests diagnostic accuracy is directly proportional to that tests potential to cause patient harm if reported inaccurately.

Sensitivity and specificity are important components of any diagnostic test because there are consequences associated with both false-positive and false negative results.

A test falsely indicating the absence of a condition in someone who truly has it can delay or prevent needed treatment wile a test falsely indicating the presence of a condition in someone who does not truly have it can result in unnecessary testing and treatment.

Incorrect treatment and false labeling of patients can also occur. Therefore diagnostic accuracy is paramount if a test is being used as the basis for further tests and treatment. Any test being used as a basis for further tests or treatment needs to be accurate. It needs to be reliable and valid. Moreover, if the consequences of a test can result in significant patient harm (such as unneeded chemotherapy) it needs to be either 100% accurate or be combined with other tests to confirm the true diagnosis.

 “Forensic” vs. “Clinical” Laboratory Testing

“Forensic” testing differs from “clinical” testing because of the consequences and the process is tightly controlled because false-positive results are unacceptable as the consequences can be grave, far-reaching and even permanent.

Forensic testing demands special handling and safeguards to protect the donor such as validated tests, certified labs, strict chain-of-custody procedures and MRO (Medical Review Officer) review. These safeguards of quality control assure the validity and integrity of the specimen.   The LDT pathway was not designed for forensic tests.

Forensic Laboratory Developed Tests (LDTs)

 Paradoxically, laboratory developed tests with the potential to cause  life-changing and possibly irreparable harm have been absent from the regulatory debate; LDT drug and alcohol tests used for “forensic” monitoring purposes.

A panoply of tests using urine, blood, hair, fingernails breath and saliva have been developed and brought to market since 2003 when the first one was introduced by Gregory Skipper, then Medical Director of the Alabama Physicians Health Program, who “convinced the initial lab in the USA, NMS near Philadelphia to start performing EtG testing.” 1

Developed as an LDT, Skipper and NMS then claimed the alcohol biomarker (which was discovered in the 1950s) “appeared to be 100 percent specific” in detecting covert use of alcohol based on a study he coauthored that involved a mere 35 forensic psychiatric inpatients in Germany, all male. 2   With this “evidence-base” and a not yet published paper in the pipeline,3   Skipper then pitched the test to the Federation of State Medical Boards (FSMB) as an accurate and reliable tool detect covert alcohol use in health care professionals.

Policy Entrepreneurship

In  “Agendas, Alternatives, and Public Policies,”4 John W. Kingdon describes the problem, policy and political streams involved in public policy making.   When these three streams come together a specific problem becomes important on the agenda, policies matching the problem get attention, and then policy change becomes possible.

Kingdon also describes “policy entrepreneurs’ who use their knowledge of the process to further their own policy ends. They ‘lie in wait… with their solutions at hand, waiting for problems to float by to which they can attach their solutions, waiting for a development in the political stream they can use to their advantage.”4

And due to a perfect confluence of streams ( Institute of Medicine report that 44,000 people die each year due to medical error,5 media reports of “impaired physicians,”  the the war-on-drugs, etc.)  the FSMB was swayed into accepting not just the validity but the necessity of using an alcohol biomarker of unknown reliability and validity on doctors referred to or monitored by state Physician Health Programs (PHPs) .

As the national organization that gives guidance to state medical boards through public policy development and recommendations, the individual state medical boards adopted use of the test without critical appraisal and no meaningful opposition.

Shortly after its founding in 1912, the FSMB began publishing a  journal called the Quarterly of the Federation of State Boards of the United States. Now known as the Journal of Medical Regulation, the publication has archived all issues with full articles dating back to 1967 and, as the official journal of the national organization involved in  medical licensing and regulation this facilitates an unskewed and impartial examination of how and when specific issues and problems were presented and who presented them and, in doing so, the “policy entrepreneurship” Kingdon describes can be seen quite clearly. For example a 1995 issue containing articles written by the program directors of PHPs in 8 different states contains an FSMB editorial acknowledging the reported 90% success rate claimed of these programs (in part attributed to the 90-day inpatient treatment programs) that concludes:

“Cooperation and communication between the medical boards and the physician health programs must occur in an effort to protect the public while assisting impaired physicians in their recovery.” 6

No one bothered to examine the methodology of these reports to discern the validity of the claims and it is this acceptance of faith without objective assessment that has allowed the passage of flawed public policy in medical regulation.

Nowhere  is “policy entrepreneurship” more glaringly displayed as it is in a 2004 issue promoting the use of EtG in monitoring doctors as under the same cover is an article identifying both the need7 for such a test and an article providing the solution.8  

“Detection of Alcohol Use in Monitored Aftercare Programs: A National Survey of State Physician Health Programs,” a survey of state Physician Health Programs (PHPs) concludes that “surreptitious alcohol use” is a significant concern” for PHPs, there is no current  “best method” for detection,  but a promising new test  with “exceptional specificity (100 percent) and sensitivity” in detecting small amounts of alcohol for up to 18 hours has recently become available.7

This same issue contains an article authored by Skipper about a new marker “not detectable unless alcohol has been consumed” recently introduced in the United States and now commercially available.”8

Notably absent from both of these articles is Skipper’s role in the commercial availability of the test. This conflict-of-interest is nowhere mentioned in this display of “creating a market then filling it.”

This “regulatory sanctification” of the test implied its tacit approval by the medical profession  (i.e. “if they are using it on doctors it must be valid”) and facilitated its marketing  to other monitoring agencies (nurses, airline pilots) as well as  Courts and Probation Departments where those doing the monitoring had absolute power while those being monitored had no voice.

Bent Science

In Bending Science: How Special Interests Corrupt Public Health Research9, Thomas McGarity and Wendy Wagner describe how special interest groups scheme to advance their own economic or ideological goals by using carefully crafted distorted or “bent” science to influence legal, regulatory and public health policy.  The authors describe how those making these decisions often assume the information that reaches them has been sufficiently vetted by the scientific community as it flows through a pipeline of rigorous peer-review and professional oversight and that the final product that exits the pipeline is unbiased and produced in accordance with the norms and procedures of science.

McGarity and Wagner note the serious and sometimes horrific consequences of bent science and provide examples involving Tobacco and Big Pharma . The authors call for:

“..immediate action to reduce the role that bent science plays in regulatory and judicial decision making” and the need for the scientific community to be involved in “designing and implementing reform.”

“Shedding even a little light on how advocates bend policy -relevant science could go a long way toward remedying these problems.  Indeed, precisely because the advocates have overtaken the law in this area, heightened attention to the social costs of bending science could itself precipitate significant change.”

In the case of EtG this shedding of light is not very hard as no “carefully crafted” studies bending science were used to sway opinion.   None existed. The only items in the pipeline were directly related to Skipper.  If anyone dare to look, the Emperor has no clothes.

Lack of Answerability and Accountability

There are difficulties in challenging bent science including a general lack of recognition of the problem and an absence of counter-studies to oppose deliberately manufactured ends-oriented research.   This has proven true with the myriad LDTs introduced into the marketplace as no counter-forces or competing economic interests producing counter-studies exist.

Multiple lawsuits, including a class-action, have been decided in favor of the labs who have taken a stand-your-ground approach supported by a body of industry-related “research” they or their affiliates produced to support the validity and reliability of the tests.

Those affected by these tests either have no power or have had their power removed. Most do not have the resources to mount a defense let alone produce counter-studies questioning the reliability and validity of the tests.

Most employee drug testing follows Department of Health and Human Services (DHHS) guidelines using FDA-approved tests that have specific cutoff levels defining a positive-result in an effort to eliminate false-positive results.10  Procedural safeguards are in place in these programs to protect the donor.  Forensic testing programs using LDTs provide no such safeguards as the testing is unregulated and there is no oversight from outside actors.

Unlike clinical LDTs “forensic” LDTs are even exempt from CLIA oversight.   The only avenue for complaint is through the College of American Pathologists (CAP) and, as an accrediting agency, they can only address problems by ensuring compliance with CAP guidelines.   If an investigation concludes lab error or misconduct CAP can mandate the lab correct the test result and come into compliance with their guidelines under threat of loss of accreditation but no other consequences exist.  Accountability has been removed yet the  consequences to those harmed by these are significant and without remedy.

State Physician Health Programs

As is the case with the LDTs  they introduced, Physician Health Programs have no oversight or regulation.   A 2013 Audit of the North Carolina PHP 11 prompted by complaints from doctors and performed by State Auditor Beth Woods found absolutely no oversight of the program by either the state medical board or medical society and that “abuse could occur without being detected.”

The Audit also found that doctors were predominantly referred to the same “PHP-approved” out-of-state facilities to which they in part attribute their high success rates in treatment. Interestingly the PHP could not identify what quality indicators or quantitative measurements were used by the PHP to “approve” the “PHP-approved” facilities.

In January of 2015 a Federal class action lawsuit was filed in the Eastern District of Michigan against the state PHP program and found health care providers were subject to the same referral system using these out-of-state facilities. The suit alleges constitutional violations related to the forced medical treatment of health care professionals and the “callous and reckless termination of professional licenses without due process.” 12

As with North Carolina, the Michigan PHP will be unable to provide what quality indicators and quantitative measurements are being used to “qualify” and “approve these facilities.    None exist. The sole indicators for approving these assessment centers are ideological and economic. In fact, the medical directors of most, if not all, of these facilities can be seen on this list of “like-minded docs.” 

Institutional Injustice

You once said “People feel like the system is rigged against them. And here’s the painful part: they’re right. The system is rigged.”

So too is this system.

As the Michigan lawsuit notes: “Unfortunately, a once well-meaning program has turned into a highly punitive and involuntary program where health professionals are forced into extensive and unnecessary substance abuse/dependence treatment under the threat of the arbitrary application of pre-hearing deprivations.”

This has become the rule not the exception. The Federation of State Physician Health Programs (FSPHP), the same group to which Dr. Skipper belongs, has systematically taken over these programs state by state by removing competent and caring doctors not agreeing with the groupthink and silenced them under threat of litigation if they violate their confidentiality agreements and “peer review” statutes.

The same system of coercion, control and abuse exists in Massachusetts.  In the past week alone I have heard from a medical student, a resident and two doctors who complained of misconduct  misconduct involving fraudulent testing and falsified diagnoses.

In “Ethical and Managerial Considerations Regarding State Physician Health Programs,” published in the Journal of Addiction Medicine in 2012, Drs. John Knight, M.D. and J. Wesley Boyd, M.D., PhD who collectively have more than 20 years experience with the Massachusetts Physician Health Program (PHP) state that:

“Because PHP practices are unknown to most physicians before becoming a client of the PHP, many PHPs operate out- side the scrutiny of the medical community at large. Physicians referred to PHPs are often compromised to some degree, have very little power, and are, therefore, not in a position to voice what might be legitimate objections to a PHP’s practices.”13

Noting that “for most physicians, participation in a PHP evaluation is coercive, and once a PHP recommends monitoring, physicians have little choice but to cooperate with any and all recommendations if they wish to continue practicing medicine,” Knight and Boyd raise serious ethical and managerial questions about current PHP policies and practice including conflicts of interest in referrals for evaluation and treatment, lack of adherence to standards of care for forensic testing of substances of abuse, violations of ethical guidelines in PHP research, and conflicts of interest with state licensing boards.

Knight and Boyd recommend “the broader medical community begin to reassess PHP’s as a whole” and that “consideration be given toward the implementation of independent ethical oversight and establish and appeals process for PHP clients who feel they are being treated unfairly.” 13

They recommend the relationship between PHP’s and the evaluation and treatment centers and licensing boards be transparent and that national standards be developed “that can be debated by all physicians, not just those who work within PHPs.”13

Accountability, or answerability, is necessary to prevent corruption.  This requires both the provision of information and justification for actions.    What was done and why? Accountability also requires that consequences be imposed on those who engage in misconduct.

In discussing the financial conflicts-of-interest between PHPs and “PHP-approved” assessment centers Knight and Boyd state:

“..if a PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwisetailor its diagnosis and recommendations in a way that will support the PHP’s impression of that physician.”  

To “consciously tailor a diagnosis” is fraud. It is political abuse of psychiatry. And it is not only the assessment and treatment centers willing to “tailor” a diagnosis; so too are the labs involved.

Physician Suicide

I can think of nothing more institutionally unjust than an unregulated zero-tolerance monitoring program with no oversight using unregulated drug and alcohol testing of unknown validity.   But that is what is occurring.   Some of us are trying to expose this corrupt system but barriers exist. As with the Laboratory Developed Tests (LDTs), those involved have intentionally taken steps to remove both answerability and accountability.  Both the tests and the body of individuals administering these tests are notable for their lack of transparency, oversight and regulation.  This renders them a power unto themselves.

Doctors (and others coerced into Professional Health Programs) across the country have reported going to law enforcement and state agencies only to be turned away.   The Federation of State Physician Health Programs (FSPHP)  has convinced these outside agencies that this is a “parochial” issue best handled by the medical profession..   Those reporting crimes are turned back over to the very people committing the crimes.

The Massachusetts Medical Society and Massachusetts DPH claim no oversight of the Massachusetts PHP, The Massachusetts Board of Registration in Medicine (BORM) will not address ethical or even criminal complaints about the doctors involved in the PHP and there is good evidence that some members of the BORM are in fact complicit in unethical and even criminal behavior. As the Massachusetts AGO represents the BORM they defer issues back to them and dig no deeper.

Drs. Knight and Boyd have suggested State Audits and we are hoping that MA State Auditor Suzanne Bump will investigate the MA PHP and the Board of Registration in Medicine’s Physician Health and Compliance Unit shortly.

One major problem is that barriers have been put in place to prevent information from getting to the right people.

The majority of people at medical societies, boards, departments of public health and other organizations are individuals of integrity and honesty but the system has been erected so that valid complaints are deflected, delayed, dismissed or otherwise tabled by sympathizers, apologists and those complicity.   The criminal activity the Massachusetts PHP is engaging in is undeniable and indefensible but who is going to hold them to account?

It is going to take a while to reform this system of institutional abuse and it has to be done state by state. Please take a look at the facts and documentary evidence and help me hold them accountable. This needs to be exposed, acknowledged and addressed.   Doctors are dying from this system of institutional abuse. It is a public health emergency no one is talking about.  Yet those behind the PHP programs are claiming this system of coercion, abuse and control is the “gold standard” of addiction treatment and, using another loophole, they want to expand this system to mainstream healthcare.


Michael L. Langan, M.D.

  1. Skipper G. Exploring the Reliability, Frequency, and Methods of Drug Testing: What is Enough to Ensure Compliance?:   Alcohol Markers and Devices. 2013;, Exploring the Reliability Frequency and Methods 2 Presentation.pdf.
  2. Wurst FM, Vogel R, Jachau K, et al. Ethyl glucuronide discloses recent covert alcohol use not detected by standard testing in forensic psychiatric inpatients. Alcoholism, clinical and experimental research. Mar 2003;27(3):471-476.
  3. Skipper GE, Weinmann W, Thierauf A, et al. Ethyl glucuronide: a biomarker to identify alcohol use by health professionals recovering from substance use disorders. Alcohol Alcohol. Sep-Oct 2004;39(5):445-449.
  4. Kingdon JW. Agendas, alternatives, and public policies. Updated 2nd ed. Boston: Longman; 2011.
  5. Leape LL. Institute of Medicine medical error figures are not exaggerated. JAMA : the journal of the American Medical Association. Jul 5 2000;284(1):95-97.
  6. Schneidman B. The Philosophy of Rehabilitation for Impaired Physicians. The Federal Bulletin: The Journal of Medical Licensure and Discipline. 1995;82(3):125-127.
  7. Jansen M, Bell LB, Sucher MA, Stoehr JD. Detection of Alcohol Use in Monitored Aftercare Programs: A National Survey of State Physician Health Programs. Journal of Medical Licensure and Discipline. 2004;90(2):8-13
  8. Skipper G, Weinmann W, Wurst F. Ethylglucuronide (EtG): A New Marker to Detect Alcohol Use in Recovering Physicians. Journal of Medical Licensure and Discipline. 2004;90(2):14-17.
  9. McGarity TO, Wagner WE. Bending Science: How Special Interests Corrupt Public Health Research. Cambridge, MA: Harvard University Press; 2008.
  10. US Department of Health and Human Services. Mandatory guidelines and proposed revisions to mandatory guidelines for federal workplace drug testing programs: notices. Federal Register. April 13, 2004;69(71):19659-19660.
  11. Wood B. State of North Carolina Performance Audit North Carolina Physicians Health Program. . Accessed March 17, 2015.
  12. U.S. District Court Eastern District of Michigan, Case No: 2:15-cv-10337-AJT-RSW (2015). Carole Lucas, R.N., Tara Vialpandno, R.N., Scott Sanders, R.N., Kelly Schultz, P.A., and all other similarly situated health professionals v. Michigan Department of Licensing and Regulatory Affairs, Carole Engel, J.D.Former Director of Michigan Bureau of Health Professions, Ulliance, Inc. (State Contractor), Carolyn Batchelor (HPRP Contract Administrator), Stephen Batchelor (HPRP Contract Administrator), and Nikki Jones, LMSW.   Filed January 30, 2015.
  13. Boyd JW, Knight JR. Ethical and managerial considerations regarding state physician health programs. Journal of addiction medicine. Dec 2012;6(4):243-246.

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Helpful resources for those abused and afraid — via 

www-bmartin-cc-pubs-bf-bfbasics-pdf-51. Supression of Dissent: Basic Information

2. The keys to backfire

• “Reveal: expose the injustice, challenge cover-up

• Redeem: validate the target, challenge devaluation

• Reframe: emphasize the injustice, counter reinterpretation

• Redirect: mobilize support, be wary of official channels• Resist: stand up to intimidation and bribery”

via Helpful resources for those abused and afraid — via .

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Letters From Those Abused and Afraid



Letters From Those Abused and Afraid.

Please sign Petition.

I get many e-mails, letters and phone calls from doctors, nurses and others who have been abused by  “professional health programs” (PHPs).  Most do not want their letters published for fear of being identified and punished by the PHP.   They are reluctant to do so even with their names and states removed as they feel their complaints alone could reveal their identity to they prying eyes of the PHP.   A few have allowed their letters to be posted and I am doing so here:    Letters From Those Abused and Afraid

I am posting Dr. Roop’s  letter below at his request.  He specifically stated his name and contact information be included. I applaud his courage.   As was the case with the Inquisition, this is system  that relies, above all else,  on secrecy and silence.

Effective “Impression management” requires both promoting positive information and suppressing negative information.

The “PHP-blueprint” has been effectively propagandized via a back-slapping parade of congratulatory misinformation; a promotional campaign that includes exaggeration of the existence and dangers of the doctors they target as well as their inflated abilities and success in “helping” these doctors and protecting the public.   Aimed at the legal, regulatory, and administrative arenas of medicine as well as the the general public, the PHP moral crusade has flourished without any meaningful opposition.

 Suppression of negative information is necessary and  involves both removal  ( comments critical of PHPs are rapidly removed as spam) and prevention.   One way of preventing negative information is by silencing critics.  Those enrolled in PHP programs who speak out often suffer “swift and certain consequences” and this effectively silences the rest.

 In reality  If more people like Dr. Roop spoke up this abusive system of coercion, control and corruption could easily be identified, exposed and reformed.

Sunshine is the best disinfectant.

The stories are the same and these patterns must be recognized.

Doctors  are vulnerable to medical abuse, just like any other patient.  Their knowledge of medicine and the medical system, means that they question, as they should, the validity and appropriateness of any treatment.   It has long been proven that patients that question their doctor’s decisions and the quality of the care provided to them, fare better and have better outcomes and are less subject to medical error or medical fraud.

The Physicians Health Program is based on a flawed philosophy that Doctors must be beaten down, forced to be submissive and obedient to PHP authority who intimidate and control, deny access to services, impose punishments, and even create criminal records with impunity and immunity.

This not quality care for anyone. It is abuse.  The PHP paradigm is just another  example of how false constructs come to to be regarded as irrefutable truth.

Once in the clutches of a  PHP a doctor is told – obey us, or lose your license, your hospital privileges, your credit rating, your good reputation – obey us no matter what we tell you to do.

 If you stand up to them, they take you down, very publicly and humiliate you, and destroy your career and good name.  Then no other doctor who saw the retaliation that happened to you is willing to buck the PHP system.  It is essentially extortion.

Dr. Janet Parker, a a human rights and disability advocate has  personal knowledge of doctors forced into the Washington PHP program Dr. Roop speaks of below.

These doctors told her that they had a plan to kill themselves if a PHP  “peer counselor” came anywhere near them –  they meant it.

3 doctors in the Washington PHP did commit suicide during the period of time when she was interviewing the WPHP referred doctors.   Last year a doctor I went to high school with and have known since childhood hanged himself due to the abuses of the Washington PHP.  HIs crime?  He was pulled over for speeding five years prior after having a few drinks at a social function.  He was given a breathalyzer and blew just over the legal limit–his entry ticket into the system Dr. Roop describes below.   As is often the case, he was given a positive alcohol biomarker just as he was about to complete the five-year PHP contract  This results in re-assessment at a “PHP-approved” facility, a new contract with the PHP and another five-years of drug and alcohol testing  all paid for out of-pocket.

And this is a national problem–three doctors being monitored by the Oklahoma state PHP killed themselves during a one month period (August 2014).

There is no evidential standard used and false accusations and even forged documents are routinely used against the targeted doctor.   Physicians are ill prepared for such criminal tactics used against them,  by the time they realize it is happening, it is too late to stop the inevitable process that threatens their medical license.  This is very emotionally traumatic to doctors who have always excelled in their schooling, worked hard to get where they are, and are facing the loss of not only their professional careers but also financial security, their self esteem and self concept.

Name: Jonathan Crane Roop MD


Comment: I am Board Certified in Internal medicine. I have endured years of emotional, psychological and spiritual abuse at the hands of the Washington Physician’s Health Program. I have suffered through a long list of injustices without recourse. They include, but are not limited to discrimination, abuse of power, breach of contract and repeated and WILLFUL medical negligence. 

Because the actions of the WPHP have been SO egregious, I assumed what was happening to me must be extraordinarily rare.

I have nothing to hide. And I have shared my story with any and all who would listen. To date, my voice, my rights and now my life have been dismissed as unimportant. MY LIFE!! It’s apparently better that I die than my tormentors be questioned and compelled to defend their indefensible and evil behavior. 

I am meeting with one last attorney tomorrow. I fully expect him to ignore the basic, indisputable and well documented facts of my case. Namely, there is massive and systematic malfeasance being committed by a tax payer funded agency in the State of Washington who act with omnipotence and without oversight. I have no reason to believe he will respond any differently than the others with whom I have met. HE WON’T CARE! HE WILL NOT BE MOVED. He will make statements that suggest I DESERVE this treatment. And that my life, as well as my imminent death, is unworthy of his time or efforts.

Once my assumptions about this last meeting are officially confirmed, I am committed to the only course of action available to me. The only thing which will put an end to this nightmare.

Today I stumbled upon your website. And today, for the first time, I have learned that my case is not rare. I suspect the other physician victims in this matter have occasionally allowed themselves to dream wistfully of justice. Justice which they have seen thwarted at every turn. Perhaps they, like me, have dreamily imagined the relief and joy and LIFE they would experience if the truth were simply presented and the perpetrators held accountable. I have imagined standing up in court and triumphantly affecting justice for myself as well as all of the other current and future victims. I deliver a powerful defense of justice. My ‘dream speech’. I have imagined that I might still live. And then I wake up. 

And so today, imagine my shock, when I found my ‘dream speech’ here. My speech. Reasonable. Honest. Consistent. And based firmly in truth, justice and defense of the powerless against the (arbitrarily) powerful. My speech, it seemed, but authored by another.

Thank you, Dr. Langan.  You have given a voice to my struggles. Please never stop speaking for me, and people like me, many of whom, I fear, will not survive to see justice. 

Despite my intention to die, I actually WANT TO LIVE! And I will live and fight on if I ever believe that there is even a small chance of justice for me and the other innocent victims of PHP’s and the ‘treatment’ centers with whom they contract (Talbott in my case. Purely evil and loathsome human beings, for the record).

So, because I do WANT to live…PLEASE HELP ME, SIR!

Can you refer me to attorneys, individuals or groups who might advocate for me and the other victims? Do you have any specific words of hope or encouragement?

Please note my name. Please add me to the list of innocent victims of these power hungry, narcissistic BULLIES.

I don’t expect to live through this. And in a way, the PHP, Talbott and the addiction ‘experts’ with whom I have been tragically acquainted are correct…My life is worth very little. But this issue is so much larger than I. I can die with some serenity if I believe there will be meaningful justice for others like me. And that those responsible will be held to account. 

Thank you Dr. Langan. Thanks to all of those involved in the creation and maintenance of this website. Although your shining beacon is barely perceivable through the darkness of injustice which surrounds and seeks to extinguish it…it is the only glimmer of hope I have found during my slow death by PHP.

Jonathan Crane Roop MD

811 S Cowley St #48

Spokane WA 99202