Massachusetts Board of Registration in Medicine Attorney Deb Stoller’s “Fraud Upon the Court”

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Fraud Upon the Court

“Fraud Upon the court” occurs when the judicial machinery itself has been tainted, such as when an attorney, who is an officer of the court, is involved in the perpetration of a fraud or makes material misrepresentations to the court. Fraud upon the court makes void the orders and judgments of that court.

Bulloch v. United States, 763 F.2d 1115, 1121 (10th Cir. 1985 states: “Fraud upon the court is fraud which is directed to the judicial machinery itself and is not fraud between the parties or fraudulent documents, false statements or perjury. … It is where the court or a member is corrupted or influenced or influence is attempted or where the judge has not performed his judicial function — thus where the impartial functions of the court have been directly corrupted.”

It has recently become evident that the  Director of the Board of Registration in Medicine’s Physician Health and Compliance Unit, attorney Deb Stoller,  has been unethically and unlawfully withholding and concealing documentary evidence that is not only exculpatory to  me but reveals that  Physician Health Services (PHS) engaged in misconduct and fraud.   She has essentially been concealing their crimes.

The “Administrative Record” filed by the Board was absent copious documentation of major importance and all of it was submitted through the care of Ms. Stoller.  The missing documents include multiple petitions and supporting documents that are neither irrelevant nor superfluous. Each of these documents contains sufficient indicia of reliability to meet probative value.Concealing material fact, misrepresentation and making false statements to a state administrative agency is unethical. It constitutes abuse of power and fraud.

Fraud on the court occurs where a party tampers with the fair administration of justice by deceiving “the institutions set up to protect and safeguard the public” or otherwise abusing or undermining the integrity of the judicial process. Hazel-Atlas Glass Co. v. Hartford-Empire Co., 322 U.S. 238, 246 (1944).

The United States Court of Appeals for the First Circuit skillfully defined the concept of fraud on the court in Aoude, supra at 1118, as follows: “A `fraud on the court’ occurs where it can be demonstrated, clearly and convincingly, that a party has sentiently set in motion some unconscionable scheme calculated to interfere with the judicial system’s ability impartially to adjudicate a matter by improperly influencing the trier or unfairly hampering the presentation of the opposing party’s claim or defense.”

 

Ms. Stoller is in violation of the Rules of Professional Conduct including Mass.R.Prof.C. 3.4(c). Fairness to Opposing Party and Counsel which states in part: A lawyer shall not: (c) knowingly disobey an obligation under the rules of a tribunal except for an open refusal based on an assertion that no valid obligation exists.

 

Mass.R.Prof.C Advocate Rule 3.3 Candor Toward The Tribunal reads:
(a)A lawyer shall not knowingly:
(1) make a false statement of fact or law to a tribunal or fail to correct a false statement of material fact or law previously made to the tribunal by the lawyer; (3) offer evidence that the lawyer knows to be false. If a lawyer, the lawyer’s client, or a witness called by the lawyer, has offered material evidence and the lawyer comes to know of its falsity, the lawyer shall take reasonable remedial measures, including, if necessary, disclosure to the tribunal. A lawyer may refuse to offer evidence, other than the testimony of a defendant in a criminal matter, that the lawyer reasonably believes is false; (b) A lawyer who represents a client in an adjudicative proceeding and who knows that a person intends to engage, is engaging or has engaged in criminal or fraudulent conduct related to the proceeding shall take reasonable remedial measures, including, if necessary, disclosure to the tribunal,; (c) The duties stated in paragraphs (a) and (b) continue to the conclusion of the proceeding, and apply even if compliance requires disclosure of information otherwise protected by Rule 1.6.

 

And under Mass.R.Prof.C. 8.4(c, d, h. It is professional misconduct for a lawyer to: (c) engage in conduct involving dishonesty, fraud, deceit, or misrepresentation; (d) engage in conduct that is prejudicial to the administration of justice; (h) engage in any other conduct that adversely reflects on his or her fitness to practice law.

The Supreme Judicial Court (SJC) reviews the Board’s decisions in part for constitutional error, see Mass.Gen.L. ch. 30A, Sec. 14(7), and is permitted to gather evidence “in cases of alleged irregularities in procedure before the agency [when those irregularities are] not shown in the record.” Mass.Gen.L. ch. 30A, Sec. 14(5). The Court may look beyond the record if it appears the agency deliberately or negligently excluded documents that may have been adverse to its decision.

On a writ of certiorari, the court’s review “is confined to the record and is for the purpose of correcting legal error, [and therefore] the inquiry about the presence or absence of genuine issues of material fact, germane to summary judgment procedure, is inappropriate. . . . [The reviewing court] need only inquire whether the commission’s decision was ‘legally tenable and supported by substantial evidence on the record as a whole.”‘ Gloucester v. Civil Serv. Comm’n, 408 Mass. 292 , 297 (1990), quoting Commissioner of Health & Hosps. of Boston v. Civil Serv. Comm’n, 23 Mass. App. Ct. 410 , 411 (1987). See G.L.c. 31, s. 2 (b); Mayor of Revere, supra at 319-322.

 

Fraud is distinguished from negligence, ignorance, and error by virtue of the fact that it is intentional; involving some level of calculation. Negligence is: “the failure to use such care as a reasonably prudent and careful person would use under similar circumstances.”   In a professional context, it is defined as: “conduct which falls below the standard established by law for the protection of others against unreasonable risk of harm… it is characterized chiefly by inadvertence, thoughtlessness, inattention, and the like.”.  Fraud, in contrast, is not accidental in nature, nor is it unplanned.  Those who commit fraud know what they are doing and are deliberate in their efforts. They are also aware that it is unethical, illegal, or otherwise improper.

Fraudulent intent is established by examining the documentation of decisions and behaviors associated with those under suspicion. As explained in Coenen: “Manipulation of documents and evidence is often indicative of such intent. Innocent parties don’t normally alter documents and conceal or destroy evidence.”

As explained in Black’s Law Dictionary,  fraud is an intentional distortion of facts and truth for the purposes of inducing another to give up something of value that they possess or to relinquish a legal right that they might otherwise retain. It is additionally defined as a “false presentation of a matter of fact whether by words or by conduct, by false or misleading allegations or by concealment of that which should have been disclosed which deceives and is intended to deceive another.”

I believe it is safe to conclude that the parties here participated in fraud.

The “litigation-packet” did not merely show “chain-of-custody” issues but forensic fraud. Misrepresenting invalid forensic test results as valid is the definition of forensic fraud. Ms. Stoller should have immediately assessed the “clear-weight” of this evidence, entered it into the docket for reconsideration and given me an opportunity to be heard. She did not.

The Federation of State Medical Board Policy specifically requires strict “chain of custody.” She violated the Board’s very own standards and then blocked me from returning to practice by putting barriers in place, refusing to allow independent evaluations and protracting the time –drawing this out in order to cause as much damage as possible to my family and me.

Mr. Bertram alleges PHS has not committed any crimes because the agency has not been charged with any crimes. This is logical fallacy. They have not been charged with any crimes because the very agencies capable of charging them with crimes are ignoring or otherwise overlooking them for various reasons.  Furthermore,  If I see someone being stabbed in the back  I can reasonably conclude it is a crime. Colluding with a laboratory to intentionally misrepresent laboratory data is laboratory fraud and covered under Title 18 of the United States Criminal Code (Wire fraud 18 USC 1343, False Statements 18 USC 1001, Conspiracy 18-USC 371, False Claims 18-USC 287 and Obstruction of Justice 18-USC 1505). I believe all of these are applicable here. In addition Dr. Sanchez violated M.G.L 156 (B) Section 69 by making false statements to a state agency.

PHS has convinced the Board not to “second-guess” their decisions and apparently the Board has convinced state AGOs to not “second-guess” theirs; each presupposing the integrity of the individuals and validity of the decisions of the agencies in question. As a result complaints by doctors of serious crimes and abuse are ignored. Fact and truth do not matter as the agencies blindly support one-another. This removes all aspects of accountability including answerability and justification for one’s actions. It is a flawed system.

In the past the SJC has overturned the Board’s decisions on due process grounds, see, e.g., Morris v. Board of Reg. in Medicine, 405 Mass. 103, 110, 539 N.E.2d 50, 54 (1989) (vacating Board decision because proceedings “denied [the physician] fairness in a due process sense.”).

This interference with the administration of Justice, abuse of authority and denial of constitutional rights warrant the Board Orders be reversed, vacated and corrected. “The touchstone of due process is protection of the individual against arbitrary action of government.” (Wolff v. McDonnell, 418 U.S. 539, 558 (1974). “[i]n a just society those who govern, as well as those who are governed, must obey the law.” (United States v. Leon, 104 S. Ct. 3430, 3457 (1984) (Stevens, J., dissenting).

The Courts have held that the Massachusetts and Federal Administrative Procedure Acts require both the agency and the court to consider the entire record, including testimony given at the hearing. In Friends of Edgartown Great Pond v. DEP, 446 Mass. 830, 845 (2006), the SJC recognized that the agency must consider the hearing evidence, finding the agency hearing complied with the Administrative Procedure Act requirements because “the record illustrates that over the course of the five-day hearing, the administrative law judge carefully considered all of the relevant evidence.”

 

The record compiled here illustrates that over the course of four years the Board not only failed to carefully consider any of the relevant evidence but most likely never saw any of it.

Our Constitution mandates that level of legal process due to reflect “respect enforced by law for that feeling of just treatment which has been evolved through centuries of Anglo-American constitutional history and civilization.” Joint Anti-Fascist Refugee Comm. v. McGrath, 341 U.S. 123, 162, 71 S.Ct. 624, 95 L.Ed. 817 (1951) (Frankfurter, J., concurring)

 

Ms. Stoller violated multiple professional regulations, ethics and the law in an ongoing campaign in which she blocked the administration of justice. By concealing the truth she prevented both exculpatory evidence favorable to my case and detrimental to the opposing party (involving misconduct and crimes from ever coming to light. It is quite clear the full Board never saw these documents. The fact that the latest Board action did not have any of the documents or petitions submitted over the past year is prima facie evidence of Fraud on the Court.  Ms. Stoller needs to be held accountable and I am requesting the SJC uses whatever power it has available to make certain this occurs. Ms. Stoller needs to be disciplined for her actions and this discipline needs to be commensurate with her crime.  In this case nothing less then disbarment and criminal charges would fit that bill.

 

 

In the Matter of Michael L Langan, M.D.

Petitioner

ON PETITION FOR A WRIT OF CERTIORARI (SJC-2015-0267)

TO THE

MASSACHUSETTS

SUPREME JUDICIAL COURT FOR THE COMMONWEALTH

MOTION TO DECIDE THE MATTER ON THE PAPERS DUE TO INTENTIONAL CONCEALMENT OF KEY DOCUMENTS AND “FRAUD ON THE COURT”

The Administrative Record filed by the Board and Assistant Attorney General Bryan Bertram’s oppositional statements suggest that the Director of the Board’s Physician Health and Compliance Unit, Attorney Debra Stoller has been interfering with the administration of justice by suppressing documentation provided as key evidence and the petitionary arguments accompanying them. The amount of missing information is profound and in review of all of the documents including Board Orders and the Board’s oppositional response to my complaint it is evident that the documents were concealed from the full Board. Mr. Bertram’s arguments are based on a very limited record as both exculpatory documents supporting my position and documents indicating misconduct by PHS were intentionally blocked by attorney Deb Stoller in violation of professional regulation consistent with Fraud on the Court. She engaged in misrepresentation, concealment and other misconduct in interference with the administration of justice.

Fraud on the court occurs when the judicial machinery itself has been tainted, such as when an attorney, who is an officer of the court, is involved in the perpetration of a fraud or makes material misrepresentations to the court. Fraud upon the court makes void the orders and judgments of that court. In Bulloch v. United States, 763 F.2d 1115, 1121 (10th Cir. 1985), the court stated “Fraud upon the court is fraud which is directed to the judicial machinery itself and is not fraud between the parties or fraudulent documents, false statements or perjury. … It is where the court or a

member is corrupted or influenced or influence is attempted or where the judge has not performed his judicial function — thus where the impartial functions of the court have been directly corrupted.” Ms. Stoller has in fact violated:

Mass.R.Prof.C. 8.4(c, d, h). Misconduct. It is professional misconduct for a lawyer to: (c) engage in conduct involving dishonesty, fraud, deceit, or misrepresentation; (d) engage in conduct that is prejudicial to the administration of justice; (h) engage in any other conduct that adversely reflects on his or her fitness to practice law.

Mass.R.Prof.C. 3.4(c). Fairness to Opposing Party and Counsel. A lawyer shall not: (c) knowingly disobey an obligation under the rules of a tribunal except for an open refusal based on an assertion that no valid obligation exists;

Rules of Professional Conduct Rule 3.4: Fairness to Opposing Party and Counsel

A lawyer shall not:

(a) unlawfully obstruct another party’s access to evidence or unlawfully alter, destroy, or conceal a document or other material having potential evidentiary value. A lawyer shall not counsel or assist another person to do any such act;

(b) falsify evidence, counsel or assist a witness to testify falsely, or offer an inducement to a witness that is prohibited by law;

(c) knowingly disobey an obligation under the rules of a tribunal except for an open refusal based on an assertion that no valid obligation exists;

(d) in pretrial procedure, make a frivolous discovery request or fail to make reasonably diligent effort to comply with a legally proper discovery request by

On March 9, 2015 an Affidavit was filed with this Court (Affidavit of Michael Langan in Support of Motion for Relief Pursuant to Earlier Court Order) because Attorney Deb Stoller refused to schedule a hearing despite this Court’s request that she do so. In this Affidavit I outline the multiple unwarranted and unjustified delays and state “my legitimate concern is that the Board will simply ignore my most recent January 20, 2015 Petition for Re-instatement. My fears are well grounded as the Board has engaged in a persistent pattern of ignoring my every reasonable effort at trying to be re-instated; and the board has abused the administrative law process to accomplish this. It was only after this Affidavit was filed with this Court that Ms. Stoller even put me on the schedule.

It appears my fears were indeed well grounded as they actually did ignore my January 20, 2015 petition. It appears the April 16, 2015 Board Hearing was simply a “sham review” to satisfy this Court’s request.

The Administrative Record compiled for the April 16, 2015 Board Hearing was absent copious relevant documents including the January 20, 2015 Petition on which it was ostensibly based. In fact, the sole petition is close to one year old. Since that time I have submitted five more petitions that are absent. Since that time I have submitted multiple documents and petitions that are not found anywhere in the Board’s record. Although some of the key documents presented to the Board since 2011 are contained therein, there is no index indicating the date they were received and this brings into question when and if these mitigating and even exculpatory documents were ever even considered.

Mr. Bertram’s oppositional statements underscore these violations and bring the abuse of authority and denial of Constitutional rights to a level of outrageousness. Mr. Bertram states “in his most recent petition to the Board to stay the suspension (“January 2015 Petition”), Dr. Langan submitted a report from an independent psychiatric evaluation (favorably opining as to his fitness to practice medicine) satisfying the first condition, but he did not satisfy the Board’s other conditions because he did not propose suitable (or any) monitoring plans with his petition. Instead, Dr. Langan sought to challenge the Board’s findings that he twice previously

violated the LOA even though he never challenged those violations before, and the time to do so has long since passed.” (page 2)

“Dr. Langan had in the past submitted a letter from Dr. Timothy Wilens, dated February 14, 2014, reporting to the Board that to the date of that letter Dr. Langan remained alcohol and substance free. Id at 158. But, that is not evidence that Dr. Langan remained abstinent in the months preceding the January 2015 Petition to the Board.” (page 8)

Mr. Bertram is correct. The February 14, 2014 report from Dr. Wilens does not cover the months preceding the January 2015 Petition to the Board, but the attached letters from Dr. Wilens dated April 24, 2014 and April 3, 2015 certainly do. The January 2015 Petition was heard at an April 16, 2015 Board Hearing and the April 3, 2015 letter from Dr. Wilens states: “I have monitored him (Langan) clinically and over the past year have been ordering and monitoring urine and saliva” toxicology tests and notes he will continue following me. This letter was written 13 days prior to the April 16th Board Hearing but absent from the Administrative Record filed by the Board October 9, 2015. The letter was provided to Board attorney Deb Stoller both by U.S. Postal service and e-mail. Additionally, it was hand delivered with the other supporting documents of my January 2015 Petition to Board attorney Tracy Ottina at the April 16th, 2015 Board Hearing.

The only possible explanation for the absence of this letter from the Administrative Record is that it was intentionally withheld. The fact that Mr. Bertram argues the absence of such documentation was used in the Board’s reasoning process to deny my Petition suggests the Board never saw it.

Due to the limited number of straightforward issues pertaining to my case (i.e. no patient care or other issues that could be used as a pretext)
this rises to the level of a Brady violation. A Brady analysis has three prongs. First, “the evidence at issue must be favorable to the

accused.” Strickler v. Greene, 527 U.S. 263, 281-282, 119 S. Ct. 1936, 144 L. Ed. 2d 286 (1999). Second, it “must have been suppressed by the
state.” Id. at 282, 119 S. Ct. 1936. Third, “prejudice must have
ensued.” The absence of a monitoring plan is the sole issue Mr. Bertram

identifies as being a factor in the Board’s denial of my petition therefore in this context had I provided a monitoring plan my petition would not have been denied. Mr. Bertram goes on to state that I have never challenged the Board’s findings that I violated my Letter of Agreement. The copious documentation I I have provided this court shows I have been challenging these findings since day one and due to the limited number of issues leading to my suspension and the documentary evidence I have provided to Ms. Stoller that is exculpating to me and incriminating for PHS I suspect it was all suppressed.

Ms. Stoller is abusing her position of authority to deny due process and fundamental fairness with the administration of Justice. She is denying Constitutional rights and violating the Rules of Professional Conduct including Mass. R. Prof. C. 3.4(a), (b), (c); 3.3 (a), (b), (c) and 8.4(a), (c), and (d)

Additionally, I have provided evidence that PHS is engaging in crimes making her in violation of Advocate Rule 3.3 Candor Toward The Tribunal which reads:

(a) A lawyer shall not knowingly:

(1) make a false statement of fact or law to a tribunal or fail to correct a false statement of material fact or law previously made to the tribunal by the lawyer;

(3) offer evidence that the lawyer knows to be false. If a lawyer, the lawyer’s client, or a witness called by the lawyer, has offered material evidence and the lawyer comes to know of its falsity, the lawyer shall take reasonable remedial measures, including, if necessary, disclosure to the tribunal. A lawyer may refuse to offer evidence, other than the testimony of a defendant in a criminal matter, that the lawyer reasonably believes is false.

(b) A lawyer who represents a client in an adjudicative proceeding and who knows that a person intends to engage, is engaging or has engaged in criminal or fraudulent conduct related to the proceeding shall take reasonable remedial measures, including, if necessary, disclosure to the

tribunal.

(c) The duties stated in paragraphs (a) and (b) continue to the conclusion of the proceeding, and apply even if compliance requires disclosure of information otherwise protected by Rule 1.6.

In a November 12, 2015 Motion to Enlarge Time to Respond to Petition Mr. Bertram states “… the undersigned Assistant Attorney General discovered that the certified administrative record was potentially incomplete. After conferring with the Board, it was determined that a copy of Dr. Langan’s petition for reconsideration that resulted in the Board order now under review was inadvertently omitted from the record. (The document was also absent from the Board’s internal docket of this proceeding, resulting in the error by the Board’s staff who assembled the record.)

According to the May 7, 2015 Board Order: “The licensee has not submitted any new documentation that contradicts any of the documents cited to above and found in the Board’s February 6, 2013 Order of Suspension. In the absence of such documentation, there is no basis for rescinding the Board’s vote based on this argument.”

In other words, as with Dr. Wilen’s letter, the Board never saw it and the proposition that this was “inadvertent” is implausible.

In addition to Dr. Wilen’s letter, three petitions were filed with the Board of Registration in Medicine in preparation for the April 16, 2015 Board Hearing. These are dated January 20, 2015 and February 20, 2015 and make reference to a September 3, 2014 Petition in which I introduced a recently acquired document from October 4, 2012.

The October 4, 2012 document from United States Drug Testing Labs (USDTL) to Dr. Luis Sanchez reports the invalidity of the confirmatory test from July 2011 and was the result of an investigation by the College of American Pathologists and precedes Dr. Sanchez report to the Board that I was non-compliant by two weeks. It is essentially exculpatory as Sanchez claimed in a written letter to the Board that he had not become cognizant of the invalidity of the test until December 10, 2012 (67-days later) and these contradictory documents in juxtaposition are prima facie evidence of misrepresentation and dishonesty. Sanchez concealed the test revision and reported non-compliance with my monitoring contract to the Board on October 19, 2012, two weeks after he was informed of the tests invalidity.

 

In fact the Administrative Record submitted by the Board contains just one Petition from May 25, 2014 that was submitted after Dr. Patricia Recupero completed her 87-page report opining I was safe to practice medicine without restriction and documenting the misconduct of PHS . This report as well as other supportive documentation previously provided to the Board from July 2011 to April 2014 the time they were produced was included with the petition (pages 153-180).

The record provides no index of when these documents were received. No timeline exists. They are not acknowledged in the written Board orders and no consideration is given to them in their written opinion. This brings into question whether or not this information was even available at the time of both Board orders. Was this information taken into account at the time it was provided or was it intentionally withheld or discarded at the time?

Due to the profound removal of due process and fundamental fairness as well as the inability of Mr. Bertram to develop an accurate oral argument due to the limited information contained in the official record I respectfully request the Court proceed with judicial review based on the documents.

Respectfully Submitted,

Michael Langan, M.D. December 9, 2015

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

mllangan1's avatarDisrupted Physician

Wretched creatures are compelled by the severity of the torture to confess things they have never done and so by cruel butchery innocent lives are taken; and by new alchemy, gold and silver are coined from human blood.– Father Cornelius Loos (1592)


17th-century-tribunal

 “PHP-Approved Attorneys”

My survey has revealed an additional factor stacking the deck and removing accountability from PHPs.  The attorneys ostensibly representing doctors are also part of the racket.

A doctor referred to a PHP will be given a list of 3 or 4 attorneys by the PHP who are “experienced in working with the medical board.” What they do not tell you is that theses attorneys are hand-picked or cultivated to abide by the rules dictated by the PHP.

They will not “bite the hand that feeds” and any procedural, ethical or criminal misconduct by the PHP will not be addressed.     Laboratory fraud, false diagnoses, and Establishment Clause violations are off…

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“Sham Peer Review”–Informative Discussion of the Underhanded Tactics Used by the Morally Disengaged Bullies Who Have Occupied the Medical Profession

Dr.  Lawrence Huntoon lectures on the common tactics used by the enemy forces who have taken an uninvited seat at the table of power in the regulation and control of the noble profession of medicine.  Collectively this band of nitwits and thugs  represent an enemy occupation and the damage has been ruinous to both the science and the art.  Clinical decision making has been reduced to algorithmic pathways and binary options that throw knowledge base and clinical acumen out the window and replaced them with  a heap of feel-good bottom-line poorly constructed dictates. These simple-minded marauders are nothing more than idiots with sticks but they’ve bamboozled the citizenry,  sweetheart-swindled the politicians and Robber barroned  their  morally disengaged  logical  fallacy into bandwagon reality under the rhetoric of cost containment and public welfare.

An enemy force has occupied our turf and it has indeed been ruinous.  Pride, integrity and enlightenment  have been torn out of the medical profession by the acceptance of poisonous ideas and concrete thinking and this disease  has  viruntly spread  from regulatory agencies to hospital administrators to those charged with governing academic medicine.

I recently spoke with a medical resident who yelled at a nurse as she was about to fatally inject  an anti-arrythmic medication at 10x the dose into a patient’s IV.   Had he not intervened the patient would in all probability have died and he undoubtedly saved  the patient’s life.  This fact is irrelevant in the current climate as the nurse he yelled at reported him for it and instead of seeing this as an acute human emotional response in a tense situation where a patient’s life was in danger,  the powers that be interpreted it as a red flag and recommended he be assessed for anger issues.  The evaluators suggested an inpatient evaluation and the assessing facility recommened treatment in their cash-only facility which, as a resident physician,  he did not have the means to pay.  Without the treatment he could not return to his residency program.  The nurse who almost killed this patient was cleared ( it was deemed a systems error) of any wrongdoing while the doctor who saved the patients  life has potentially lost  his career because he exhibited an understandable human response to a crises situation –  Apparently he should have said “pretty please” or whispered “just don’t let this happen again”

I heard of another case in which  a patient had  had multiple colonoscopies, endoscopies and batteries of lab tests for an undiagnosed gastrointestinal ailment for which no one could come up with a diagnosis.  The patient subsequently consulted with an independent astute diagnostician and who came up with an accurate yet unusual diagnosis; a so called zebra among the horses and he was able to treat the condition and the.symptoms abated within a week.  Coming up with the correct diagnosis when others have failed is an accomplishment that has historically generated the praise of one’s colleagues; met with respect, admiration, a toast and round of applause. But those days are long gone and instead of accolades this astute diagnostician and finder of the cause and cure of a difficult diagnosis got a raft of shit and sneers as the sniveling sheeple dong repeated colonoscopies without a clue felt disrespected.  He made them look bad.  He failed to communicate with them and they reported him to hospital administration for being “unprofessional” An investigation ensued that took on a life of its own.  Mobbing and sham peer review followed and he ended up dying by suicide– A death sentence for making a brilliant and correct diagnosis.

Question Authority: The Need for Anti-Authoritarians in the Medical Profession

mllangan1's avatarDisrupted Physician

Screen Shot 2015-05-30 at 7.27.10 PM
Anti-authoritarians question whether an authority is a legitimate one before taking that authority seriously.  images-24To evaluate the legitimacy of  an authority it is necessary to:
1. Assess whether they actually know what they are talking about.   2. Assess whether the authorities are honest in their intentions.
When anti-authoritarians assess an authority to be illegitimate, they challenge and resist that authority.
There is a paucity of anti-authoritarianism in the medical community concerning groups that have gained tremendous sway in the regulation of the medical profession.    There is, in fact, an absence of anti-authoritarian questioning  of  what is essentially illegitimate and irrational authority.
images-26
Most doctors are unaware of the impact these organizations have had on both the regulation of the medical profession and social control of individual doctors.  Through “moral entrepreneurship” and “bent science” these groups have successfully swayed both policy-makers and the public to support an agenda not supported by reality…

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Documentary Evidence of Top-Down Corruption–See how PHP Colludes with USDTL Labs in Forensic Fraud

mllangan1's avatarDisrupted Physician

IMG_9516“A body of men holding themselves accountable to nobody ought not to be trusted by anybody.”
― Thomas Paine 

USDTL drug testing laboratory claims to advance the”Gold Standard in Forensic Toxicology.”  “Integrity: Results that you can trust, based on solid science” is listed as a corporate value. “Unlike other laboratories, our drug and alcohol testing begins and ends with strict chain of custody.” “When people’s lives are on the line, we don’t skip steps.”  Joseph Jones, Vice President of Laboratory Operations explains the importance of chain-of-custody in this USDTL video presentation.

Dr. Luis Sanchez, M.D. recently published an article entitled Disruptive Behaviors Among Physicians in the Journal of the American Medical Association discussing the importance of  of a “medical culture of safety” with “clear expectations and standards.”  Stressing the importance of values and codes-of-conduct in the practice of medicine, he calls on physician leaders  “commit to professional behavior.”

Sanchez is Past President of…

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A Prayer of Gratitude- John F. Kennedy

mllangan1's avatarDisrupted Physician

“As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.”– Thanksgiving Day Proclamation 1963—John F. Kennedy.

IMG_1072Let us therefore proclaim our gratitude to Providence for manifold blessings–let us be humbly thankful for inherited ideals–and let us resolve to share those blessings and those ideals with our fellow human beings throughout the world.

On that(this) day let us gather in sanctuaries dedicated to worship and in homes blessed by family affection to express our gratitude for the glorious gifts of God; and let us earnestly and humbly pray that He will continue to guide and sustain us in the great unfinished tasks of achieving peace, justice, and understanding among all men and nations and of ending misery and suffering wherever they exist.

–Thanksgiving Day, 1963

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Reefer Mad and Power Hungry

Link to article:https://digboston.com/reefer-mad-and-power-hungry/

Please comment on DigBoston website

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In 2013, Dr. Steven Adelman of Physician Health Services (PHS)—a powerful nonprofit founded by the Massachusetts Medical Society that provides help to residents and doctors struggling with substance abuse problems—published a now-infamous article on KevinMD titled, “Against the Medicalization of Marijuana,” in which he lambasted the 63 percent of voters who supported the Massachusetts initiative petition to eliminate criminal and civil penalties for marijuana by qualifying patients with diagnosed debilitating medical conditions. Blasting the mandate for the Department of Public Health to “operationalize the so-called medicinal use of cannabis in the Commonwealth,” Adelman wrote, “the community of physicians has been scratching its collective head and wondering, ‘What in the world are we going to do about patient requests to become certified to purchase, or grow, so-called medical marijuana?’”

In his report, Adelman noted the alleged perilousness of addiction, withdrawal, and cognitive impairment related to cannabis, and warned of the potential onslaught of underground entrepreneurs waiting to capitalize. Adelman, a so-called addiction expert at Harvard Vanguard, predicted a floodgate of unscrupulous profiteers diverting “massive” amounts of this “valuable” “addictive” “substance” to “non-patients,” and guessed that the health and well-being of the “greater public will be jeopardized for the relief of a few.”

As noted by many activists but ignored by all but niche marijuana media, in another instance, Adelmanblamed the bombing of the Boston Marathon on “marijuana withdrawal.” One of his cohorts, Dr. Robert Dupont of the Institute for Behavior and Health, rode a similar bandwagon, arguing that Dzhokhar Tsarnaev smoked his way to failure and, because of a disappointing report card, said, “Fuck it, I’ll become a terrorist.” DuPont also served as director for the  National Institute on Drug Abuse and currently runs one of the largest Employee Assistance Programs (EAP) in the U.S. with former DEA honcho Peter Bensinger. These guys are in the drug-testing business!

Most doctors don’t think like this. That includes most members of the Massachusetts Medical Society. But very few speak out about the fraud being carried out against the legalized medicinal use of cannabis. How does the same medical society that publishes the New England Journal of Medicine allow this type of tripe and rabble to evade editorial scrutiny? Why no backlash from dissenting doctors? Easy, no one has stood up to Adelman because as the head of an influential Physician Health Program (PHP) like PHS, he has power over the license of every doctor in Mass.

Such state operations have come under major scrutiny. A recent Medscape article titled “Physician Health Programs: More Harm Than Good?” reveals patterns of anonymous referrals, false diagnoses, and a lack of credible process. These state-based programs appear to have created a climate of fear in doctors, as all it takes is an anonymous referral to someone like Adelman to ruin a career. For these reasons, many doctors will not even talk about medical marijuana privately, let alone in public out of fear that they might get referred to their state PHP.

It’s hard to know who to hold accountable for these lies. PHS operates under the national Federation of State Physician Health Programs (FSPHP), which is located in Massachusetts. Meanwhile, the FSPHP is an arm of the American Society of Addiction Medicine (ASAM), which also pushes self-serving public policy under the guise of contributing to the greater good. That despite the Massachusetts Medical Society’s charge 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.”

Dr. Langan was an instructor in medicine at Harvard Medical School and an assistant professor of medicine at Massachusetts General Hospital for more than 15 years. He is a co-founder of a medical device startup and blogs at disruptedphysician.com.

DR. MICHAEL LANGAN

“Conformity is the jailer of freedom and the enemy of growth.” – John F. Kennedy.

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“Conformity is the jailer of freedom and the enemy of growth.” – John F. Kennedy.

Born – May 29, 1917
Brookline, Massachusetts,
Died- November 22, 1963
Dallas, Texas, aged 46

The “Impaired Physician”–Increasing the Grand Scale of the Hunt

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“Wretched creatures are compelled by the severity of the torture to confess things they have never done and so by cruel butchery innocent lives are taken; and by new alchemy, gold and silver are coined from human blood.”  Father Cornelius Loos  ( 1592 )

 

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How Impaired Physicians Can be Helped–Medscape Business of Medicine Article Published February 24, 2015. Click on image to access

How can impaired Physicians be helped?

1.   Impairment among physicians is growing:  Why?  

Answer:  It is not.   State Physician Health Programs (PHPs) are “diagnosing” impairment when there is no impairment.  They are pathologizing the normal and expanding in scope to increase the grand scale of the hunt.

2.  What’s the Prognosis for Impaired Physicians?

Answer:  Not Good.   Those who need help (the truly impaired)  are afraid to get help for fear of being monitored by their state PHP while many of those ensnared by PHPs are not impaired.   There is absolutely no oversight, regulation or accountability.  This needs to be evaluated in the context of physician suicide.    The system is one of institutional injustice and abuse of power. 

3.  Is your knowledge of physician impairment up-to-date?  

Answer:   No.  This will only occur after an evidence-based Cochrane type review separates information from misinformation; An objective non-biased investigation by outside actors identifying any conflicts-of-interest, misconduct or lack of evidence-base in the current system and separating the art and science of the medical profession from the politicalization and exploitation of the medical profession.

The list of doctors on Like-Minded Docs  solves the final piece of a  puzzle. It explains why so many doctors across the country are claiming fabrication and manipulation of personality and cognitive tests to support nonexistent diagnoses at these “PHP-approved” assessment centers.    The relationship between the state PHP’s and the “PHP-approved” assessment centers is the same as it is between the state PHPs and the corrupt labs.

As Drs. John Knight and J. Wesley Boyd note in Ethical and Managerial Considerations Regarding State Physician Health Programs, published in the Journal of the American Society of Addiction Medicine,  this is what is known as “tailoring a diagnosis”–a euphemism for the political abuse of psychiatry.  According to the Global Initiative on Psychiatry “Political abuse of psychiatry refers to the misuse of psychiatric diagnosis, treatment and detention for the purposes of obstructing the fundamental human rights of certain individuals and groups in a given society.”   The shoe fits here.  In fact it fits very well.

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The Global Initiative on Psychiatry opposes the Political_Abuse_of_Psychiatry  wherever  it may occur and “supports those psychiatrists and psychiatric organizations that pressure the offending states to discontinue the practice and lobby vigorously those organizations which are wavering. The main way for individuals and organizations to work is through diplomatic channels. It is necessary to expose the practice and to embarrass countries that are at fault by expelling them from organizations such as the World Psychiatric Association. This can only be ensured by properly organized open investigation of psychiatric practice and interviews with the alleged victims”

Political abuse of psychiatry in the profession of medicine needs to be treated in the same way.

An evidence based Cochrane type assessment of their “research” and an Institute of Medicine Conflict of Interest review are long overdue.

In evaluating a physician for “impairment” or being “disruptive” the Physician Health Programs (PHPs)  under the Federation of State Physician Health Programs (FSPHP)  are not gathering data to form a hypothesis.  They are making data fit a hypothesis that arrived at the out-of-state “PHP-approved” assessment center well before the alleged miscreant doctor.

With guilt assumed from the start, no due process, no appeal, and no way out physicians are being bullied, demoralized, and dehumanized  to the point of hopelessness, helplessness and despair.

This needs to end now.

Medicine is predicated on competence, good-faith, and integrity. 

Medical ethics necessitates beneficence, respect, and autonomy. 

The scaffold erected here is designed for coercion and control. 

Exposure, transparency, and accountability are urgent. 

The emperor has no clothes.

Sunshine is the best disinfectant.

https://artbylisabelle.wordpress.com/2015/03/01/three-shells-and-a-pea-asam-fsphp-and-lmd/

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Snakes in Smocks: Unrecognized Corporate Psychopathy in the Medical Profession


Psychopathy

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Psychopathy is present in all professions. In The Wisdom of Psychopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success, Kevin Dutton provides a side-by-side list of professions with the highest (CEO tops the list) and lowest (care-aid) percentage of psychopaths.   Interestingly surgeons come in at #5 among the professions with the highest percentage of psychopathy while doctors  (in general) are listed among the lowest.

Although by no means a scientific study, Psycopaths, by their very nature, seek power and it would make sense that a psychopath among us might pick surgery over pediatrics or pathology as they are drawn to power, prestige, and control. Be this as it may the incidence of psycopathy or psychopathic traits in doctors of any specialty is low. Statistics indicate that no more than 1% of men in general exhibit psychopathic traits. In Women these characteristics are far less.

Due to irresponsible behavior and a tendency to ignore or violate social conventions and rules,  psychopaths frequently find themselves engaged in conduct involving the criminal justice system or involved in other disciplinary action. Juvenile delinquency, arrests, school suspensions and misconduct related issues are barriers that preclude professional careers for many and, with around 15% of the prison population estimated to be psychopathic, incarceration and recidivism are common final pathways. Because of this tendency it would be highly unlikely for most sociopaths to follow a standard professional career pathway involving academic rigor and normal professional and societal expectations,  because impulsive irresponsible actions commonly blocks it. This would predict a probably much lower prevalence of psycopathy in physicians compared to the general population.

That being said, such self imposed removal from a potential  career is the sole product of getting caught for misconduct and being held accountable for it.   Psychopaths possess several traits that make this difficult.    With a talent for “reading people” and identifying their weak spots and vulnerabilities they are able to get people to see what they want them to see.  Psychopaths often exude charm, confidence and charisma.  They can lie effortlessly and are very convincing..

The natural history of psychopathy involves risky behavior and the ability to get away with it or out of it. The consequences of this depend on if and when it occurs. It is entirely conceivable that some may live their entire lives undetected. With a need for stimulation and a proneness to boredom the psychopath is particularly prone to drug abuse and addiction and twice as likely as the general population to be diagnosed.

 Psycopathy involves a path of risky behavior as well as the potential for being held accountable for it. At any age the behavior that brings they psychopath to the attention of the criminal justice system is often drug or alcohol related. The natural history of the average psychopath reveals an overrepresentation in prison with a 15x greater risk in general. Any statistics on psycopathy in a population is based on psychometric evaluations retrospectively in specific populations. Being arrested or getting caught for something does not reveal the pathology or the correlation. You have to look for it.

And nothing is known of subpopulations of psychopaths and the impact of intelligence, education, profession and other factors and how they relate to outcomes and consequences over time. Egocentricity and a sense of entitlement drives they do not adapt to the environment but try to make the environment adapt to them. Without empathy and lacking remorse the goal is always self-serving and a question of what they can get out of it.

 Many judges, as an alternative to incarceration, have been requiring people arrested for drug and alcohol related offenses to attend AA meetings and provide proof of participation. As misguided as this is on other levels it is also dangerous. Given a choice between incarceration and attending AA the majority of any population, including those with psychopathic traits, would choose the latter. And as in any situation they would use it to see what they could get out of it. Masters of manipulation and impression management in a room full of potential victims. The reports of rape and theft coming out is no surprise. It is in all likelihood much worse.

And in reality psychopaths exist in every profession, including medicine.

What is the natural history and final common pathway of M.D. psychopaths?  Where do these shape-shifters end up?

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In his book Without Conscience, Dr. Robert Hare notes “If we can’t spot them, we are doomed to be their victims, both as individuals and as a society. ” Dr. Clive Boddy in Corporate Psychopaths observes that unethical leaders create unethical followers, which in turn create unethical companies and society suffers as a result.” And if you look at the FSPHP branch of the ASAM that is exactly what you will find.  less than 1/% of the population are psychopaths but they represent more that 10% of those in prisons.  What is the natural history of the physician psychopath? You do the math.

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A 2010 study, Corporate Psychopathy: Talking the Walk, found that 3 to 6 percent of corporate employees may be responsible for the majority of ethical breaches in corporations, with corporate psychopathy tending to be concentrated at the higher levels of organizations.

This group here, Like-minded Docs,  is largely responsible for what happens to any doctor referred to a state PHP because all of the medical directors of  the “PHP-approved” assessment and treatment centers can be found right here.

So too can Bob Dupont and Greg Skipper who have introduced the non-FDA approved drug and alcohol LDTs.  Stuart Gitlow, President of ASAM is also on the list.

This group is essentially in control of doctors and determines their fates and the percentage of psychopathy here is much much more than the  3-6% found at Enron.

Some of these doctors have done horrible things that most doctors would never do under any circumstances (steal IV pain relieving drugs from dying cancer patients I.V. bags, selling the ‘date-rape” drug to DEA agents).

On this list are multiple felons and a fair number of double felons who got their licenses back by saying they were not responsible for what they did.  They were helpless over drugs or alcohol and have now been saved by the good graces of 12-step spirituality.

And with that the medical boards gave them power without accountability.  There is no regulation, oversight, answerability or need to justify their actions.  It is a free for all and this list is a gold-mine for anyone studying organized psychopathy.

Physician Health Programs are a funnel for the sociopath and without restraint they are only growing.

This is what John Nash described would happen without counter-forces to keep their numbers low.

http://psychopathyinfo.wordpress.com/2012/03/22/characteristics-of-corporate-psychopaths-and-their-corporations/

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