What happened to the practice of medicine?

MediPro Solutions LLC's avatarMediPro Solutions Blog

Historically, the prshutterstock_79082722actice of medicine was highly regarded and demonstrated a precious connection between physician and patient. One  of mutual admiration, trust, and care. In recent years, those attitudes have changed significantly. The main social network for doctors in the US, SERMO, recently included an extended debate about how patients feel about their physician. The opinion was that patients possess a mistaken thought about their physician’s economic interests. Patients understand that medicine can be a business, however they don’t know where the cash goes, and this has harmed many physician-patient relationships.

In my own youth, a family doctor that lived just down the street made house calls. I am reasonably certain his practice functioned mainly in cash and his patients knew what they were spending money on.  There were no practice managers or midlevel “physician extenders” to boost revenue. I doubt that he was in medicine for the money. He was…

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Wanted!–a Few Statisticians, Biostatisticians and Epidemiologists who want to make a difference in Medicine, Society and our Future

The Displacement of the idea that facts and evidence matter, by the idea that everything boils down to subjective interests and perspectives is — second only to American political campaigns — the most prominent and pernicious manifestation of anti-intellectualism in our time. — Larry Laudan, Science and Relativism (1990)

mllangan1's avatarDisrupted Physician

 “That everyone shall exert himself in that state of life in which he is placed, to practice true humanity towards his fellow men, on that depends the future of mankind.” – Albert Schweitzer 
“By and by never comes” –St Augustine

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“A day’s impact is better than a month of dead pull”-Justice Oliver Wendell Holmes, Jr.

 I am looking for a few honest and credible statisticians, biostatisticians or epidemiologists who want to make a difference in the spirit  of service and helping others.  I can’t pay you but you would be combating injustice, corruption and dishonesty.   You would be doing your part in helping the Medical Profession, honest and decent doctors, our country and  perhaps our future.  

It is only a few public policy steps and minor changes in state regulatory statutes before what is described in the ASAM White Paper on Drug Testing comes to fruition.  Before we know it…

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Physician Suicide, Organizational Justice and the “Cry of pain” Model: Hopelessness, Helplessness and Defeat

tireddoctorAccording to Talbott, “impaired doctors must first acknowledge their addiction and overcome their ‘terminal uniqueness’ before they can deal with a drug or alcohol problem.” “Terminal uniqueness “ is a phrase Talbott uses to describe doctors’ tendency to think they can heal themselves. “M-Deity” refers to doctors “being trained to think they’re God,” an unfounded generalization considering the vast diversity of individuals that make up our profession. This attitude, according to some critics, stems from the personal histories of the treatment staff, including Talbott, who are recovering alcoholics and addicts themselves. One such critic was Assistant Surgeon General under C. Everett Koop John C. Duffy who said that Ridgeview suffered from a “boot-camp mentality” toward physicians under their care and “assume every physician suffering from substance abuse is the same lying, stealing, cheating, manipulating individual they were when they had the illness. Certainly some physicians are manipulative, but it’s naïve to label all physicians with these problems.”

mllangan1's avatarDisrupted Physician

They can be a terror to your mind and show you how to hold your tongue
They got mystery written all over their forehead
They kill babies in the crib and say only the good die young
They don’t believe in mercy
Judgement on them is something that you’ll never see
They can exalt you up or bring you down main route
Turn you into anything that they want you to be–Bob Dylan, Foot of Pride


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Although no reliable statistics yet exist, anecdotal reports suggest a marked rise in physician suicide in recent years. From the reports I am receiving it is a lot more than the oft cited “medical school class” of 400 per year.

This necessitates an evaluation of predisposing risk factors such as substance abuse and depression, but also requires a critical examination of what external forces may be involved in the descent from suicidal ideation to suicidal…

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The Medical Profession under Dictatorship–Revisiting Dr. Leo Alexander’s prescient warnings from 1949

mllangan1's avatarDisrupted Physician

“Let it be considered, too, that the present inquiry is not concerning a matter of right, if I may say so, but concerning a matter of fact.”–Adam Smith

“Most men endure the sacrifice of the intellect more easily than the sacrifice of their daydreams.  They cannot bear that their utopias should run aground on the unalterable necessities of human existence”  -Ludwig von Mises

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“Science under dictatorship becomes subordinated to the guiding philosophy of the dictatorship.” So begins Medical Science Under Dictatorship1 written in 1949 by Leo Alexander and published in the New England Journal of Medicine. Alexander acted as consultant to the Secretary of war and the Chief Counsel for the Nuremberg trials.

The guiding philosophic principle is Hegelian or “rational utility” and “corresponding doctrine and planning”, Alexander said “replaced moral, ethical and religious values” and Nazi propaganda was highly effective in perverting public opinion and public conscience…

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Backdraft: How Firefighter Arson was Reduced by Admitting, Defining and having Zero-Tolerance for the Problem–A Lesson for the Medical Profession

Backdraft: How Firefighter Arson was Reduced by Admitting, Defining and having Zero-Tolerance for the Problem–A Lesson for the Medical Profession.

Some researchers believe that firefighter arsonists undergo a mental process referred to as RPM: the arsonist Rationalizes the crime, Projects blame, and Minimizes the consequences.
The impact of firefighter arson can be severe. People die or are seriously injured, including fellow firefighters. Homes are destroyed. An arsonist from within the fire department can disgrace the whole department, and his actions diminish public trust.  Several states that have experienced the crime of firefighter arson have developed new legislation that directly impacts the prosecution of firefighters accused of arson.
The most crucial step was admitting that the problem exists.  The second was defining the problem. The third was having zero tolerance for those engaged in the problem.    States that have taken this approach have found a marked reduction in firefighter arson.

The Irrational Authority

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The Irrational Authority.  Originally posted on:

Chaos Theory and Pharmacology

A blog dedicated to the study of complex relationships in pharmacology. “Journalism is printing what someone else does not want printed: everything else is public relations.” ― George Orwell

The Irrational Authority

Goodle F. Re: ‘Drug Policy: We Need Brave Politicians and Open Minds
The BMJ. December 17, 2014.

Drug policy: we probably need an “irrational authority”

“One thing is for certain. When society gives power of diagnosis and treatment to individuals
within a group schooled in just one uncompromising model of addiction with the majority attributing their very own sobriety to that model, they will exercise that power to diagnose and treat anyone and everyone according to that model. The birth of Addiction Medicine as an ABMS accepted discipline is sure to be a success for the drug and alcohol testing and 12-step treatment industry, but its spawn is sure to be an inauspicious mark on the Profession and Guild of Medicine and a bane of society for years to come.” ―Michael Lawrence Langan.(1)

References

1. DISRUPTED PHYSICIAN 101.2: “ADDICTION MEDICINE” IS A SELF-DESIGNATED PRACTICE SPECIALTY UNRECOGNIZED BY THE AMERICAN BOARD OF MEDICAL SPECIALTIES–(AN AMA CENSUS TERM INDICATING NEITHER TRAINING NOR COMPETENCE).
URL: http://disruptedphysician.com/2014/11/21/disrupted-physician-101-3-addic… (date accessed: December 17, 2014).

Competing interests: No competing interests

Additional comments

I. The original title of this response:

– Drug policy: we probably need an “irrational authority”.

Please read as:

– Drug policy: we definitely need an “irrational authority”.

II. Societies like the American Society of Addiction Medicine and American Psychiatric Association have been self-proclaimed as “rational authorities”: a euphemism created probably by complex defense mechanisms of self-preservation in a society used to suppress dissenters and reward the wrongdoers.

“The Ministry of Peace concerns itself with war, the Ministry of Truth with lies, the Ministry of Love with torture and the Ministry of Plenty with starvation. These contradictions are not accidental, nor do they result from ordinary hypocrisy: they are deliberate exercises in doublethink.”
― George Orwell, 1984

“Doublethink means the power of holding two contradictory beliefs in one’s mind simultaneously, and accepting both of them.”
― George Orwell, 1984

III. We probably need more “irrational authorities”.

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

mllangan1's avatarDisrupted Physician


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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.

Screen Shot 2015-03-19 at 9.09.39 PM 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…

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Utilizing the Medical Profession as a Urine Collection Agency–The ASAM White Paper on Drug-Testing

mllangan1's avatarDisrupted Physician

“The rights of every man are diminished when the rights of one man are threatened.” ― John F. Kennedy

Before the  2012 Drug and Alcohol Testing Industry Association (DATIA) annual conference, Dr. Robert Dupont delivered a speech entitled “Drug Testing and the Future of American Drug Policy.”    He describes a “New Paradigm” for substance abuse treatment that enforces “zero tolerance for alcohol and drug use”  that is enforced by monitoring with frequent random drug and alcohol tests in which positive tests are “met with swift, certain, but not draconian, consequences.” The paradigm is based on the current Physician Health Programs blueprint.  Dupont states:

“…physician health programs , have set the standard for effective use of drug testing. These pioneering state programs provide services to health care professionals with substance use disorders. The programs are run by physicians, some of whom in recovery themselves. PHPs feature relatively brief…

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Three shells and a pea–ASAM, FSPHP, and LMD

mllangan1's avatarDisrupted Physician

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Three shells and a pea–ASAM, FSPHP, and LMD.

As home to some of the countries top ranked hospitals and most prestigious medical schools,  Massachusetts is an international healthcare hub with world-class teaching, research and clinical care. Two of the top three psychiatric hospitals in the United States as rated by U.S. News and World Report are found here in Massachusetts with McLean Hospital earning the top prize and Massachusetts General Hospital ranked number three. However, this medical mecca of learning and research is apparently unable to attract anyone with the competence and skill to assess a physician for substance abuse or disruptive behavior.

In Massachusetts if the State PHP feels a physician is in need of an assessment the evaluation must be done at “a facility experienced in the assessment and treatment of health care professionals.”  No exceptions. And apparently these esoteric skills are only found in Georgia, Arkansas…

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