DisruptedPhysician.com was listed among the top 70 physician blogs of 2016 -2017. The list was created by Healthcareadministrator.org after “through scrutiny and deep research” to “settle with only the best bloggers.” You can get all of the information and see the full list at “Healthcare Aministrator top-70-physician-blogs.”

Please help me keep the momentum going and donate to Disrupted Physician at https://www.gofundme.com/PHPReform

Source: Disrupted Physician Listed Among Top 70 Physician Blogs of 2016-2017 by HealthcareAdministrator.Org

DisruptedPhysician.com was listed among the top 70 physician blogs of 2016 -2017. The  list was created by Healthcareadministrator.org after “through scrutiny and deep research” to “settle  with only the best bloggers.”  You can get all of the information and see the full list at “Healthcare Aministrator top-70-physician-blogs.”

 

Please help me keep the momentum going and donate to Disrupted Physician at https://www.gofundme.com/PHPReform

Link to GofundMe  here.

In  F. Scott Fitzgerald’s  The Great Gatsby, Nick Carraway observes that “the loneliest moment in someone’s life is when they are watching their whole world fall apart, and all they can do is stare blankly”      In 1896 Émile Durkheim described “melancholy suicide” as being “connected with a general state of extreme depression and exaggerated sadness, causing the patient no longer to realize sanely the bonds which connect him with people and things about him. Pleasures no longer attract.”     Heightened perceptions of defeat and entrapment are known to be powerful predictors of suicide. According to the “Cry of Pain” model people are particularly prone to suicide when life  experiences are interpreted as signaling defeat, defined as a sense of a “failed struggle.” Unable to find some sort of resolution to a defeating situation, a sense of entrapment proliferates and the perception of no way out provides the central impetus for ending one’s life.

Source: Physician Suicide and Organizational Justice: The Role of Hopelessness, Helplessness and Defeat

Lord Acton warned that we should not make moral allowances for powerful people just because they are powerful. If a common man murdered someone, Acton explained, he should hang. But when a king or queen murders, we make allowances for it. “I would hang them higher than Haman, for reasons of quite obvious justice, still more, still higher, for the sake of historical science” Acton wrote.  The same dynamic applies here.One thing is for certain.  There should be zero-tolerance for forensic fraud perpetrated by those in positions of power.   This is  worse than Annie Dookhan as her victims were abstractions.  She did not see the damage that resulted from her laboratory misconduct.And as far as I can find, these documents are the most elaborate and complete representation of the mechanics of forensic fraud available and show the sequential steps between the requesting party and complicit lab.   The documents also show how easy laboratory misconduct is accomplished as well as the moral detachment of the involved parties.

Source: Defending MA BORM Deb Stoller’s Five-Year Concealment of Fraud–Nothing Left but Logical Fallacy and Lies

Please donate at:  DisruptedPhysician Gofund

https://www.gofundme.com/PHPReform

We have dealt some significant blows and I would like to keep throwing some direct punches at the enemy but at this point it is getting difficult as financial issues have become a critical issue and I urgently need funding and support.As this is critical and I want to do everything I possibly can to make this happen please let me know what I can
do in return and I would like to throw this out.Anyone who donates to my fund can consider me available for consultation anytime 7 days a week and 24 hours per day indefinitely and that’s a promise.  Unlike the groups we are dealing with here I keep my word.

Source: To continue the fight on DisruptedPhysician.com I urgently need funding and support-Please donate to help me keep throwing some direct punches at the enemy. At this point I need your help and rest assured it will not be forgotten!

Please donate to my fund at:   https://www.gofundme.com/PHPReform

We have dealt some significant blows and I would like to keep throwing some direct punches at the enemy but at this point it is getting difficult as financial issues have become a critical issue and I urgently need funding and support.

As this is critical and I want to do everything I possibly can to make this happen please let me know what I can do in return and I would like to throw this out.

Anyone who donates to my fund can consider me available for consultation anytime 7 days a week and 24 hours per day indefinitely and that’s a promise.  Unlike the groups we are dealing with here I keep my word.

/Widgetflex.swf

Anonymous referrals to state PHPs can result in loss of careers, families and even lives.   I have heard from doctors targeted due to age , religion, sexual preference , nationality, political stance and appearance.  Referred to the  state PHP with an anonymous complaint of “alcohol on breath” or “anger issues,” these good doctors were removed from practice under the guise of protecting the public.   By claiming a doctor has a  “potentially impairing illness” and falsely labelling him or her with a substance use or behavioral disorder they are able to remove due process and remove any doctor from practice. The system is designed to give the appearance of legitimacy.   It is not.  The stories I have heard and continue to hear from doctors  and medical students are as horrific as they are heartbreaking.  I have heard from female doctors who refused to go out on a date with, spurned sexual advances and even been raped by other doctors who then reported them to their state PHP for damage control.   I have heard from many doctors who discovered misconduct such as insurance or Medicare fraud who were promptly reported to their PHP and doctors who were reported by competitors for patients.   I have heard from doctors reported out of jealousy, anger, racism and bigotry.    Some of these storied can be seen on who have thwarted sexual advances and even been raped who were reported to their state “letters from those abused and afraid

My work in physician health reform has resulted in some significant gains.  For example the Medscape article  Physician Health Programs- More Harm Than Good? by Pauline Anderson was the result of  Medscape Editor taking an interest in my tweets about a year earlier and contacting me and taking an interest in my blog.  Physician Health Programs- More Harm Than Good?    broke new ground as it was the first mainstream medical article critical of PHPs. This was read by British Medical Journal Editor Jeanne Lenzer and this led to “Physician health programs under fire.”    In this article published in the BMJ she takes on the financial conflicts of interest, abuse and fraud in PHPs and the FSPHP’s response to direct and specific questions revealed what an irrational and illegitimate authority they are.   They cannot provide direct and simple answers to direct and simple questions and remain tongue tied to this day.

By all counts their days are numbered and the articles mentioned above and more to come are the direct result of bottom-up activism.  So too is a forthcoming audit by Massachusetts state Auditor Suzanne Bump whose office has already interviewed enough abused doctors to warrant an investigation which will hopefully look into the misconduct and fraud being perpetrated by the Massachusetts PHP in collusion with a specific group of attorneys within the medical board that blocks due process and conceals evidence to protect the PHP and harm innocent doctors.

It took 25 years for the FSPHP to rise.  Let’s hope their demise is much quicker.  They need to be named as the enemy and addressed on a state by state basis.  We have dealt some significant blows and I would like to keep throwing some direct punches to the enemy but at this point it is getting difficult due to financial matters and I urgently need funding and support.

As this is critical and I want to do everything I possibly can to make that happen so just let me know what I can do in return.   What I would like to offer  is this.

Anyone who donates to my fund can consider me available for consultation at anytime 7 days a week and 24 hours per day indefinitely.

The need for allies and funding is urgent as time is critical.  We have to expose this group as an illegitimate and irrational authority, expose their fraud and scams and expose the backgrounds of some of the individuals involved.    Physician health programs should not longer be considered the elephant in the room.  All you have to do is look at documentary facts  and evidence to see what is happening and any ignorance at this point would have to be deemed willful ignorance.  You cannot continue to ignore the obvious.  To those within the PHPs and their sympathizers and apologists your silence speaks volumes To save American Medicine it is essential this be exposed, investigated and the perps held accountable.  Silence is no longer an option.

 

Accountability is necessary to prevent corruption and requires both the provision of information and justification for actions. What was done and why?   Accountability also necessitates consequences-the ability of outside actors to punish and sanction those who commit the misconduct Without these constraints corruption is inevitable.

Source: The drug and alcohol testing and treatment industry plan to utilize the medical profession as a urine collection agency: The ASAM White Paper on Drug Testing and the “Future of American Drug Policy.”

 

In my February 2016 post  The “PHP-Blueprint”–A Trojan Horse for Profit and Wider Social Control  (copied below) I describe the planned expansion of a substance abuse management program currently being used on doctors to other people including the elderly,  pregnant mothers, college students and kids.  I suggest the following documents be read:

1. Robert Dupont’s 2012 Keynote speech before the Drug and Alcohol Testing Industry Association.
2. Robert Dupont’s address before the House Subcommittee on Oversight and Investigation Combatting the Opioid Epidemic
3. 2014 Journal of the American Medical Association (JAMA) article entitled “Addiction Medicine: The Birth of a New Discipline”
4. The ASAM White Paper on Drug Testing
5. Why good addiction centers connect clients to AA or NA

Robert Dupont’s 2012  keynote speech  before the  Drug and Alcohol Testing Industry Association (DATIA) describes a  “new paradigm” for addiction treatment  he proposes be expanded to the workplace, the healthcare system, and schools.  The ASAM White Paper on Drug Testing describes in great detail  how they plan to introduce non-FDA approved laboratory developed tests (LDTs) into the healthcare system and require doctors to drug test all patients ranging from pediatrics to obstetrics to geriatrics.   They wish to do away with the  forensic protections currently used in  workplace drug-testing  (such as strict documented chain-of-custody and Medical Review Officer (MRO) evaluation) by using your doctor’s office as a drug and alcohol testing collection agency and I describe this in detail here:  Utilizing the Medical Profession as a urine collection agency–The ASAM White Paper on Drug Testing. 

Dupont’s address before the House Subcommittee lobbying for the “PHP model” as standard of care in opioid treatment illustrates the “policy entrepreneurship” and “bent science” this group has used to advance their agenda.  Here Dupont makes the ludicrous claim that a survey of doctors being monitored by PHPs rating their experiences from “extremely hurtful” to “extremely helpful” found that “only 3% said it had been hurtful to any extent” with the remainder reporting their experience as helpful and “nearly 50% reporting ‘extremely helpful.'”

“When asked to rate which components of the PHP program were most valuable to them the highest rating went to participation in the 12-step fellowships, followed by their formal treatment experiences and their sustained random monitoring.” 

Of course this does not comport with reality.  It is just  propaganda pushing the “PHP-blueprint” and an agenda of more and more testing and treatments.  This is all based on a 2009 study called  Setting the Standard for Recovery: Physicians’ Health Programs”  and Dupont is the lead author on this paper. The conflicts-of-interest here are incredible.

It was recently proposed the same groups that developed and manage the substance abuse management programs being used on doctors act as organized bodies to advocate for all people with addiction and in recovery to pursue public policy changes for addiction treatment on a national level.  This recommendation was made by the Editor-in-Chief of ASAM Weekly to fellow members of the American Society of Addiction Medicine (ASAM) and 250,000 addiction medicine professionals in a September 27, 2016 ASAM Weekly Editorial Comment and the author is on the list of “like-minded docs” and closely affiliated with the primary architects of this system. He is part of their inner circle and just another foot soldier in the Trojan Horse.

See:  Conflicts-of-Interest -obvious ploy to influence public policy under a seemingly altruistic agenda for profit.

A significant problem is  that the vast majority of people know little or nothing about Physician Health Programs (PHPs) and even fewer care.  They need to before it is too late.   Abbie Hoffman spoke of Dupont’s  expertise in drug testing both scientifically and politically as representing “the greatest threat to civil liberties we seek to protect” and warned “know your enemy.”       A warning that has apparently been ignored as he and the groups he represents  will in all likelihood be elected as representative bodies advocating for addiction medicine at large and be given power to lobby for legal, regulatory and public health policy changes in addiction treatment. They will continue to push an agenda that benefits the drug and alcohol testing, assessment and treatment industry and all we can do is watch helplessly, as Cassandra did, while these  soldiers emerge and wreak their predicted havoc.

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Source:  The “PHP-Blueprint”–A Trojan Horse for Profit and Wider Social Control

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“In the small world of drug testing, these four—Angarola, Bensinger, DuPont and Willette—are affectionately referred to as the Gang of Four. Dr. John Morgan explains, “They are the ones responsible for a good deal of drug testing’s success, and some of the fear that goes along with it. Remember these names. These men are among the most competent and knowledgeable about drug testing—scientifically and politically. They are well-informed: they have to be. Their livelihoods depend upon their credibility. Unfortunately their expertise represents the greatest threat to the civil liberties we seek to protect. Know your enemy.” ¹

Steal This Urine Test – Fighting Drug Hysteria In America – By Abbie Hoffman with Jonathan Silvers. 1986

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A recent Huffington Post article written by Maia Szalavitz, The Rehab Industry Needs to Clean Up Its Act Here’s How, describes the need to radically rethink and reform American addiction treatment.. The article quotes Dr. Mark Willenbring who states

“What we simply need is a nice bulldozer, so that we could level the entire industry and start from scratch.”

Agreed, but the chances of this are slim to none if the “PHP-blueprint” becomes the “New Paradigm.”  To prevent this from happening it is critical to disprove the claims, recognize the threat, and address the matter directly and collectively.   We need political and social activism in the same spirit as Abbie Hoffman whose words from three decades ago are aptly accurate.  His prescient warnings remain unknown, forgotten, or irrelevant to us today but their accuracy is crystal clear.  Few people know the enemy.

On April 23, 2015 Dr. Robert Dupont, MD addressed the House Subcommittee on Oversight and Investigations Combatting the Opioid Abuse Epidemic and proposed widespread application of a “New Paradigm” for substance abuse management based on the nation’s physician health program (PHP) model of care.

This model is being brandished as “gold standard for addiction treatment” to the drug and alcohol rehabilitation community and general public. The medical literature contains numerous articles claiming the high success rate of these programs^4,6,9,10and they are being promoted to set the “ standard for recovery” as a replicable model to be used for treating “other addicted populations.”¹¹  In his speech before the House Subcommittee Dupont states critics call the expansion “utopian” but many would beg to differ. “Dystopian” would be more like it.

There has been an increasing scrutiny of these programs recently  not yet covered by mainstream media.  The link between the marked increase in physician suicide (which is much more than the oft quoted medical school class of 400 per year is directly related to the FSPHP takeover of PHPs).  A recent Medscape article   describes the coercion, control, secrecy and conflicts-of-interest between the PHPs and their “PHP-approved” assessment and treatment centers.  The simple fact is the majority of doctors referred to these programs do not have a substance use disorder or psychiatric problem but are given one nevertheless. This removes their locus of control and puts the PHP in complete power.  Their fate is in the hands of the PHP.

The assessment and treatment facilities used by PHPs do not take insurance and require payment up front. It is all out of pocket because if insurance was involved the fraud would have been discovered long ago. The PHPs have no accountability.  There is no oversight by medical boards or medical societies and answerability and justification for actions are absent.  And as we are hearing the rehabilitation industry itself is unregulated.  So too are the junk-science lab tests used in PHP programs as these non-FDA lab tests and the corrupt labs that use them have no oversight form the FDA or any other agency able to hold them to account.  It is a free for all.

Those ensnared in this web do know the enemy but can do nothing about it.   I am hearing story after story of doctors seeking help from their medical societies, law enforcement,  the media and the ACLU only to be turned away.

Their stories are remarkably similar An increasing number of complaints involving PHPs and the preferred assessment and treatment centers and contracted commercial labs are being reported.   A recent lawsuit filed by a doctor against the North Carolina PHP and Medical Board reported onMedscape last week is a prototypical case. The scenario typically goes like this: An accusation is made against a doctor who has had no previous disciplinary history or concerns (alcohol on breath, throwing a surgical instrument) and referred to the state PHP; An assessment is recommended by the PHP at an out-of-state “PHP-approved” assessment and treatment center; the assessment confirms a psychiatric problem or substance use disorder and recommends typically three-months of inpatient treatment followed by a 5-year contract with the state PHP for monitoring. It is becoming clear that doctors who do not fit the diagnostic criteria for a disease are being diagnosed with a disease. There are also complaints of laboratory misconduct and forensic fraud.

It is important to recognize that State PHP programs require strict adherence to 12-step doctrine¹¹ and limit assessments to not only ASAM facilities but to a specific constellation of 12-step assessment and treatment centers with medical directors who belong to a group called like-minded docs.  It is in fact a “rigged game.”

In “Six lessons from state physician health programs to promote long-term recovery” Dupont and Dr. Greg Skipper attribute this success rate to the following factors:¹²

(1) Zero tolerance for any use of alcohol and other drugs;

(2) Thorough evaluation and patient-focused care;

(3) Prolonged, frequent random testing for both alcohol and other drugs;

(4) Effective use of leverage;

(5) Defining and managing relapses; and

(6) The goal of lifelong recovery rooted in the 12-Step fellowships.¹²

In truth the sole basis for these claims is a single retrospective cohort study of 904 physicians monitored by 16 state PHPs initially published in the British Medical Journal in 2008.² In 2009 the same study was published in the Journal of Substance Abuse Treatment³ and deemed the “PHP-blueprint. Methodologically flawed and rife with conflicts-of-interest this study is the sole foundation of all of the claims.   Of the 904 participants 102 were “lost to follow up” and of the remaining 802, 155 failed to complete the contract but despite the small numbers this study has been hashed and rehashed to brandish the claims of an 80% success rate physician including subsets of psychiatrists,⁴surgeons⁵ and anesthesiologists⁶  In his address to the House Subcommittee Dupont, who is a co-author on every one of these papers, claims similar success in a subgroup of opioid addicted doctors.

None of this has been subjected to normal scientific peer-review procedures and represents a serious departure from the normal standards of scientific inquiry

The same forces that have created and sustained the current monopoly of 12-step oriented treatment in America have grand plans through links  forged though government, private agencies and the drug and alcohol testing assessment and treatment industry.

Through a combination of large-scale funding, rhetorical persuasion and moral panics they have gained both tremendous sway and power in the profession of medicine and the collateral damage they have caused is widespread and permanent.   They are poised to do the same to others using the  same methods and the procedural protections afforded to those currently being tested for substances of abuse in Federal Workplace Drug Testing programs will be removed without your consent or knowledge.   I recently heard from someone  that these groups are lobbying the Nuclear Regulatory Commission into accepting this model with some resistance.

As far-fetched as all of this sounds all one has to do is look. The greatest threat to the civil liberties we seek to protect is no longer a threat but a reality.

Examine the documents below and connect the dots to see the coming Trojan horse for systemic application of a flawed substance abuse management program with no evidence base.

Medicalization of 12-step  will be accomplished when “addiction medicine” becomes recognized as a bona-fide medical specialty by the American Board of Medical Specialties.(ABMS) which is slated to occur within the next couple years. At that point this group will deem 12-step ideology as best practice  “evidence-based” doctor recommended care. This will “sanctify” the  ideology as medical “standard of care” and can then be imposed on anyone with impunity and immunity.   Medicalization subverts the Establishment clause of the 1^st Amendment and the propaganda supporting this has already begun.   See the 12-step “facilitation”  piece below giving the reasoning they will use.  This is not facilitation but coercion.

The ASAM White Paper on Drug Testing promotes random testing of everyone using the Non-FDA approved tests of unknown validity currently used in state physician health programs. This will be implemented through the healthcare system by removing procedural protections currently in place under federal guidelines. This is sure to be a boon for anyone battening and fattening off the Drug and Alcohol Testing Industry Association or rehab racket gravy train but a burden and pain for the rest of us.

The conflicts of interest are unfathomable.

Dupont and fellow “Gang of Four” member Peter Bensinger (DEA chief, 1976–1981) run a corporate drug-testing business. Their employee-assistance company, Bensinger, DuPont & Associates is the sixth largest in the nation and managing drug testing for some 10 million Americans including Kraft Foods,  the FAA and even the Justice Department.  They sell drug-testing management programs.  The “New Paradigm” is simply a ruse to get non-FDA approved testing into the wider workplace via loopholes and workarounds.  His ties to the drug and alcohol testing and treatment industry are easy to find.  Drug testing is a multi-billion-dollar-a-year industry. DATIA [Drug & Alcohol Testing Industry Association] represents more than 1,200 companies and employs a DC-based lobbying firm, Washington Policy.  Many of the non-FDA approved tests they are using in the “PHP-blueprint” they in fact introduced to the market themselves with no evidence base. It is reprehensible.

And the people who will suffer most in the “New Paradigm” will be those who are already marginal in American society. That’s a given. I have heard from doctors who are gay or belong to a minority group who claim they were referred to a PHP due to discrimination but had no recourse.

Medicalization of behavior  removes due process as the victimized are simply put in a labeled group.  The perpetrators justify  their actions through  actuarial logic that safely enables them to deny and dismiss underlying prejudice from view  by categorization of risk.   Discrimination is justified and rationalized.   Just read the documents below and connect the dots. If you do not like what you see then do something about it.  Say something. Write something. Tweet something.  Make a phone call. Just do something. \

The Emperor has no clothes and this needs to be exposed.  Either defend what you read below or protest this New Inquisition.  We need revolt and Revolution.  The Federation Of State Physician Health Programs (FSPHP) regime is simply another front-group designed to force the medical profession in line for the profits of the rehab racket.  The FSPHP is the enemy not state PHPs. They need to be put under “new management.”  The bullies, thugs and profiteers need to  be removed.  This system needs to be reformed and repaired  with transparency and accountability. To accomplish this the entire long running mess needs  to be bulldozed  and rebuilt from scratch. Advocacy and watch-dog groups need to be formed to protect those currently ensnared in this system.

1. Robert Dupont’s 2012 Keynote speech before the Drug and Alcohol Testing Industry Association
2. Robert Dupont’s address before the House Subcommittee on Oversight and Investigation Combatting the Opioid Epidemic
3. 2014 Journal of the American Medical Association (JAMA) article entitled “Addiction Medicine: The Birth of a New Discipline”
4. The ASAM White Paper on Drug Testing
5. Why good addiction centers connect clients to AA or NA

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1. Hoffman A, Silvers J. Steal This Urine Test: Fighting Drug Hysteria in America. 1 ed: Penguin Books.
2. DuPont RL, McLellan AT, Carr G, Gendel M, Skipper GE. How are addicted physicians treated? A national survey of Physician Health Programs. Journal of substance abuse treatment. Jul 2009;37(1):1-7.
3. White WL, Dupont RL, Skipper GE. Physicians health programs: What counselors can learn from these remarkable programs. Counselor. 2007;8(2):42-47.
4. Skipper GE, Campbell MD, Dupont RL. Anesthesiologists with substance use disorders: a 5-year outcome study from 16 state physician health programs. Anesthesia and analgesia. Sep 2009;109(3):891-896.
5. Yellowlees PM, Campbell MD, Rose JS, et al. Psychiatrists With Substance Use Disorders: Positive Treatment Outcomes From Physician Health Programs. Psychiatric services. Oct 1 2014.
6. DuPont RL, McLellan AT, White WL, Merlo LJ, Gold MS. Setting the standard for recovery: Physicians’ Health Programs. Journal of Medical Regulation. Mar 2010;95(4):10-25.
7. Dupont RL, Skipper GE. Six lessons from state physician health programs to promote long-term recovery. Journal of psychoactive drugs. Jan-Mar 2012;44(1):72-78.
8. McLellan AT, Skipper GS, Campbell M, DuPont RL. Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States. Bmj. 2008;337:a2038.
9. DuPont RL, McLellan AT, White WL, Merlo LJ, Gold MS. Setting the standard for recovery: Physicians’ Health Programs. Journal of substance abuse treatment. Mar 2009;36(2):159-171.
10. Buhl A, Oreskovich MR, Meredith CW, Campbell MD, Dupont RL. Prognosis for the recovery of surgeons from chemical dependency: a 5-year outcome study. Archives of surgery. Nov 2011;146(11):1286-1291.