Doctors are Dying due to Laboratory Developed Death (LDD)–Help me get this exposed as they plan on expanding these tests to others. You could be next.

April 9, 2015April 9, 2015mllangan1 7 Comments

“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

The use of non-FDA approved Laboratory Developed Tests (LDTs) for drug and alcohol testing is currently limited to PHPs and the criminal justice system. (i.e. monitoring programs in which those doing the testing have power and those being tested have no power). That may soon change. See Drug Testing and the Future of American Drug Policy and The American Society of Addiction Medicine White Paper on Drug Testing describing the plans for widespread expansion of this drug testing to other groups including kids. This system of institutional injustice is killing doctors by suicide as the medical societies and Departments of Public Health have given PHPs full autonomy and authority. Can you name one other company, organization, group or agency that has no transparency, regulation or oversight? The PHP system has removed themselves from all accountability. That is a red flag in itself. If they are not held accountable they may very well be after you next as their goal is expansion to other groups including kids! Doctors are afraid to talk about this for fear of being ensnared themselves. Those already in these programs will not speak for fear of punishment. Help me get the word out –too many doctors are dying including three in Oklahoma in a one month period–all being monitored by the PHP.

“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. He explains how this expressed itself in a rapid decline in standards of professional ethics in the medical profession. This all started “started from small beginnings” with subtle shifts in the attitudes of physicians that there is such a thing as a life not worthy to be lived.

In 1985 the British Sociologist G.V. Stimson wrote of a new form of professional control in the United States that had emerged in the preceding decade whose “success rests on the ability to take certain areas of conduct such as alcoholism and drug abuse (which are formally disciplinary issues) and handle them as diseases.”²

Stimson writes:

“The impaired physician movement is characterized by a number of evangelical recovered alcoholic and addict physicians, whose recovery has been accompanied by an involvement in medical society and treatment programs. Their ability to make authoritative pronouncements on physician impairment is based on their own claim to insider’s knowledge.”²

Among these authoritative pronouncements was the use of specialized treatment centers. Many professionals were critical of these programs including Assistant Surgeon General John C. Duffy who criticized the “boot-camp mentality”⁴ toward doctors and American Society of Addiction Medicine President Leclair Bissel who was asked in a 1997 interview when the field began to see physicians as a specialized treatment population replied “when they started making money..” .” ⁵ Amid reports of abuse, coercion and control the Atlanta Journal Constitution ran a series of reports in 1987 concerning multiple suicides at one of these programs (5 while in the facility and at least 20 after discharge.⁶ Neither these suicides nor a large settlement against the same facility finding for fraud, malpractice, and false imprisonment involving intentional misdiagnosis⁷ generated any interest among the medical community at large.

And by 1995 the ship had sailed as the FSPHP relationship with the FSMB was forged. A 1995 issue of The Federal Bulletin: The Journal of Medical Licensure and Discipline, contains articles outlining the high success rates of these programs in 8 states with an editorial comment from the FSMB that concludes:

“cooperation and communication between the medical boards and the physician health programs must occur in an effort to protect the public while assisting impaired physicians in their recovery.”⁸

The Federation of State Medical Boards (FSMB) has approved any and all policy and regulation put forth by what is now organized under the Federation of State Physician Health Programs (FSPHP) with no apparent inquiry or opposition.

In 2003 Dr. Gregory Skipper, one of the key players of the impaired physician movement partnered with NMS labs to develop the alcohol metabolite ethyl-glucuronide (EtG) as a laboratory developed test¹³ ¹⁴ he proposed be used as a monitoring tool for covert alcohol use in physicians after a pilot study involving just 14 psychiatric inpatients.¹⁵

The policy entrepreneurship this group so effectively uses to advance their goals can be seen in a 2004 issue of the Journal of Medical Licensure and Discipline containing articles both presenting the problem ¹¹ and providing the solution.¹¹ The EtG was introduced as an accurate and reliable indicator of covert alcohol use and the impact of this cannot be underestimated as it introduce to the market not only unregulated non FDA approved tests for forensic use but tests reaching further back into history then those used by workplace drug-testing programs.

When workplace drug testing was introduced debates over both the accuracy and scope of tests occurred. The employees right to privacy and the employers right to have a drug-free workplace were discussed with the general consensus being testing for impairment was a legitimate concern but preservation of private life should remain.

What was done here dissolves both.

PHP programs require abstinence from all substances including alcohol and strict adherence to 12-step doctrine⁹ yet many of the physicians monitored by them are neither addicts nor alcoholics. Requiring abstinence from drugs and alcohol while using non-FDA approved Laboratory Developed Tests in monitoring programs is a dangerous combination. The suicides reported by the Atlanta Journal Constitution in 1987 were prior to the introduction of these tests. Adding these tests of unknown validity to an already abusive program of coercion and control would only worsen the situation.

I have been hearing of multiple suicides involving both the fear of results and false results. I have also been hearing of doctors who have killed themselves because they were suffering from depression but did not seek help as their fear of being ensnared into the PHP outweighed the need to get help.

Three decades after G.V. Stimson so accurately defined the impaired physician movement the impaired physician movement defines the professional control of medicine.. Their involvement in medical society physician health programs (PHPs) and treatment programs has evolved into absolute control of both. Pronouncements on physician impairment have evolved from insider’s claims to written edict. And their reach has extended from impairment due to drugs and alcohol to “potential impairment” and “relapse without use.” Their reach has extended from drug and alcohol impairment to all other aspects of medicine and the impact has been profound. Medicine has been subordinated to the guiding philosophy of the impaired physician movement and doctors are dying in droves due to laboratory developed death.

In The Argument of Fascism Ludwig von Mises wrote:

It cannot be denied that Fascism and similar movements aiming at the establishment of dictatorships are full of the best intentions and that their intervention has, for the moment, saved European civilization. The merit that Fascism has thereby won for itself will live on eternally in history. But though its policy has brought salvation for the moment, it is not of the kind which could promise continued success. Fascism was an emergency makeshift. To view it as something more would be a fatal error.

Laboratory Developed Death (LDT) = A death related to the use of non-FDA approved and unregulated Laboratory Developed Tests (LDTs) in zero-tolerance abstinence based monitoring programs. As a positive test results in “swift and certain” consequences the use of tests of unknown validity absent the standard safeguards used to protect the donor from false positives or fraud creates an underlying climate of anxiety described as “Russian Roulette without the gun.” Introduced in 2004 they were tested on doctors in physician health programs and probationers and parolees in the criminal justice system Fear surrounding the potential results of a test and the consequences as well as the consequences imposed due to a true, erroneous or intentionally falsified positive test have resulted in suicides.

Backfire Step 3: REFRAME –Fraudulent Concealment of Fabricated Forensic test correction, False Statements Under Color of Law : Need to hold accountable

April 7, 2015May 15, 2015mllangan1 4 Comments

Laboratory developed tests (LDTs) have no FDA or CLIA oversight. Avoiding regulatory oversight is just one of the ways those involved in the use of these tests avoid accountability. Without answerability to third parties they have essentially removed themselves from consequences.

College of American Pathologists (CAP) accreditation is the sole avenue for complaint. CAP does not sanction. They only have the ability to educate lab to come under compliance with CAP standards under threat of loss of accreditation and it is under this threat that they can force a laboratory to correct both unintentional and intentional errors. This is what was done in my case.

I filed a complaint with CAP in January of 2012. The “Litigation packet ” showing forensic fraud was sent to CAP and I was informed that the investigation could take many months. In October of 2012 I was suddenly reported to the Board of Registration in Medicine for “noncompliance” with AA meetings (that were the sole and direct result of this test) and action was taken against my medical license which resulted in my suspension.

In December of 2012, the Chief Investigator for CAP, Amy Daniels called me to see how I was doing in light of the “amended” test. She told me that the test had been invalidated on October 4, 2012. I told her this was news to me as I was in the process of being suspended for “noncompliance” and called the Director of Operations at Physician Health Services (PHS) Linda Bresnahan who predictably told me she was unaware of any revision to the test.

But the very next day a letter was sent out signed by PHS Medical Director Dr. Luis Sanchez, M.D. stating that they had just found out about the amended test on December 10. 2012, the day before when I called them. Interestingly the letter acknowledged the invalidity of the test but stated PHS and the BORM would “continue to disregard” it. Sanchez also made it a point in the letter to state they were were not aware of any consequences resulting from it. They denied any knowledge of an October 4, 2012 revision which would have been 67-days earlier than this acknowledgment and dismissal of the test.

In response to 93-A demand letters from my attorney for fraud, PHS, Quest and USDTL all refused to consider any damages by blaming my suspension on me. They claimed my suspension was due to my “noncompliance” with attending AA meetings that was officially reported to the Board October 18, 2012. The claimed the test that was used as a stepping-stone for all subsequent adverse events was completely irrelevant and had nothing to do with anything. This is what is known as “moving the goalpost.” What they did not know was that I would eventually be able to get the document proving they knew what they knew and when they knew it.

The response letters revealed important information that was previously only speculative with no way to prove. Both labs, in defense, claimed that the test was sent as “clinical” specimen at the request of PHS (an ultra vires out of scope act as they are a 503(B) charity. PHS is not a healthcare provider and is not authorized to practice medicine.

PHS and the labs were apparently unaware of the new HIPAA Privacy rule that requires labs to provide patients with their lab tests without approval from the agency ordering the test. PHS had previously refused to provide labs by hiding under confidentiality and medical records regulations.

At first they refused but CAP and the DOJ -civil rights division forced USDTL to provide the document below dated October 4, 2012 informing Dr. Luis Sanchez of the amended test he reported in a signed letter to a state agency that he had just found out about December 10, 2012. The letter undeniably shows Sanchez lied to a state agency in a written letter. This is also a prima facie crime. It is just one of many crimes that Board Attorney Deb Stoller has facilitated for PHS as her job is to ignore, suppress, minimize and deflect any criminal acts committed by PHS and protect them. And this needs to be made public. PHS needs to be held accountable. So too do the actions of Ms. Stoller whose job as an agent of the state makes her involvement even more egregious than the perpetrators.

The documents below show a clear violation of M.G.L. 256 (B) Section 69 done under Color of Law.

Title 18, U.S.C., Section 242
Deprivation of Rights Under Color of Law

This statute makes it a crime for any person acting under color of law, statute, ordinance, regulation, or custom to willfully deprive or cause to be deprived from any person those rights, privileges, or immunities secured or protected by the Constitution and laws of the U.S.

This law further prohibits a person acting under color of law, statute, ordinance, regulation or custom to willfully subject or cause to be subjected any person to different punishments, pains, or penalties, than those prescribed for punishment of citizens on account of such person being an alien or by reason of his/her color or race.

False Statements Relating to Health Care Matters (18 U.S.C. § 1035) It is a crime to knowingly and willfully falsify or conceal a material fact, make any materially false statement, or use any materially false, fictitious, or fraudulent writing or document in connection with the delivery of or payment for health care benefits, items, or services. 11 Chapter 2 ~ Summary of Fraud and Abuse Laws

Mail and Wire Fraud (18 U.S.C. §§1341 and 1343) Statutes, which prohibit the use of the mails or the wires to further “schemes” to defraud

Perjury and False Statements

PERJURY BY WRITTEN INSTRUMENT.

FALSE STATEMENTS (18 U.S.C. § 1001)

This statute prohibits the making of any false, fictitious, or fraudulent statement to the United States or a government agency. This statute is exceedingly broad: It covers any statement or representation made to the government or any of its agents. A statement can be made either orally or in writing, and it can be sworn or unsworn.

Supression of Dissent: Basic Information

2. The keys to backfire

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

• Redeem: validate the target, challenge devaluation

• Reframe: emphasize the injustice, counter reinterpretation

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

via Helpful resources for those abused and afraid — via http://www.bmartin.cc .

Robert DuPont, Physician Health Programs and Expansion of the “New Paradigm.”

April 7, 2015April 7, 2015mllangan1 5 Comments

Robert DuPont, The ASAM, FSPHP, Physician Health Programs and the “New Paradigm.”

“With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world.”-Twelve Steps and Twelve Traditions, AA World Services, Inc (1953).

In 2012 Former White House Drug Czar (1973-1977) Robert Dupont, M.D. delivered the keynote speech at the Drug and Alcohol Testing Association (DATIA) annual conference and described a “new paradigm” for addiction and substance abuse treatment. The former National Institute on Drug Abuse Director proposed expansion of this paradigm to other populations including workplace, healthcare, and schools.

As a substance abuse treatment program that “sets the standard for effective use of drug testing,” the proposed new paradigm is based on the state Physician Health Program (PHP) model

Dupont wants to expand the PHP model to other populations. In an article published in the Journal of Psychoactive Drugs in 2012, he and co-author Greg Skipper, M.D, (Director of Professionals Health Care at Promises Treatment Center) describe the necessity for wider application of this new paradigm. They review the successes of similar programs monitoring commercial pilots, attorneys, probationers, and those in the criminal justice system, and proclaim the “need to reach more of the 1.5 million Americans who annually enter substance abuse treatment, which now is all too often a revolving door.”¹ They conclude:

This model of care management for substance use disorders has been pioneered by a small and innovative group of the nation’s physicians in their determination to help other physicians save their careers and families while also protecting their patients from the harmful consequences of continued substance abuse. In fulfilling the professional admonition “physician: first heal thyself,” these physicians have created a model with wide applicability and great promise.¹

“Based on abundant evidence, a “new paradigm” for substance abuse treatment has evolved that is the exact opposite of harm reduction. This paradigm enforces a standard of zero tolerance for alcohol and drug use that is enforced by monitoring with frequent random drug and alcohol tests. Detection of any drug or alcohol use is met with swift, certain, but not draconian, consequences.”

Straight, Inc. –Torture as treatment

In 1981 Dupont made similar claims about Straight, Inc., a non-profit teenage rehabilitation center. The predecessor of Straight, Inc., the Seed, was started in 1970 in Florida with a start up grant of $1 million dollars from the federal governments National Institute on Drug Abuse (NIDA). Director of NIDA, Robert L. DuPont, Jr. had approved the grant.on the antidrug cult Synanon founded in 1958. Deemed a the “family oriented treatment program,” Dupont encouraged organization and expansion. Targeting the children of wealthy white families they exploited parents fears for profit. Signs for hidden drug use such as use of Visine, altered sleep patterns, and changes in clothing style were used as indications for referral. Any child who arrived would be considered an addict in need of their services. Coercion, confrontation, command and control as the guiding principles,. Submit or face the consequences. .We know what’s right. The idea was to strip the child of all self-esteem and then build him back up again in the straight image. Abused dehumanized, delegitimized, and stigmatized-the imposition of guilt, shame, and helplessness for ego deflation and murder of the psyche to facilitate canned and condensed 12-step as a preparatory step on the path of lifelong spiritual recovery.

Children were coaxed or terrorized into signing confessions, berated, and told they were in “denial. Inaccurate and false diagnoses were given to wield greater control. Reports and witness accounts now indicate that many of the kids did not even have drug problems but by creating a “moral panic” about teenage drug use they exploited parents fears for profit. Straight, Inc. became the biggest juvenile rehabilitation center in the world. Health officials in Boston cited Straight for treating a 12 -year old girl for drug addiction when her records revealed all she did was sniff a magic marker! Pathologizing normality.

Methodologically flawed research , deceptive marketing, and propaganda were all used to support the continuation of the program. Designed to be hidden from public view. Straight, Inc. had no regulation or oversight. These programs of torture and abuse resulted in many suicides, suicide attempts, post-traumatic stress disorder and other psychological and grave psychological trauma. There is a FB page dedicated in memory to all of those who died.

The retrospective five year cohort study they published in 2008 is their flagship study about which they parade an 80% success rate. It is methodologically flawed in many ways with missing and incomplete information and misleading interpretation. It’s all propaganda.

The 2008 Physicians Health Program study inexplicably excluded resident physicians because they “were both younger than the average practicing physician and therefore at higher risk of substance abuse.” Other than cherry picking to favor success what is the logic behind that.

More importantly, however, is the 24 that “left care with no apparent referral” and the 48 that “involuntarily stopped or had their licenses revoked.”

It would seem logical that there must have been some major precipitating event leading to the 24 physicians who left care. And what happened to the physicians who were removed from the programs and had their licenses revoked ?–event that could very well lead to feeling hopeless with no way out and precipitate a completed suicide.

They list only 6 suicides and it appears that the outcome suicide they are using is one that was done while being actively monitored in the program. If they were removed from PHS or had their licenses revoked and subsequently committed suicide we don’t know. The outcome seems to be the last recorded clerical status of the monitored physician.

Since this group is now lobbying to use this “blueprint” as a successful model applicable to other populations and may be involved in the assessment and monitoring of a much larger population should the random drug and alcohol testing of all physicians come to be it is essential that who they are be exposed as well as the validity of the claims they make. There are no evidence-based reviews of any of the ASAM studies including the junk science of the EtG and PEth tests that will surely be used in any physician monitoring program that were introduced and marketed by Greg Skipper yet he lists no conflicts of interest. The 12-step evidence is self-evident in the “blueprint.”

Interestingly, I cannot even find any criticisms of the design of the study and its flaws–only praise and sloganeering. We need to speak up before the door closes for good..

The vast majority of people know little about Physician Health Programs. They seldom reach the threshold of public attention.

Unless specifically looking for information about them, little treatment community blandishment, there is a dearth of informative in depth analysis

ASAM/FSPHP/LMDs

April 7, 2015mllangan1 1 Comment

ASAM/FSPHP/LMD Blueprint

Front-Groups representing corporate (drug testing labs, EAPs, inpatient treatment industry) and political (prohibitionist, war on drugs, AA 12-step paradigm of addiction) interests.

American Society of Addiction Medicine ( http://www.asam.org ) –ASAM primarily a lobbying group/special interest group. Origins can be directly traced to Alcoholics Anonymous (A.A.) and started by Dr. Ruth Fox. Goal originally to get the medical establishment to accept the chronic brain disease model and 12-step spirituality as the only treatment for alcoholism.

Federation of State Physician Health Programs (http://www.fsphp.org )–ASAM took over state Physician Health Programs (PHPs) by joining state PHPs and outnumbering non-ASAM physicians were eventually weeded out (removed, contracts not renewed, retired)

Like Minded Docs (http://www.likemindeddocs.com/about-us.html )–a right wing conservative subset of ASAM. 12-step ideology and facilitation primary goals.

Physician Health Programs and Professional Health Programs (PHPs)–started in the 1970s as “impaired physician” programs and existed in every state by 1980. Changed to Physician Health Programs (PHPs) to focus on wellness rather than impairment. Organizational goal to help sick doctors and protect the public and originally funded by medical societies and staffed by volunteer physicians. Now taken over by ASAM doctors.

Map below shows number of ASAM certified physicians by State in 1988 (ASAM then known as AMSAODD).

ASAM/ABAM “Board Certification” not recognized by American Board of Medical Specialties.

Group of physicians “in recovery” In 1986 started calling themselves “experts” in addiction medicine. Addiction Psychiatry only recognized subspecialty in addiction medicine and requires 4 year psychiatry residency and 1 year of fellowship at an accredited training program and stringent testing and oversight.

ABAM certification requires only an MD and board certification in ANY specialty.

Aced it!

ABAM certification = Diploma Mill. Started in 1986.

I took exam in 2010 to make this point and passed by 65 points with a score of 459 (Passing = 394).

Purpose of Diploma Mill = Profiteering from multi-billion dollar treatment industry now dominated by the “Minnesota Model” (i.e. addiction is a chronic “brain-disease,” complete abstinence, life-long spiritual recovery (AA, 12-step).

“PHP-approved” assessment and treatment centers. State PHPs and the FSPHP mandate that any assessment and treatment be done at a “PHP-approved” assessment and treatment center and exclude non-PHP approved assessment and treatment centers.

No criteria or list of “PHP-approved” assessment and treatment centers. None exist. All of the “PHP-approved” facilities can be correlated with list of Like-Minded Docs. LMDs are medical directors of all “PHP-approved” assessment and treatment centers.

Major Issues:

1. state Medical Boards are mandating doctors for evaluations at facilities for which no criteria exists for PHP”approval.” ? Anti-trust

2. Establishment Clause violations –doctors being mandated to 12-step facilities only.

Number of physicians in US board certified in Addiction Psychiatry = around 1000

Number of physicians in US “board certified” by ASAM = over 4000

Who are they? The majority of these physicians are “recovered” addicts and alcoholics who had licenses revoked. They were able to regain their licenses by convincing State Medical Boards that they were 1) Recovered, reformed, redeemed. 2) Societal need for addiction medicine doctors. Convinced boards that if their licenses were restored they would altruistically dedicate their lives to helping other addicts and alcoholics. Win-win situation.

Licenses restored they then became “certified” in addiction medicine.

Where did they go? 1) Joined PHP programs funded by State Medical Societies and staffed by volunteer physicians. 2). Staffed 12-step inpatient drug rehabilitation programs as Medical Directors.

The State PHPs were “sitting ducks.” The equivalent of other employee EAPs but without protection (i.e. no union or worker organization set up to protect a doctors interests) No oversight, regulation, inspection, or transparency but layers of procedural protection).

They systematically and slowly took over the PHPs in each State and now monopolize the system. Physicians who did not go along with the “groupthink” were removed over time.

In Massachusetts the coup was accomplished when Dr. John Knight, M.D. was removed in 2009 and Dr. J. Wesley Boyd, M.D, PhD was removed in 2010.

http://connects.catalyst.harvard.edu/Profiles/display/Person/85877 http://connects.catalyst.harvard.edu/Profiles/display/Person/85647

http://www.jwesleyboyd.com/?p=280

Physicians removed from PHPs were threatened with swift and certain consequences if they violated confidentiality agreements or “peer review” protection. “Win or lose, you’ll lose everything. Most effective, however, was the implied and unspoken threat that if they did not do as they asked they could end up being monitored by them. (having been witness to ethical violations and criminal activity committed with impunity the message was heard loud and clear.

The State PHPs taken over by the ASAM physicians are under the umbrella organization FSPHP.

http://www.fsphp.org

PHS formally entered into this partnership in 2013.

http://www.massmed.org/News-and-Publications/Vital-Signs/PHS-Partners-with-the-Federation-of-State-Physician-Health-Programs/#.U2ElTl5oOCg

The ASAM staffed treatment centers are also under an umbrella organization.

https://www.naatp.org

Conservative subset of the ASAM “Like-Minded Docs”

http://www.likemindeddocs.com/about-us.html

In reviewing my records please note that every person involved in my “assessment” and “treatment.” Has been a Like-Minded Doc including the Medical Review Officer at PHS, Wayne Gavryck, a former alcoholic and graduate of the program with a history of malpractice and no qualifications. (in contrast to Knight and Boyd he has no publications, teaching, or academic affiliations. He is also the person at PHS who should have thrown out the PEth test.

Primary purpose = Profit and monopoly. Who profits?

The architect of the system Robert Dupont (ASAM, LMD). Owns an EAP and drug testing company (6^th largest in US). http://www.bdaeap-online.com/?s_username=nisenhanced

http://www.alternet.org/civil-liberties/random-drug-testing-all-chilling-proposal-key-addiction-journal-major-invasion

http://en.wikipedia.org/wiki/Robert_DuPont

http://www.thenation.com/article/173654/gops-drug-testing-dragnet#

2). The drug testing companies.

How does it work? Like-Minded Docs is to the ASAM what the Tea-Party is to the GOP and the FSPHP are the brown-shirts of the group.

How it Works

Step 1) Positive Urine -(below cutoff metabolite of prescribed med, fabricated) Disregard for MRO standards and protocol. Ignore guidelines and standards of care. Report any and all positives to Boards of Medicine (Boyd and Knight discuss). http://bit.ly/19iXBq3

Step 2) Refer for an evaluation at a facility experienced in the diagnosis and treatment of health care professionals (Hazelden, Bradford, Talbott,). Hearing same pattern across the country. Neuropsychological assessment fraud with diagnosis of “denial” based on elevated L-score on MMPI and “cognitive impairment” based on shaving off executive function points on the Wechsler IQ scale. Deem unable to practice medicine and recommend 1-4 month inpatient rehabilitation.

Step 3) “noncompliance” default. With PHS programs the “trump card” is to call the monitored physician “noncompliant” and report it to the board.

In my case

Wayne Gavryck, MD. Medical Review Officer for PHS, Inc. Reported PEth test as positive July 19^th, 2011.

Have documentation confirming collusion PHS with USDTL to commit fraud (2011)

Based on the positive PEth recommended an evaluation at a facility experienced in the “evaluation and treatment of health care professionals.” Given 3 choices.

Talbott –Medical Director Paul Earley

Hazelden—Medical Director Omar Manajwela in 2011, and now Marv Seppala.

Bradford—Medical Director Mike Wilkerson

Have documentation confirming collusion with Talbott Rehabilitation Center to commit fraud (2008) . Had evaluation in 2008 under Paul Earley.-Fabricated MMPI. Documented by oversight Board.

I chose Hazelden.. Dr. Omar Manajwela did not find any history of alcohol abuse (past or present) and I was not admitted for treatment. He could not explain the positive PEth test, however, so recommended AA meetings. I informed Hazelden I had requested the “litigation packet” as I suspected fraud and was told they could revise my discharge summary if I was able to prove this.

Linda Bresnahan then requested I verify attendance at AA meetings by giving them phone numbers of anonymous attendees and said that it was the recommendation of Hazelden. Made multiple requests to Dr. Omar Manajwela to verify that 1) he did not recommend this , and 2) that it was inappropriate. He refused.

I obtained the “litigation pack” that showed forensic fraud. Documents show collusion with labs to both produce the positive test (USDTL, Fax from PHS, inc. to USDTL requesting a chain of custody be added to an already positive test) and cover-up (Quest diagnostics). Confirmed fraud after investigation by The College of American Pathologists). CAP forced USDTL to change PEth from “positive” to “invalid.” This was done 10/4/2012.

I contacted Hazelden multiple times and sent them the litigation packet showing misconduct and asked that they revise my record and recommendations.

Dr. Marv Seppala,Medical, Director of Hazelden, acknowledged the test was invalid but refused to make any changes in my records or help me convey this to the BORM.

PHS called me “noncompliant” 10/8/2012.

PHS barred me from using my asthma medication. With a history of severe asthma since childhood, it had been under control for 10 years. Had multiple cold induced asthma attacks documented by Dr. Bierer. Had to stop exercising at gym I had been going to almost every day for years.

After suffering a cracked molar I was told it would require partial sedation by orthodontist. Told Dr. Chinman who told me they would test my hair and if they found anything “that would be it”. Left untreated 9 months. I chewed on one side of my mouth and tolerated the pain.

They also tried to financially torture me. Multiple excessive charges billed by PHS with demand that I pay or they would report me to the BORM for noncompliance. These are tests that were not even done and an audit of PHS would reveal them to be false. I told Dr. Chinman I was having financial difficulties because of what was occurring but that I had put . $2000.00 away for Christmas presents. The next day Linda Bresnahan demanded $2000.0 under threat of reporting me to the Board.

I requested a day off from testing because my daughters were dancing in Providence in the Irish Step dancing finals (Oireachtas) and would not be available that day. The day before the Oireachtas he called me and told me he had to change our monthly appointment and the only time he could see me was the next day, it was mandatory, and if I did not he would report me to the BORM. The appointment was the exact same time my daughters were dancing. He looked it up.

Robert Dupont – Former White House Drug Czar (1973 to 1977) and the Director of the National Institute on Drug Abuse(NIDA) (1973-1978). Fellow of the American Society of Addiction Medicine. Founding President of the Institute for Behavior and Health, Inc. He and Peter B. Bensinger (former DEA administrator) founded Bensinger, Dupont, & Associates, a national consulting firm that specializes in workplace drug testing(EAP). ( http://bit.ly/1nNjWzi ).

Former architect and champion of Straight Inc. There have been multiple suicides of kids abused by these programs. Memorial FB page of those who died from these programs. http://on.fb.me/1mtmQOf http://bit.ly/1c2Mv6

PHP model based on this model “New paradigm” PHP model of substance abuse treatment based on single methodologically flawed study of 902 physicians (retrospective non-blinded cohort) with false endpoints to hide the number of suicides. Claiming 80% success rate . No Cochrane or other critical review. Biased opinion piece. Sole basis for “gold standard.” http://bit.ly/N0fMbN

http://bit.ly/N0fMbN.

Greg Skipper—Introduced EtG as biomarker for alcohol testing based on little science. Partnered with F. Wurst (who holds the patent). Came up with arbitrary cutoff of 100, tested it on doctors in the Alabama PHP program, and marketed it to a drug testing company as proof positive of alcohol ingestion. Ruined countless (hand sanitizer alone can cause levels > 2000). SAMHSA advisory put out stating little science and advising against its use. Very poor sensitivity hand sanitizer alone can cause levels of 2000) Most EAP’s abandoned it but PHPs (and a handful of other programs where the tester has absolute control and the person being tested has none) continued to use it. Now introduced PEth as confirmation of drinking in combination with the EtG. Like the EtG there is no evidence base and specificity unknown. Also proselytizing Soberlink alcohol testing device

Without Dr. William Morgan the 2004 Red Sox World Series win would not exist–a true Boston Hero

April 6, 2015June 14, 2015mllangan1 2 Comments

The essay below found on 123HelpMe.com called The “Doctor Who Saved Boston.” is about Dr. William J. Morgan, the brilliant hand surgeon who helped the Red Sox win the World Series for the first time in 86 years. Morgan performed surgery on Curt Schilling’s severely damaged ankle that allowed him to pitch in game 6 of the ALCS against the Yankees when we were down three games to two.

No known medical or surgical options existed to allow Schilling the functionality to pitch. But just as things were looking bleak Dr. Morgan miraculously performed an unprecedented procedure he invented that allowed Schilling to pitch seven innings winning the game 4-2. He created a wall of stitches to hold Schillling’s torn tendon sheath in place before game 6’s win and again before game 2 of the World Series that we also won.

And October 27. 2004 is a magical date for red sox fan. Watching it unfold with my wife and daughters and the joy and excitement that followed is a vivid memory for me that I will never forget and it should be noted that without Dr. Morgan that night would never have happened. Without Dr. Morgan the curse would not have been reversed. He is a true Boston hero. But, as with all of us, he is not perfect. In November of 2003 he was arrested for driving under the influence and, as a Massachusetts doctor, he was mandated to Physician Health services (PHS) under a monitoring contract. According to news sources from February of 2010 Dr. Morgan was forced to give up his right to practice medicine in Massachusetts as a result of “unspecified allegations” and reading these reports the assumption that he must have done something very wrong is assumed–a logical and rational conclusion based on how we assume the world works.

I was reminded of doctor Morgan because today is opening day for the Red Sox. Over the past couple weeks I have been contacted on average four time a day by doctors who are currently suffering under their state physician health programs or by those who wanted to tell me of the circumstances surrounding the suicides of doctors they loved. The stories I have been hearing are heartbreaking and unreal but the patterns are the same. One of the most bothersome facts is that I have yet to hear from anyone who was truly an addict or alcoholic. Like Dr. Morgan, some life event bought them a one-way ticket into a PHP and from that point on their lives and locus of control was placed in the hands of others. Most of the doctors I have spoken to are good and kind doctors who were referred for situational factors and one-offs–mistakes or circumstances that were transient. Many were given positive tests using the non-FDA approved laboratory developed tests (LDTs) and pulled out of practice resulting in suicide.

The “unspecified allegation” leading to Dr. Morgans 2010 loss of license was that he had a positive Phosphatidyl-ethanol (Peth) test ordered by Dr. Luis Sanchez and reported as positive by USDTL. And as seen here, these two cannot be trusted. Intentional fraud perpetrated in this manner requires zero tolerance. It also brings into question the validity of all testing done by PHS and performed by USDTL. It is extremely concerning that criminal acts done under color of law is not being addressed by the state medical society and the Department of Health (DPH).

The sociologist Stanley Cohen’s States of Denial: Knowing about Atrocities and Suffering (Polity Press, 2001) systematically analyzes processes of denial by both individuals and governments and describes five methods of denial:

1. Deny responsibility: “I don’t know a thing about it.”

2. Deny injury: “It didn’t really cause any harm.”

3. Deny the victim: “They had it coming to them.”

4. Condemn the condemner: “They’re corrupt hypocrites.”

5. Appeal to higher loyalties: “I owe it to my mates.”…

None of these apply here. I happen to know that the positive test given to Dr. Morgan was not the result of anything he did. Sanchez and Jones claim professionalism and high ethical standards but the undeniable evidence shows they are unethical individuals engaging in criminal acts. These need to be exposed and those involved need to be held accountable.

Schadenfreude is a word taken from German and literally means “harm-joy.” Along with psychopathy and narcissism. schadenfreude seems to be a common characteristic of those involved in PHPs. Deriving pleasure in the misfortunes of others and particularly if that person is someone who represents what they could never be. I understand they took particular pleasure in bringing down Dr. Morgan and he deserves to be restored to his status as a true Boston hero. The city of Boston and Red Sox fans everywhere have the responsibility to make sure they be charged criminally by law enforcement. We owe it to Dr. Morgan and any others who have been victimized by the Massachusetts PHP.

The Doctor Who Saved Boston

The memories of the Red Sox run to the 2004 World Series championship this year will remain in the minds of Sox fans forever. It is about Dr. William J. Morgan, a brilliant hand surgeon who performed a risky

Whether it is David Ortiz’s walk off performances against the Angels and Yankees, Manny Ramirez’s tape measure home runs, or Derek Lowe winning the clinching games of all three playoff series, Red Sox nation will not soon forget the memories that the “bunch of idiots,” as centerfielder Johnny Damon dubbed this year’s Sox club,provided them, nor will they forget the Sox all out assault on baseball and Boston sports history.

But of all the images the fans retain, of all the feelings they experienced, of all the heroes Sox nation put on an altar and worshipped – the most memorable has to be Curt Schilling pitching three games on an inured ankle, blood from broken sutures seeping through his sock and a look of obvious discomfort on his face, winning two, and capturing the heart’s of every member of Red Sox nation.

But to understand the elation of the Nation and the reason that it has turned Curt Schilling into a God in the church that Cy Young, Ted Williams, and Carl Yaztremski built, we have to take a step back and remember the predicament that the Red Sox were in just over two months ago.

It was October 12, and the Yankees had beaten the Red Sox in Game one of the ALCS. It was only one game, but that familiar feeling was back. That familiar feeling that Red sox fans have of doom and gloom lingering just over the horizon returned.

Curt Schilling, the hired gun, the man who Sox management had brought in to beat the Yankees in just this situation, had not only lost the game, but looked utterly ineffective in doing so, allowing six runs in just three innings of work and the media was reporting that Schilling may not pitch again.

On June 10, reports came out on ESPN and in the Boston papers that Schilling had a minor injury to his ankle but that he would pitch through it and make his start that night and would not have to go on the disabled list.What came out later on in the papers was that Schilling had made the majority of his starts in the 2004 season only after undergoing shots of marcaine, which sportsinjuries.com describes as a long lasting local anesthesia that is used for pain management and works by blocking nerve sensations.The attitude that the Red Sox seemed to take toward Schilling’s injury was no harm, no foul, and after June little was heard about Schilling’s ankle, that is until October 5.October 5 was the beginning, and almost the end, of the Red Sox 2004 playoff run. It was a glorious, and infamous, day in Red Sox history. Curt Schilling pitched 6 and 2/3 strong innings at Anaheim, allowing just two runs and scattering nine hits as the Red Sox cruised to a 9-3 victory.

But late in the sixth inning, Schilling pulled up lame after fielding a slow roller down the first base line and throwing the ball over first baseman Kevin Millar’s head. He was favoring that same right ankle that had been hurting him all year.

Back to October 12, and the feelings of anxiety that every Sox fan from Maine to Rhode Island no doubt had in the pit of their stomachs. Questions were swirling around Boston. Just how serious was Schillings injury? Could he pitch again? Would he pitch again? Is there a God?

Jamie Musler, an assistant clinical specialist at Northeastern, put the injury into perspective.

Musler said that Schilling tore the tissue that covers his peroneal tendon, which sits in a small groove in the fibula and is partly responsible for moving and planting the foot. Musler said that this type of injury is caused by a traumatic event to the foot or ankle, like a significant ankle sprain, and when Schilling was moving his foot, the tendon was slipping out and causing an uncomfortable, but not necessarily painful, snapping sensation because the tendon was snapping across the fibula. This, Musler said, would directly affect foot mechanics and cause a huge problem in Schilling’s delivery.

And it would present a huge road block in Boston’s attempt to win a World Series title.

Schilling meant more to the 2004 Red Sox club than any other player. He was the tone setter and the ace, and without him the Sox would have no chance against the hated Yankees.

The Red Sox needed Schilling, because number two starter Pedro Martinez is not the fire balling Dominican dandy he used to be. And the Yankees, it seemed, had his number of late after he lost two late season starts to them, prompting Pedro to say in a press conference after one of those losses that he could “just tip my hat and call the Yankees my daddy.”

After Pedro, things got even bleaker, with inconsistent and fragile Derek Lowe, aging and unpredictable knuckleballer Tim Wakefield, and young, playoff inexperienced Bronson Arroyo filling out the rotation. These four hurlers are serviceable and talented major league pitchers, but they were not the automatic win that Schilling had proved himself to be in postseason’s past, especially in 2001, when he garnered co-MVP honors after defeating the Yankees in the World Series.

So in comes the man from behind the scenes. The man who would help the Red Sox end 86 years of playoff futility, Red Sox team doctor Bill Morgan, who talked about the injury and treatment in “Faith Rewarded,” the DVD that the New England Sports Network (NESN) recently released.

“It was a very unique situation. Either we did this or (Schilling) didn’t pitch,” Morgan said. “And he was determined that he was going to pitch, no matter what it took.” But what could Morgan do?

What followed was possibly the most publicized treatment of a sports injury in history. One could not turn on a New England news program or open up a New England paper without the top story being about Curt Schilling’s right ankle.

First, according to boston.com, the Red Sox front office brought in Dr. George H. Theodore, chief of foot and ankle service at Massachusetts General Hospital, to help Dr. Morgan try to create a brace to immobilize Schilling’s ankle while he pitched. The idea was that by eliminating movement of the ankle he would eliminate movement of the tendon and eliminate the sensation. But the problem, Schilling insisted, was that the sensation was altering his delivery, and that became apparent after his struggles in Game one of the ALCS. File that idea in the circular cabinet.

Next on the block, according to boston.com, was pair of customized cleats. Morgan had Reebok play around with different styles of cleats, from high tops to low tops, raised bottoms to lowered bottoms, in an attempt to find Schilling a comfortable medium. No dice. Schilling still could not get comfortable.

According to the Massachusetts Medical Board’s website, Dr. William Morgan is an orthopedic surgeon who specializes in hand surgery. He has his own private practice in Brighton, but his primary work setting is in hospitals. Morgan works out of several area hospitals and rehabilitation centers, including St. Elizabeth’s Medical Center of Boston and New England Baptist Hospital, New England Rehabilitation Services of Central Massachusetts, Worcester Medical Center, and University of Massachusetts Memorial Medical Center. Morgan also works out of the Massachusetts Hospital School.

Morgan got his degree from the Texas Medical College and Hospital in Galveston, Texas. He received post graduate training at the University of Massachusetts Medical Center. He continued his post grad training in hand and upper extremity surgery at the Roosevelt Hospital in New York, Brigham and Women’s Hospital, New England Baptist Hospital, and the Kantonspittal in Basle, Switzerland.

Morgan performed successful wrist surgery on one former Boston Red Sox superstar shortstop Nomar Garciaparra, allowing him to come back from what could have been a career altering injury as the All Star he was before he was injured.

The point is that Morgan is not some shaky med student on his first hospital residency. He has been around the block a few times and he knows his orthopedic surgery.

Musler said that with any injury, a doctor has to analyze it by thinking “what is the injury? What can we do to keep the tendon in place? If the feeling is throwing (Schilling) off, how do we help that?”

Morgan, it would seem, did just that, and came up with a new treatment, which he based off of the usual treatment for Schilling’s injury. Musler said that the usual treatment for the injury is to go in and deepen the groove that the peroneal tendon sits in. Musler showed me a video of the procedure in which surgeons cut away the tissue surrounding the tendon and the tendon sheath and then used a surgical drill and chisel to physically deepen the groove in the fibula that the tendon sits in. The surgeons then sutured the sheath back in place and closed the opening.
But Morgan and the Sox didn’t have that much time. They had four days. They went in, did the procedure, gave Schilling another marcaine shot, and, as they say, the rest is history.

Schilling came back and won game six against the Yankees. After the game, Morgan took out the sutures, Musler said, to avoid infection.

Morgan did the procedure again before Game two of the World Series, and Schilling would later say that had the series gone past four games he and Morgan had decided not to do the procedure again and that Schilling would shut it down for the rest of the series.

This time, Schilling was pitching on what is the biggest stage in sports, the World Series, against the best hitting team in baseball, the St. Louis Cardinals, whose line up featured Albert Pujols, the best young hitter in baseball and an MVP candidate, Scott Rolen, the RBI leader in the NL during the regular season, hard hitting and speedy shortstop Edgar Renteria, and two probable Hall of Famers in outfielders Larry Walker and Jim Edmonds.

Schilling was dominant. He made the heralded and hyped Cardinal offense look like a team of Little Leaguers as he pitched six strong innings allowing no earned runs and only four hits.
The rest, as they say, is history. The Sox would go on to sweep the Cardinals in four games, ending their 86 year dry spell of World Series titles and sending New England into a euphoria that it has still not recovered from.

But one has to wonder if there will be any lingering effects from the injury. Will Schilling be alright to pitch next year as the Sox try to repeat as champs?

Mary J. Hickey, an Assistant Clinical Specialist in the Northeastern department of Physical therapy, thinks so.

“Curt made an informed choice about his ankle. I don’t think there will be any long lasting damage,” Hickey said.

But Schilling is not out of the woods yet. Hickey said that Schilling faces at least four to six weeks in a cast, during which he will be seen often by Morgan and the Red Sox medical staff, and Musler said that Schilling faces five to six months of rehab to get back his range of motion, endurance, strength, and sports’ skill. Musler said that this could risk further injury if Schilling is not properly prepared for next season and presses when he is not ready.

Regardless of rehab and healing time, Curt Schilling and Red Sox fans are on cloud nine. The Red Sox are World Series champions for the first time in 86 years, and Sox fans have a new hero and new memories.

The memory of Curt Schilling, of him pitching hurt, grimacing in the dugout, bloody sock and all, will remain with everyone who saw it, even Yankees fans, forever. Schilling billed himself as the hired gun, a man who said in an interview with the Boston Herald before the ALCS that “he was not sure of any scenario more enjoyable than making 55,000 people from New York shut up.” But in the end he was so much more than just a hired gun, he was a hero in real red socks. And he made more than 55,000 people from Boston stand up and applaud as he became the newest Red Sox player to be canonized in the church of Red Sox nation, alongside Yaz, the Kid, Pudge and Cy.

And not to be forgotten is the man behind the scenes, the quiet and unassuming surgeon who made it all possible, Dr. William Morgan, whose name will be forever linked to Curt Schilling, the Red Sox and the 2004 World Series. He may not have thrown a pitch or swung a bat, but William Morgan saved the 2004 Boston Red Sox from being another team that just missed. And he saved Red Sox fans from finally having to utter those awful words – “wait ‘til next year.” But because of Bill Morgan and the entire Red Sox medical staff, next year is this year.

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

April 6, 2015April 10, 2015mllangan1 11 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Stephen Snook, PhD

Confirmatory Distortion

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

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

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

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

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

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

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

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

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

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

TT Wilsons PHP Playbook–Feel Good Fallacies, False Dichotomies and Frontal Lobotomies

April 5, 2015April 5, 2015mllangan1 2 Comments

images-34 Although my challenge to reveal his true identity in “Rantings from the Bully Pulpit” remains unaddressed, the doctor known as “TT Wilson” has put his two cents in on a couple of issues over the past month. I previously posted his comments to illustrate the groupthink and common tactics of doctors involved in state Physician Health Programs (PHPs) and Drug Courts. Wilson’s comments are pathognomonic of these groups and his new comments are chock full of humdingers that reinforce my notion of Wilson’s LMD affiliation. .Although Wilson never answered any of my questions his apparently piqued curiosity prompted him to query some my way.

The question is whether or not I would revise my posts concerning the legitimacy of addiction medicine when it is “embraced by the ABMS (American Board of Medical Specialties) in two years.” My answer is no.

ABMS accepting addiction medicine into the fold is not a product of the discipline meeting the collectively identified standards set by ABMS but a product of ABMS altering its standards to let addiction medicine in through the back door. I do not know the specifics yet but if history is any indicator I would guess it to be a mixture of loopholes, workarounds and cash leverage.

The current addiction medicine paradigm is not built on the scientific method or evidence base but a foundation built on shortcuts, manipulation of public policy, bent science, flawed and biased research and tinkering with the machinery of regulatory and administrative law. My criticisms are based on specific and easily documentable examples of which there are many. ABMS giving addiction medicine a thumbs up does not change any of that It is analogous to the Federation of State Medical Boards approving EtG for alcohol monitoring. The validity of EtG did not go up when the FSMB approved it. Valid criticisms are valid criticisms. Unfortunately ABMS certification will facilitate a bigger net for addiction medicine specialists schooled in one uncompromising model of addiction and treatment. The inevitable result will be more deaths due to a one size fits all abstinence based treatment paradigm necessitating zero-tolerance for alcohol and drugs but utilizing junk-science drug and alcohol testing of unknown validity–a recipe for suicide as is being seen in doctors will be played out on a larger scale. Teenagers being teenagers will be forced into a revolving door of testing, treatment and lifelong abstinence and many will end up dying. Don’t get me wrong —teenagers with real drug and alcohol problems need treatment but, as was seen in Straight, Inc., a large number of those coerced into abusive programs for treatment were there because they experimented with drugs and in all likelihood were engaging in behavior that would have stopped on its own accord as they matured. Unfortunately, many were not given that opportunity.

If I am interpreting the next topic correctly Wilson seems to be advocating we do away with the trouble of internship and residency training and that specialty certification be obtained by simply taking a test. (how addiction medicine does it now). Hey why not take it even further-we’ve all got computers these days so why not dispense with medical school too and earn your degree from home.

This pattern of softening the rigors and minimizing the importance of knowledge and experience is a concerning theme however. The ASAM White paper argues that the use of MROs for forensic drug and alcohol testing is unnecessary.

Interesting thought but internships, residencies and fellowships exist for a reason–apprenticeship, knowledge and experience.

Wilson then points out the ABIM MOC debacle –another common tactic this group utilizes when confronted with criticism—pointing the finger and deflecting the criticisms to another group to avoid a direct answer. His reference to my blog as a “rant” and “rage” is per PHP script. Deeming criticisms as rants and rages is intended to minimize and invalidate them and avoid a direct answer. Critics are frequently diagnosed with “resentment” and “unresolved issues” no matter what the validity of the criticisms.

TT Wilson then states ABMS approval of addiction medicine as a specialty necessitates I “rage” against ABMS and not doing so would be inconsistent. The logic is similar to the false-dichotomies and either or fallacies frequently used such as brain disease and moral failing, Abstinence and relapse, and other areas where they completely exclude the middle. Consistency of my comments would require I comment ABMS acceptance was the result of backdoor dealings and a mistake but that is the extent of it. Wilson then expresses his anticipation of delight believing ABMS sanctification will somehow stupefy me into some sort of fugue or dumbfounded disbelief as ABMS legitimizes addiction medicine. I don’t know what expectations are in providing him the great fun and endless amusement he mentions of in anticipatory schadenfreude but in reading his comment I was picturing him rubbing his hands together and grinning ear to ear.

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Logical fallacies, false dichotomies and a bag of tricks and tropes with no substantive value but that appeal to the intended audience are all part of the PHP playbook. A torrent of rodomontade including appeals to the authorities creeds and values. .–“promoting a culture of safety..,” “in the interests of Professionalism” and “protecting the public good..” are always part of the preface. Boosterism and puffery to rally the troops. A problem is then created by identifying a threat using exaggerated rhetoric and fear monitoring to instill anxiety and inspire a moral panic. “Something must be done.” The public good has been assailed. Exude authority and respectability and offer assistance using special knowledge to address the threat and make the audience feel good by describing an auspicious and improved future.

Feel Good Fallacies

“Feel good fallacies” are used to frame positions in a way that makes people feel good about supporting certain policies even when scientific evidence shows there is no need for them. TT Wilsons comment that “communities see how well run addiction programs save lives and force crime away from their homes” in reference to drug courts is characteristic of “feel good fallacies” and one of many tactics used to misrepresent, censor, suppress, mislead, ignore, marginalize or bury the truth.

TT Wilson delivers another classic “feel good fallacy” in his response to Dr. Jonathan Roop’s brave and heartfelt letter detailing the injustices and abuses he suffered under the heavy boot of the Washington state PHP. Comments concerning the substantive and serious issues he described were invariably of concern and support. TT Wilson, however sidesteps the specific issues described by Dr. Roop and gives a happy ending anecdote about a drunk doctor who was saved by the PHP and successfully restored to work gainfully employed, healthy and sober. TT Wilson asks Roop how this case should have been handled and this “feel good fallacy” is a hallmark of PHPs who use these anecdotes to promote the “new paradigm” of PHPs as “gold standard” treatment. The question TT Wilson asks is rhetorical and consistent with the PHP template of

A) Ignore, marginalize or bury criticisms and complaints.

B) Boast How great these programs are in saving lives and protecting the public.

Featured Image -- 31210 Complaints are successfully deflected,and marginalized no matter how valid or how substantive or serious the deviation from standard of care, ethical breach or legality. Often the victim is blamed and complaints such as Dr. Roops are deemed delusions or fabrications, the product of an impaired physicians sick mind or a manifestation of denial. In fact, this was the official response to Knight and Boyd’s paper concerning ethical and managerial problems with PHPs. In response to the specific and substantive issues Knight and Boyd describe and a call for outside oversight and regulation of PHPs ASAM President Stu Gitlow published an editorial basically saying there was no need for regulation or oversight because, guess what?–we have an 80% recovery rate. Can’t argue with success!

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Well, actually you can. The 80% recovery rate being boasted is based on the “PHP blueprint” that is being used to claim PHPs are the “gold standard” and “new paradigm” to promote expansion of the PHP model to other populations. It is their flagship product and claim to fame and used as a promotional tool.

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Just curious, but once addiction medicine is embraced by the ABMS in two years will you revise your posts? Frankly if they opened many of our boards to anyone who cared to take them a remarkable number of bright people would pass them without the rigor of residency or indignation of internships. I suspect that the powers that be know this hence the long and painful vetting process that goes on before one is deemed ‘board eligible’, a term that had stood for decades, then was deemed out of existence for a few years but now is back without much fanfare. And who put the ABMS in charge of anything? Why, they did that themselves. Funny how that works for some groups but is not appropriate for others. Oh well, all of this will be moot in a couple of years. Any comments about how the ABIM folded on their highly ordained MOC policies? Now that’s a story.

So when the ABMS recognizes the ABAM will you rage against them? Any sense of consistency would demand something like that. I can’t wait, it will be great fun to watch. Endless amusement. Thanks!!

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The three e-mails below were received within a twenty-four hour period from a physician supporting (and in all likelihood involved in) drug courts and physician health programs (PHPs). E-mails such as this are invariably anonymous and I usually drag them right to the trash where they belong but the trio below provides valuable insight into the mentality of those involved. And for that reason I am posting them as they were received.

Under the nom de plume of “TT Wilson” the author presents non-sequitur and fallacious logic to promote drug courts, PHPs and the sanctification of an illegitimate and irrational medical specialty.

He presents either/or logical fallacy and false dichotomy. You are either with us or against us! He appeals to professionalism yet his words show he has no inkling of the true definition, resorts to simple-minded cliches and meaningless platitudes and then sinks into ad hominem attacks on my blog and then me.

Ironically he accuses me me of ranting in a rant!

He is a prototypical example of the sham-artist physicians typically involved in these programs–an authoritarian paternalistic know-it-all who can only rant under the shield of gang-stalking power or a shroud of absolute anonymity.

As I have said time-and-time again if any factual errors exist in my blog I will not only remove them but remove my blog.

So I am going to make this offer to “TT Wilson”–if you wish to provide a rebuttal of any of the documentary evidence I provide in my blog herein then do so now. If you can I will delete the whole kit and kaboodle. Simple as that.

You Sir are an incompetent and a coward. If not then prove me wrong. I challenge you to reveal your true identity. Let’s level the playing field a tad on this. It is easy to present an opinion while cowardly hiding behind a veil of anonymity. Let’s see if you have the courage to debate this publicly.

I won’t be holding my breath on this one.

February 7, 2015 7:45 PM

Comment: It looks like it is too late already. The ABAM is closer than ever to becoming a member of the ABMS, there is a big push from the Obama administration to fund addiction treatment and to greatly widen access. As communities see how well run addiction programs save lives and force crime away from their homes the trend will be very hard to stop. I agree, PHPs are draconian when they work with physicians thought to have SUDs, but I would rather have them too tough than too lax. And a sober physician should be OK with that.

February 7, 2015 3:00 PM

Comment: Actually well run drug courts help patients who would have otherwise kept using substances of abuse. Drug courts are quite dictatorial by design and clearly a defiant patient will defeat even the most caring and competent efforts to help them. Of course we prefer that the patients be in a stage of change that leaves them open to treatment, but more than a few we’ve helped were not about to change without pressure from the court.

And I stipulated well run drug courts. There are many incredibly poorly run drug courts. When a judge doesn’t get it things are just as bad or worse than when the medical team doesn’t get it. And the studies done are typically dismal. Very short, small sample size, no standardization.

As far as impaired physicians are concerned, it is not enough to just stop using and declare innocence. If a cardinal event has attracted the attention of the medial (sic) board and that board requires participation in treatment to maintain licensure, well that goes with the license. You can certainly choose not to participate, and the board can then choose to not let you practice. They do the same thing with physicians with psychiatric issues. And they encounter a huge amount of denial in this population, I would say more so than the lay population. At least the denial is louder.

Dictatorial — sure. Fair — well, no. But life is not fair.

As doctors we owe it to our patients to be held to a higher standard. If someone of authority says I need to be screened, they are most welcome to any fluid or hair sample they require. Is that fair? Surely not. Does that make it bad? Not at all.

Do you have a better approach? So far you haven’t demonstrated it in your myriad postings.

As far as ABAM is concerned, have you cried out about the ER boards, Pain Medicine boards, and all of the other boards that have been added to the charter members of the ABMS over the years? Heck, back in the day a buddy of mine was grandfathered into the board of Plastic Surgery without even taking a test. He sent them $500 and he was board certified. Got a really nice certificate too, but it didn’t come with a frame. Years later they started requiring fellowship training and actually taking a test.

I enjoy your site — clearly there are problems with the way care is being delivered by some individuals in some cases. Of course that is true of every aspect of medicine. No one is advocating that we shut down every other aspect of medicine. Well some are, but that is for another discussion.

My concern is that your ranting will deter some people away from meaningful treatment, very much like those who seethe against vaccinations lead the unknowing to not treat their children. If I was cynical I could invoke Darwin here. Thinning the herd.

And you might want to get some help with wordpress. This endless scrolling is distracting. I was missing a good third of your content.

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February 7. 2015 9:45 PM

Comment: Finally made it to your last entry. Please learn how to conduct a wordpress blog — your technique is very distracting.

You protesteth too much good sir. Put aside your denial and get some treatment. I am sure Harvard was glad to be rid of you. They are very lucky you are out of there.

There might be some legitimate content in there somewhere, but by the time I reached the bottom of the page I was ready to hand you a mood disorder questionaire. Not that we really need you to fill one out to make a diagnosis.

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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)

April 4, 2015mllangan1 Leave a comment

Disrupted Physician

Educational and Professional Standards in Medical Specialties and Subspecialties

The increasingly rapid growth and complexity of medical knowledge in twentieth century American medicine resulted in the creation of specialties and subspecialties.

A related development was the creation of “boards” to “certify” physicians as knowledgeable and competent in the specialties and subspecialties in which they claimed to have expertise. The American Board of Ophthalmology, organized in 1917, was the first of these.

As the number of medical specialties proliferated an umbrella organization was formed to accomplish this task. The Advisory Board for Medical Specialties was created in 1933 and reorganized as the American Board of Medical Specialties (ABMS) in 1970. This non-profit organization oversees board certification of all physician specialists and sub-specialists in the United States.

The ABMS recognizes 24 medical specialties in which physicians can pursue additional training and education to pursue Board Certification.

In 1991 the American Board of Medical Genetics was…

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Vaccinations and the fraying of modern memory

April 1, 2015mllangan1 Leave a comment

Utopia, you are standing in it!

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EtG–The Rosie Ruiz of Bent Science and Bad Medicine

April 1, 2015mllangan1 7 Comments

Disrupted Physician

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) Screen Shot 2015-03-19 at 11.55.08 PM On April 21, 1980 Rosie Ruiz appeared to win the 84th Boston Marathon’s female category with a time of 2:31:56. Her time would have been the fastest female time in Boston Marathon history and and the third-fastest female time ever recorded in any marathon.

“Miss Ruiz, an administrative assistant for Metal Trading Inc. in Manhattan, received the traditional laurel wreath, a medal and a silver bowl for her victory,” According to the New York Times

Ruiz was unknown in the running world and her victory raised suspicions. After studying marathon photographs she didn’t appear in any of them until the very end and conducting…

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Educational and Professional Standards in Medical Specialties and Subspecialties

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