FSPHP

Abuse Hidden Under a Veil of Benevolence: Bill Cosby, Physician Health Programs and Cognitive Dissonance

mllangan1 14 Comments

Fake ASAM ‘Doctors’ Push AA Cult For Profit.

The blue slides below are from a  presentation at the 2014 FSPHP spring meeting in Denver, Colorado and can be seen here.   The presentation was given by past FSPHP President Gary Carr, MD, Current FSPHP President Warren Prendergast, MD, West Virginia PHP Director Brad Hall, MD and Montana PHP Director Mike Ramirez, MS.

 

This needs to be seen as a "to-do" list.

This needs to be seen as a “to-do” list.

A.A. = ASAM = FSPHP 

The quote is from Alcoholics Anonymous and the full passage is as follows:

“We are convinced that a spiritual mode of living is a most powerful health restorative. We, who have recovered from serious drinking, are miracles of mental health. But we have seen remarkable transformations in our bodies. Hardly one of our crowd now shows any mark of dissipation.
      But this does not mean that we disregard human health measures. God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such persons. Most of them give freely of themselves, that their fellows may enjoy sound minds and bodies. Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward.”–Alcoholics Anonymous, 4th Edition,  The Family Afterward

Federation of State Physician Health Program (FSPHP) physicians often quote A.A. because they are defined by A.A. in both mechanics and mentality.  The “impaired physician” movement began with evangelical recovered addict and alcoholic physicians whose recovery was based on 12- step spirituality.  As this group molded into the American Society of Addiction Medicine (ASAM) many of them found employment at 12-step rehabilitation facilities and others joined their state Physician Health Programs and organized under the FSPHP.   Their ability to make authoritative pronouncements on physician impairment is  based on their own claim to insiders knowledge of recovery as brandished in this A.A. passage which I find condescending toward the medical profession and oddly narcissistic.

This special knowledge, of course, was based on the chronic relapsing brain disease model with lifelong abstinence and participation in 12-step recovery.

These “miracles of mental health” joined their state PHPs and those who did not agree with their rigid inflexible views were removed.   Those with access to special secret knowledge were eventually able to outvote those with intelligence and open minds as this groupthink infested and eventually monopolized  PHPs.

 

It is important to understand that the ideology of  A.A. is the ideology of the ASAM is the ideology of the FSPHP 

Like all “front-groups” the ASAM purports to serve one agenda while in reality serving another.  The ASAM claims to be a “physician society with a focus on addiction and its treatment” According to their website their mission is to

  • increase access to and improve the quality of addiction treatment;
  • to educate physicians (including medical and osteopathic students), other health care providers and the public;
  • to support research and prevention;
  • to promote the appropriate role of the physician in the care of patients with addiction;
  • and to establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers and consumers of health care services, and the general public

In order to accomplish this the  American Board of Addiction Medicine certifies doctors  to “provide assurance to the American public that Addiction Medicine physicians have the knowledge and skills to prevent, recognize and treat addiction.”

Ostensibly these are laudable goals that are almost universally endorsed.   The perceived organizational purpose and public persona are altruistic and humanitarian.  Treating addiction not only saves individual lives but improves the community.  It is for the common good.

 

Abuse Hidden Under Benevolence and Torture as Treatment

History reveals that all manner of abuse can lie underneath a patina of benevolence.   In the past few months alone we have both Bill Cosby and the  British Parliamentary pedophile ring as prototypical examples.  Both cases reveal a decades long coverup of allegations in which the abusers escaped little or no investigation into their alleged crimes. Abuse of power with a large gap between the power of the abuser and the powerlessness of the abused is a common denominator.  If the abuser endorses our own beliefs systems it creates a discord that promotes disbelief.  It does not fit.   Accusations are dismissed, deflected or otherwise suppressed.   Power effectively extinguishes the truth.  Disbelieved and delegitimized, information is suppressed, charges are not filed and law enforcement and the media turn a blinkered eye for decades. Indifference, disbelief, rationalization and cognitive dissonance prevent exposure and accountability. Hidden in plain site the truth was there and easy to find.  The problem was no one was looking. Most did not want to look.

It does not take much sleuthing to uncover what is beneath the veil of the American Society of Addiction Medicine.  The history, mentality and mechanics are well documented and reveal where they came from,  how they evolved and what they have planned.    It is a complicated web and hard to explain but once the pieces of the puzzle are fit together it is clear.  But it involves assembling a complex puzzle by finding the individual pieces scattered in disparate areas including the regulatory, clinical, administrative and professional niches of the medical profession,  Alcoholics Anonymous and 12-step related organization, public policy, all levels of the political arena and other areas. Once put together the portrait is clear.

In reality the ASAM is a political action group or special interest group that is designed to cement the chronic relapsing brain disease model with lifelong abstinence and spiritual recovery as the one and only treatment for addiction.   A.A. is used as the energy source of the operation.  By labeling addiction a “disease” requiring “treatment” in which someone is helpless they are able to dictate all aspects by coercion and control.  But in my opinion the A.A. ideology is just used as a ruse to support the multi-billion dollar drug and alcohol testing, assessment and treatment industry.  The zero-tolerance mindset of the “treaters” combined with the “helplessness” of the diseased enables them to erect a revolving door of testing, assessment and treatment that provides them with both control and a steady stream of money.

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The FSPHP mandates 12-step ideology on all doctors in a zero-tolerance system of abuse and control while at the same time putting out misinformation that the PHP programs are the “new paradigm.”  The page below is from the book Drug-Impaired Professionals by Robert Holman Coombs.

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This is they type of propaganda these groups have propagated.   What is described above is absurd and unrealistic but it is reported, reproduced and repeated to the point that it is accepted as the truth.

The majority of physicians referred to these programs are not even addicts. These programs of Zero-tolerance and 12-step indoctrination are based on coercion and control.  They are causing many doctors to die by suicide as they are feeling hopeless, helpless and defeated.    This portrayal of a group of blissful 12-stepping doctors over the moon because they found spirituality is nonsense.

But you will not find many doctors speaking out against them for fear of “contingency management.”  Disagreeing or even questioning PHP practices including the validity of 12-step can literally cost you your license.

I have spoken to multiple physicians and nurses and have encouraged them to tell their stories here but they are afraid of retribution and “unintended consequences.”  And who can blame them?

They can send you back to one of the “PHP-approved” facilities for “stinkin thinkin.”

Unfortunately the ASAM and FSPHP have successfully bamboozled others into believing they are true experts with noble intent.  They have bamboozled the Federation of State Medical Boards (FSMB) to the point where they have gained autonomy and unrestrained managerial prerogative.    They essentially use the state Boards to impose sanction on doctors who they report doctors for “noncompliance” which includes disagreeing with or questioning mandated A.A  or refusing to admit you have a chronic relapsing brain disease when you in fact do not.    They are in fact imposing A.A. on doctors and forcing them to accept their thinking under threat of loss of licensure.  This  violates the Establishment Clause and is a very serious problem that is being ignored.  It is a slippery slope we are on.

The FSMB House of Delegates adopted an updated Policy on Physician Impairment at their 2011 annual meeting distinguishing “impairment” and “illness”  stating that Regulatory Agencies should recognize the PHP as their expert in all matters relating to licensed professionals with “potentially impairing illness” that predates impairment often by many years.”  

It also defines “relapse without use” as “behavior without chemical use that is suggestive of impending relapse.”Screen shot 2013-05-13 at 1.30.29 PM

G. Douglas Talbott defines  “relapse without use”  as  “emotional behavioral abnormalities” that often precede relapse or “in A. A. language –stinking thinking.”

The ASAM has  monopolized addiction treatment in the United States.  But what the FSPHP arm has done is far more sinister.   A.A. has effectively taken over regulatory medicine and the private lives of doctors as a form of social control.  A doctor can be referred to a PHP for virtually anything and if the PHP believes he or she is in need of an assessment it will be done by a “PHP-approved” facility which means it will be done by a 12-step facility.  The PHP selects who will be monitored and dictates every aspect of what that entails and the entire process is done within the confines of A.A. ideology.  It is a, in fact, a  rigged game as the medical directors of the PHP approved facilities can all be seen on this list of like-minded docs who refer to theselves as “trusted servants” and “believe that evidence from extensive, well-designed studies demonstrates the great benefits of Twelve-Step recovery modalities including Twelve Step Facilitation in promoting long-term recovery.”

A.A. is imposed  on doctors through the FSPHP.  The FSPHP political apparatus exerts a monopoly of force.    And the bottom line is that A.A. has taken over all aspects of “physician health” and is forcing doctors to accept doctrine that is perhaps helpful to a few, useless or unneeded for many, and harmful and sometimes lethal to others.  This is unacceptable and it needs to be recognized.

 

“New Paradigm” of Zero-Tolerance and 12-step Spirituality Based on “success” of PHP to Move to Other Occupations and Kids.

To move this “new paradigm” to other populations they had to gain control of the doctors first.  They have not only created a monopoly but buffered themselves from physicians who may disagree with what they are doing to others.  This current system essentially stifles them.

The power, immunity and impunity this group yields over doctors was done silently and with no opposition. It was done by sequential public-policy steps.  This is why anyone interested in civil liberties and human rights should recognize the menace this presents to society.   The scaffold is in place and they are just adding more nooses.  Just ask the airline pilots.  They plan to impose similar systems on teachers, students and athletes.

And this is all spelled out in the ASAM White Paper on Drug Testing.   What people need to realized is what is described therein is just a few public policy steps away from them.  The only organization they have to convince is the organization that regulates any type of professional license, employment or benefit.

Gaining regulatory sway in the medical field and control over individual doctors was necessary to move this model to other populations.  It is merely a stepping stone for things to come.  It is only a few public policy steps from us to you.

This impacts us all.   It enables control of research, public policy and public health.   It is a system that suppresses dissent and shapes conformity.  The FSPHP  encourages the confidential referral of outliers.

The ASAM is pro-drug war and anti-medical marijuana.  This essentially silences most doctors for fear of being recognized and being brought in.  I know many doctors who will not even talk about it in public.

This is fixed doctrine and will not change.

That is why the ACLU and other groups who promote civil rights, those who are against the drug war and anyone involved in Medical Marijuana need to step in.    These  groups need to recognize the reality of who these people are, what they have planned and understand why they need to be stopped.   They are currently not even in the public eye and by outward appearances they appear to be benign.   In truth they are malignant and rapidly metastasizing without any symptoms.

In Order to Stop This the Following Must be Done

1) get a team of epidemiologists/statisticians to attack the “evidence-base” and “research” that the ASAM/FSPHP has used to support their claims (junk science, pseudoscience, success of 12-step, etc) and do a Cochrane type meta-analysis that will show there is little to no basis for it.

2) Demand accountability of the PHPs. Assign accountability to the Medical Societies and Departments of Public Health. Demand they be accountable for state-contractors with the Medical Boards (many of whom are complicit–in Massachusetts the Board of Registration in Medicine is simply an extension of the state PHP-i.e. Like-minds.

3) Demand that the criminal activity taking place within these PHPs be addressed by law enforcement.

4) Demand the Attorney General enforce the rampant Establishment Clause Violations occurring with mass 12-step coercion.

5) Identify and expose the  backgrounds of many of the individuals involved including felons and double felons who reinvented themselves as “addiction medicine” doctors. Many of these individuals are repeat offenders with a history of manipulating the system who should have never had their licenses returned.  In my opinion the ASAM/FSPHP/LMD rigged system is an example of corporate psychopathy.  While corporate level psychopathy is estimated at around 3% the numbers here appear to be much higher if one looks at the moral disengagement, unethical decision making, lack of empathy and externalization of blame evident in their personal histories.

6) Correctly identify that this system of institutional injustice is responsible for the astronomical suicide rate in physicians. This is due to the fact that doctors who need help are not getting it for fear of being ensnared by the state PHP and those already ensnared are being subject to coercion, abuse, institutional injustice, degradation, dehumanization, delegitimization and civil and human rights abuses and that this is a public health emergency that needs to be addressed.

7) reveal the scam set up between the PHPs, rogue labs, and “PHP-preferred” assessment and treatment gulags.

8) show how this is only a few public policy steps from Doctors to Pilots to Teachers to students to kids. etc. etc.

This necessitates that we get the conversation going before it is too late.

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Physician Suicide

mllangan1 45 Comments

Physician Suicide.

Physician Suicide 101:  Secrets, lies and solutions by Dr. Pamela Wible, M.D., is now featured on KevinMD.com.  Please read and comment!   We need to use this as a stepping stone to start discussing the Elephant in the room; state Physician Health Programs (PHPs) organized under the Federation of State Physician Health Programs.  These programs once served the dual purpose of helping sick doctors and protecting the public from harm.

Taken over by the “impaired physician” movement the current manifestation is one of absolute power and unrestrained managerial authority with no meaningful oversight, regulation or accountability.  It is a culture of institutional injustice that is preventing doctors from seeking help for fear of being ensnared and monitored by them.  Those being monitored by them are subject to bullying, abuse and forced 12-step indoctrination under threat of loss of licensure.  Many of these doctors do not even have an addiction or substance use disorder.   Situational factors, a “one-off” or even a false accusation can result in monitoring by these programs that encourage confidential referral for things such as being behind on medical charts.  Sham peer-review is rampant.32-640x472

Moreover, the authority bestowed on this group is both illegitimate and irrational. The mechanics and mentality of the Federation of State Physician Health Programs conforms to that of the American Society of Addiction Medicine (ASAM). Although there are some Addiction Psychiatrists involved, the vast majority are  “specialists” in “Addiction Medicine.“

The ASAM is not even recognized by the American Board of Medical Specialties as a bona fide specialty. It is a Self-Designated-Medical-Specialty; an AMA term used to keep track of what any group of doctors is calling themselves.

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Dr. Gregory H. Miday (1982-2012) A Doctor who would have made this world a better place.

In fact, American Board of Addiction Medicine (ABMS) “board certification” is little more than a diploma mill.

Yet these “specialists” are now in charge of ALL things related to PHYSICIAN HEALTH.

Many of the physicians running these programs had their licenses revoked and got them back by claiming salvation through the good graces of Alcoholics Anonymous and other 12-step methodology. Many have felony convictions. Some have double felonies.

At best we have unqualified zealots. But one major problem I have heard over and over again from physicians forced into these programs is an absolute lack of justice, empathy and even civility by those in charge.

A note from Dr. Karen Miday whose son Greg died by suicide after having a Corona in Peurto Rico while on vacation:

Dr. Gregory H. Miday ( 1982-2012) My physician son died of suicide 2 years ago while being monitored by the Missouri PHP. When he called to notify them of his relapse (while vacationing in Puerto Rico) and his intent to admit himself to a local public treatment center (decision made in consultation with his psychiatrist during an office visit that morning) the PHP said they did not approve of the plan. They told him to come speak with them instead. He chose otherwise. His phone calls to the PHP were the last ones he ever made. Clearly, he did not see them as benevolent. I sincerely doubt that he is their only casualty. Yet, where are the statistics? How many others have died under their watch. Strangely, the clinical director ( an RN, and likely recovering addict) told my husband that no internal review of my son’s case was planned. Such reviews after a suicide are mandatory at every public mental health facility I have practiced at. Our best and our brightest are being subjected to substandard care without any oversight or accountability. I can’t bring my son back. I do hope, however, that others will join me in an effort to pull the curtain back on these programs and perhaps save other lives. Karen Miday, MD, Cincinnati, OH

Misconduct, fraud, and even crimes are being reported.

Perhaps the 12-step salvation is just a ruse for some of them; a convenient cloak under which to hide all manner of abuse with impunity and immunity.

These individuals have been granted unrestrained managerial prerogative and absolute power over doctors. They decide not only who to monitor but how that monitoring proceeds in every last detail. Our fates, literally, lie in the hands of this group. No more physicians should die by this system of institutional injustice, bullying and pseudoscience. The conflicts-of-interest are abhorrent and would be incomprehensible in any other venue.

Isn’t it time we take charge? And the solution is fairly simple.

Oversight, regulation, and auditing by OUTSIDE groups. That is how it’s done everywhere else. Why do these guys get a pass?  Why would anyone be against procedural fairness and transparency in any situation? These are legitimate questions.

State Medical Societies, Departments of Public Health, the American Medical Association, the American Council on Graduate Medical Education, the Institute of Medicine and other Accreditation and Professional Organizations need to start addressing this.

This is a Public Health Emergency that is not going away.  It needs to be addressed directly and with urgency; not with kid gloves and temporization.

Accountability is without exception.  It requires both the provision of information and justification for actions.   Accountability also requires consequences for actions if they breach standards-of-care, ethics and the law.

 Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good.

Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

Disrupted Physician 101.4–The “Impaired Physician Movement” takeover of State Physician Health Programs

mllangan1 12 Comments

Forget what you see
Some things they just change invisibly–Elliott Smith

IMG_8923

Physician Impairment

The Sick Physician: Impairment by Psychiatric Disorders, Including Alcoholism and Drug Dependence, published by the American Medical Association’s (AMA) Council on Mental Health in The Journal of the American Medical Association in 1973,1 recommended that physicians do a better job of helping colleagues impaired by mental illness, alcoholism or drug dependence. The AMA defined an “impaired physician” as “a physician who is unable to practice medicine with reasonable skill and safety to patients because of mental illness or excessive use or abuse of drugs, including alcohol.”

Recognition of physician impairment in the 1970s by both the medical community and the general public led to the development of “impaired physician” programs with the purpose of both helping impaired doctors and protecting the public from them.

IMG_1010The 1975 media coverage of the deaths of Drs. Stewart and Cyril Marcus brought the problem of impaired physicians into the public eye. IMG_0940Leading experts in the field of Infertility Medicine, the twin gynecologists were found dead in their Upper East Side apartment from drug withdrawal that New York Hospital was aware of but did nothing about. Performing surgery with trembling hands and barely able to stand, an investigation revealed that nothing had been done to help the Marcus brothers with their addiction or protect patients. They were 45 –years old.

Top: Twin Gynecologists Stewart and Cyril Marcus Bottom: The Movie

Top: Twin Gynecologists Stewart and Cyril Marcus
Bottom: The Movie “Dead Ringers” starring Jeremy Irons based on the Marcus twins

Although the New York State Medical Society had set up its own voluntary program for impaired physicians three years earlier, the Marcus case prompted the state legislature to pass a law that doctors had to report any colleague suspected of misconduct to the state medical board and those who didn’t would face misconduct charges themselves.

Physician Health Programs

Physician health programs (PHPs)  existed in almost every state by 1980. Often staffed by volunteer physicians and funded by State Medical Societies, these programs served the dual purpose of helping sick colleagues and protecting the public. Preferring rehabilitation to probation or license revocation so long as the public was protected from imminent danger, most medical boards accepted the concept with support and referral.

As an alternative to discipline the introduction of PHPs created a perception of medical boards as “enforcers” whose job was to sanction and discipline whereas PHPs were perceived as “rehabilitators” whose job was to help sick physicians recover. One of many false dichotomies this group uses and it is perhaps this perceived benevolence that created an absence of the need to guard.

Employee Assistance Programs for Doctors

Physician Health Programs (PHPs) are the equivalent of Employee Assistance Programs (EAPs) for other occupations. PHPs meet with, assess, and monitor doctors who have been referred to them for substance use or other mental or behavioral health problems.

Most EAPs, however, were developed with the collaboration of workers unions or some other group supporting the rights and best interests of the employees. PHPs were created and evolved without any oversight or regulation.

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The American Society of Addiction Medicine can trace its roots to the 1954 founding of theNew York City Medical Society on Alcoholism (NYCMSA) by Ruth Fox, M.D whose husband died from alcoholism.

The society, numbering about 100 members, established itself as a national organization in1967, the American Medical Society on Alcoholism (AMSA).

By 1970 membership was nearly 500.

In 1973 AMSA became a component of the National Council on Alcoholism (NCA) in a medical advisory capacity until 1983.

But by the mid 1980’s ASAM’s membership became so large that they no longer needed to remain under the NCADD umbrella.

In 1985 ASAM’s first certification exam was announced. According to Dr. Bean-Bayog, chair of the Credentialing Committee, “a lot of people in the alcoholism field have long wanted physicians in the field to have a high level of skills and scientific credibility and for this body of knowledge to be accredited.”2 And in 1986 662 physicians took the first ASAM Certification Exam.

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By 1988 membership was over 2,800 with 1,275 of these physicians “certified” as “having demonstrated knowledge and expertise in alcoholism and other drug dependencies commensurate with the standards set forth by the society.”3 “The formation of State Chapters began with California, Florida, Georgia, and Maryland submitting requests.4

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In 1988 the AMA House of Delegates voted to admit ASAM to the House. According to ASAM News this “legitimizes the society within the halls of organized medicine.”2

By 1993 ASAM had a membership of 3,500 with a total of 2,619IMG_8919certifications in Addiction Medicine. The Membership Campaign Task Force sets a goal to double its membership of 3,500 to 7,000 by the year 2000 to assure “the future of treatment for patients with chemicals. It represents a blueprint for establishing addiction medicine as a viable entity.”5

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Many of these physicians joined state PHPs and over time have taken over under the umbrella of the FSPHP.

Others became medical directors of treatment centers such as Hazelden, Marworth and Talbott.

  1. The sick physician. Impairment by psychiatric disorders, including alcoholism and drug dependence. JAMA : the journal of the American Medical Association. Feb 5 1973;223(6):684-687.
  2. Four Decades of ASAM. ASAM News. March-April 1994, 1994.
  3. . American Medical Society on Alcoholism & Other Drug Dependencies Newsletter. Vol III. New York, NY: AMSAODD; 1988:12.
  4. . AMSAODD News. Vol III. New York, NY: American Medical Society on Alcoholism & Other Drug Dependencies; 1988.
  5. Membership Campaign Update. ASAM News. Vol VIII: American Society of Addiction Medicine; 1993:11.

Inquisition_10_Pushing_Off_Bridge

johnnyLawrence

Physician Suicide

mllangan1 7 Comments

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Physician Suicide 101: Secrets, Lies & Solutions by Dr. Pamela Wible, M.D.,  will hopefully serve as a stepping-stone to start discussing the elephant in the room; Physician Health Programs (PHPs) and their relationship to physician suicide.

The current state-of-affairs in these once benevolent programs that served a dual purpose of helping and protecting the public from “impaired” physicians is one of unrestrained managerial authority and absolute power with no meaningful oversight, regulation or accountability.

Moreover, the authority bestowed on this group is both illegitimate and irrational. The Federation of State Physician Health Programs is composed of American Society of Addiction Medicine “specialists” in “Addiction Medicine.”

The ASAM is not even recognized by the American Board of Medical Specialties as a bona fide specialty. It is a Self-Designated-Medical-Specialty; an AMA term used to keep track of what any group of doctors is calling themselves.

In fact, American Board of Addiction Medicine (ABMS) “board certification” is little more than a diploma mill.

Yet these “specialists” are now in charge of ALL things related to PHYSICIAN HEALTH.

Many of the physicians running these programs had their licenses revoked and got them back by claiming salvation through the good graces of Alcoholics Anonymous and other 12-step methodology. Many have felony convictions. Some have double felonies.

At best we have unqualified zealots. But one major problem I have heard over and over again from physicians forced into these programs is an absolute lack of justice, empathy and even civility by those in charge.

Misconduct, fraud, and even crimes are being reported.

Perhaps the 12-step salvation is just a ruse for some of them; a convenient cloak under which to hide all manner of abuse with impunity and immunity.

These individuals have been granted unrestrained managerial prerogative and absolute power over doctors. They decide not only who to monitor but how that monitoring proceeds in every last detail. Our fates, literally, lie in the hands of this group. No more physicians should die by this system of institutional injustice, bullying and pseudoscience. The conflicts-of-interest are abhorrent and would be incomprehensible in any other venue.

Isn’t it time we take charge? And the solution is fairly simple.

Oversight, regulation, and auditing by OUTSIDE groups. That is how it’s done everywhere else. Why do these guys get a pass?  Why would anyone be against procedural fairness and transparency in any situation? These are legitimate questions.

State Medical Societies, Departments of Public Health, the American Medical Association, the American Council on Graduate Medical Education, the Institute of Medicine and other Accreditation and Professional Organizations need to start addressing this.

It is a public heal emergency that is not going away.  It needs to be addressed directly and with urgency.

Accountability is without exception.   Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good.

Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

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Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

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Physician Suicide, the “Impaired Physician Movement” and ASAM: The Dead Doctors at Ridgeview Institute under G. Douglas Talbott

mllangan1 49 Comments

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“Gentlemen, it is a disagreeable custom to which one is too easily led by the harshness of the discussions, to assume evil intentions. It is necessary to be gracious as to intentions; one should believe them good, and apparently they are; but we do not have to be gracious at all to inconsistent logic or to absurd reasoning. Bad logicians have committed more involuntary crimes than bad men have done intentionally.”–Pierre S. du Pont (September 25, 1790)

“It is easier to believe a lie one has heard a hundred times than a truth one has never heard before.” –Robert S. Lynd

Ridgeview Institute was a drug and alcohol treatment program for “impaired physicians” in Georgia created by G. Douglas Talbott, a former cardiologist who lost control of his drinking and recovered through the 12-steps of Alcoholics Anonymous.

Up until his death on October 18, 2014 at the age of 90, Talbott  owned and directed a number of treatment facilities for impaired professionals, most recently the Talbott Recovery Campus in Atlanta, one of the preferred referrals for physicians ordered into evaluation and treatment by licensing boards today.

G. Douglas Talbott is a prototypical example of an “impaired physician movement” physician–in fact in many ways he may be considered the”godfather” of the current organization.  He helped organize and serve as past president of the American Society of Addiction Medicine (ASAM) and was a formative figure in the American Medical Association’s (AMA’s) Impaired Physician Program.

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G. Douglas Talbott (center), with sons Mark (left) and Dave (right). (image: Ham Biggar)

The cost of a 28-day program for nonprofessionals at Ridgeview in 1987 was $10,000 while the cost was “higher for those going through impaired-health professionals program,” which lasted months rather than 28 days.1

In 1975 after creating the DeKalb County Impaired Physicians Committee for the Medical Association of Georgia, Talbott founded the Georgia Disabled Doctors Program for the assessment and treatment of physicians. Founded in part because “traditional one-month treatment programs are inadequate for disabled doctors,” and they required longer treatment to recover from addiction and substance abuse.   According to Talbott, rehabilitation programs that evaluate and treat the rest of the population for substance abuse issues are incapable of doing so in doctors as they are unlike any other of the inhabitants of our society. Physicians are unique. Unique because of their incredibly high denial”, and he includes this in what he calls the “Four MDs,” “M-Deity”, “Massive Denial” “Militant Defensiveness” and “More Drugs.”2   And these factors set doctors apart from the rest.

According to Talbott, “impaired doctors must first acknowledge their addiction and overcome their ‘terminal uniqueness’ before they can deal with a drug or alcohol problem.” “Terminal uniqueness “ is a phrase Talbott uses to describe doctors’ tendency to think they can heal themselves.

“M-Deity” refers to doctors “being trained to think they’re God;”3 blinded by an overblown sense of self-importance and thinking that they are invincible-an unfounded generalization considering the vast diversity of individuals that make up our profession.   Although this type of personality does exist in medicine,  it is a small minority -just one of many opinions with little probative value offered as factual expertise by the impaired physician movement and now sealed in stone.

Former Assistant Surgeon General (Ret) Admiral (Ret) John C. Duffy

Former Assistant Surgeon General (Ret) Admiral (Ret) John C. Duffy

This attitude, according to some critics, stems from the personal histories of the treatment staff, including Talbott, who are recovering alcoholics and addicts themselves. One such critic was Assistant Surgeon General under C. Everett Koop John C. Duffy who said that Ridgeview suffered from a “boot-camp mentality” toward physicians under their care and “assume every physician suffering from substance abuse is the same lying, stealing, cheating, manipulating individual they were when they had the illness. Certainly some physicians are manipulative, but it’s naïve to label all physicians with these problems.”1

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LeClair Bissell

American Society of Addiction Medicine (ASAM) President (1981-1983) LeClair Bissell was also highly critical of Talbott’s approach. Bissell, co-author of the first textbook of ethics for addiction professionals4 when asked if there was any justification to the claim that doctors are sicker than other people and more vulnerable to addiction replied:

“Well, based on my treatment experience, I think they are less sick and much easier to treat than many other groups. I think one reason for that is that in order to become a physician…one has to have jumped over a great many hurdles. One must pass the exams, survive the screening tests and the interviews, be able to organize oneself well enough to do examinations and so on, and be observed by a good many colleagues along the way. Therefore I think the more grossly psychotic, or sicker, are frequently screened out along the way. The ones we get in treatment are usually people who are less brain-damaged, are still quite capable of learning, are reasonably bright. Not only that, but they are quite well motivated in most cases to hang on to their licenses, the threat of the loss of which is frequently what puts them in treatment in the first place. So are they hard to treat? No! Are they easy patients? Yes! Are they more likely to be addicted than other groups? We don’t know.”5

“I’m not much for the bullying that goes along with some of these programs,” Bissell commented to the Atlanta Journal and Constitution in 1987.3

The constitution did a series of reports after five inpatients died by suicide during a four-year period at Ridgeview.6 In addition there were at least 20 more who had killed themselves over the preceding 12 years after leaving the treatment center.1

Bissell, the recipient of the 1997 Elizabeth Blackwell Award for outstanding contributions to the cause of women and medicine remarked: “When you’ve got them by the license, that’s pretty strong leverage. You shouldn’t have to pound on them so much. You could be asking for trouble.”3

According to Bissell: “There’s a lot of debate in the field over whether treatment imposed by threats is worthwhile…To a large degree a person has to seek the treatment on his own accord before it will work for him.”3

A jury awarded $1.3 million to the widow of one of the deceased physicians against Ridgeview,7 and other lawsuits initiated on behalf of suicides were settled out of court.6

The Constitution reported that doctors entered the program under threats of loss of licensure “even when they would prefer treatment that is cheaper and closer to home.” 8 The paper also noted that Ridgeview “enjoys unparalleled connections with many local and state medical societies that work with troubled doctors,” “licensing boards often seek recommendations from such groups in devising an approved treatment plan,” and those in charge are often “physicians who themselves have successfully completed Ridgeview’s program.”8

In 1997 William L. White interviewed Bissell whom he called “one of the pioneers in the treatment of impaired professionals.” The interview was not published until after her death in 2008 per her request.   Noting that her book Alcoholism in the Professions9 “remains one of the classics in the field”, White asked her when those in the field began to see physicians and other professionals as a special treatment population; to which she replied:

“When they started making money in alcoholism. As soon as insurance started covering treatment, suddenly you heard that residential treatment was necessary for almost everybody. And since alcoholic docs had tons of money compared to the rest of the public, they not only needed residential treatment, they needed residential treatment in a special treatment facility for many months as opposed to the shorter periods of time that other people needed.”10

Talbott claimed a “92.3 percent recovery rate according to information compiled from a five-year follow-up survey based on complete abstinence and other treatment.”11 A 1995 issue of The Federal Bulletin: The Journal of Medical Licensure and Discipline, published by the Federation of State Medical Boards, contains articles outlining impaired physician programs in 8 separate states. Although these articles were little more than descriptive puff-pieces written by the state PHP program directors and included no described study-design or methodology the Editor notes a success rate of about 90% in these programs and others like them 12 and 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.” 12

No one bothered to examine the methodology to discern the validity of these claims and it is this acceptance of faith without objective assessment that has allowed the impaired physician movement through the ASAM and FSPH to advance their agenda;  confusing ideological opinions with professional knowledge.

“There is nothing special about a doctor’s alcoholism,” said Bissel

“These special facilities will tell you that they come up with really wonderful recovery rates. They do. And the reason they do is that any time you can grab a professional person by the license and compel him or her into treatment and force them to cooperate with that treatment and then monitor them for years, you’ll get good outcomes—in the high 80s or low 90s in recovery rates—no matter what else you do.”10
“The ones I think are really the best ones were not specialized. There were other well-known specialty clinics that claimed all the docs they treated got well, which is sheer rot. They harmed a great many people, keeping them for long, unnecessary treatments and seeing to it that they hit their financial bottom for sure: kids being yanked out of college, being forced to sell homes to pay for treatment, and otherwise being blackmailed on the grounds that your husband has a fatal disease. It’s ugly.”10

Stanton Peele’s “In the Belly of the American Society of Addiction Medicine Beast” describes the coercion, bullying, threats and indoctrination that are standard operating procedure in Talbott’s facilities.13  Uncooperative patients, “and this covers a range of sins of commission or omission including offering one’s opinion about one’s treatment,” are “threatened with expulsion and with not being certified-or advocated for with their Boards.”13

The cornerstone of treatment is 12-step spiritual recovery. All new patients are indoctrinated into A.A. and coerced to confess they are addicts or alcoholics. Failure to participate in A.A. and 12-step spirituality means expulsion from the program with the anticipated result being loss of one’s medical license.

In May 1999 Talbott stepped down as president of the American Society of Addiction Medicine (ASAM) as a jury awarded Dr. Leonard Masters a judgment of $1.3 million in actual damages and an undisclosed sum in punitive damages for fraud, malpractice, and the novel claim of false imprisonment.14

The fraud finding required a finding that errors in the diagnosis were intentional. Masters, who was accused of overprescribing narcotics to his patients was told by the director of the Florida PHP that he could either surrender his medical license until the allegations were disproved or submit to a four-day evaluation.

Masters agreed to the latter, thinking he would have an objective and fair evaluation. He was instead diagnosed as “alcohol dependent” and coerced into “treatment under threat of loss of his medical license. Staff would routinely threaten to report any doctor who questioned any aspect of their diagnosis or treatment to their state medical boards “as being an impaired physician, leaving necessary treatment against medical advice,”14  the equivalent of professional suicide.

Masters, however, was not an alcoholic.

According to his attorney, Eric. S. Block,  “No one ever accused him of having a problem with alcohol. Not his friends, not his wife, not his seven children, not his fellow doctors, not his employees, not his employers, No one.” 15

He was released 4 months later and forced to sign a five-year “continuing care” contract with the PHP, also under continued threat of his medical license.

Talbott faced no professional repercussions and no changes in their treatment philosophy or actions were made. They still haven’t.  They have simply tightened the noose and taken steps to remove accountability.

Up until his recent death, Talbott continued to present himself and ASAM as the most qualified advocates for the assessment and treatment of medical professionals for substance abuse and addiction.16

ASAM and like-minds still do.

In most states today any physician referred for an assessment for substance abuse will be mandated to do so in a facility just like Ridgeview.

There is no choice.   In mechanics and mentality, this same system of coercion, control, and indoctrination has metastasized to almost every state only more powerful and opaque in an unregulated gauntlet protected from public scrutiny, answerable and accountable to no one.  Laissez faire Machiavellian egocentricity unleashed.    For what they have done is taken the Ridgeview model and replicated it over time state by state and tightened the noose.  By subverting the established Physician Health Programs (PHPs) started by state medical societies and staffed by volunteer physicians they eliminated those not believing in the mentality of the groupthink.   They then mandated assessment and treatment of all doctors be done at a “PHP-approved” facility which means a facility identical to Ridgeview.  This was done  under the scaffold of the Federation of State Physician Health Programs (FSPHP).  They are now in charge of all things related to physician wellness in doctors.

  1. Durcanin C, King M. The suicides at Ridgeview Institute: Suicides mar success at Ridgeview with troubled professionals. Atlanta Journal and Constitution. December 18, 1987, 1987: A13.
  2. Gonzales L. When Doctors are Addicts: For physicians getting Drugs is easy. Getting help is not. Chicago Reader. July 28, 1988, 1988.
  3. King M, Durcanin C. The suicides at Ridgeview Institute: A Doctor’s treatment program may be too tough, some say. Atlanta Journal and Constitution. December 18, 1987a, 1987: A12.
  4. Bissell L, Royce JE. Ethics for Addiction Professionals. Center City, Minnesota: Hazelden; 1987.
  5. Addiction Scientists from the USA: LeClair Bissell. In: Edwards G, ed. Addiction: Evolution of a Specialist Field. 1 ed: Wiley, John & Sons, Incorporated; 2002:408.
  6. Durcanin C. The suicides at Ridgeview Institute: Staff members didn’t believe Michigan doctor was suicidal. Atlanta Journal and Constitution. December 18, 1987, 1987: A8.
  7. Ricks WS. Ridgeview Institute loses $1.3 million in suit over suicide. Atlanta Journal and Constitution. October 11, 1987, 1987: A1.
  8. King M, Durcanin C. The suicides at Ridgeview Institute: Many drug-using doctors driven to Ridgeview by fear of losing licenses. Atlanta Journal and Constitution. December 18, 1987b, 1987: A1.
  9. Bissell L, Haberman PW. Alcoholism in the Professions. Oxford University Press; 1984.
  10. White W. Reflections of an addiction treatment pioneer. An Interview with LeClair Bissell, MD (1928-2008), conducted January 22, 1997. Posted at http://www.williamwhitepapers.com. 2011.
  11. Williams c. Health care field chemical dependency threat cited. The Tuscaloosa News. January 16, 1988, 1988: 16.
  12. Schneidman B. The Philosophy of Rehabilitation for Impaired Physicians. The Federal Bulletin: The Journal of Medical Licensure and Discipline. 1995;82(3):125-127.
  13. Peele S. In the Belly of the American Society of Addiction Medicine Beast. The Stanton Peele Addiction Website (accessed March 28, 2014) http://web.archive.org/web/20080514153437/http://www.peele.net/debate/talbott.html.
  14. Ursery S. $1.3M verdict coaxes a deal for doctor’s coerced rehab. Fulton County Daily Report. May 12, 1999b 1999.
  15. Ursery S. I was wrongly held in alcohol center, doctor charges. Fulton Count y Daily Report. April 27, 1999a 1999.
  16. Parker J. George Talbott’s Abuse of Dr. Leon Masters MD ( http://medicalwhistleblowernetwork.jigsy.com/george-talbott-s-abuse-of-leon-masters ). Medical Whistelblower Advocacy Network.

    There is enormous inertia—a tyranny of the status quo—in private and especially governmental arrangements. Only a crisis—actual or perceived—produces real change. When that crisis occurs, the actions that are taken depend on the ideas that are lying around. That, I believe, is our basic function: to develop alternatives to existing policies, to keep them alive and available until the politically impossible becomes politically inevitable.-Milton Friedman

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Physician Suicide

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Physician Suicide 101: Secrets, Lies & Solutions by Pamela Wible, M.D.

Physician Suicide, the “Impaired Physician Movement” and ASAM:  The Dead Doctors at Ridgeview Institute under G. Douglas Talbott, by Michael Langan, M.D.

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Disrupted Physician 101.1: The “Impaired Physician Movement” and the History of the American Society of Addiction Medicine (ASAM)

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Disrupted Physician 101.1: The “Impaired Physician Movement” and the History of the American Society of Addiction Medicine (ASAM).

Henry David Thoreau

“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 1985 the British sociologist G. V. Stimson wrote:

“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.”

The American Society of Addiction Medicine’s mission is to “establish addiction medicine as a specialty recognized by professional organizations, governments, physicians, purchasers, and consumers of health care products, and the general public.”  

In this they have succeeded.images-4

And in the year 2014 Stimson’s characterization of the “impaired physician movement” remains as accurate and apt as it was in 1985. But the “number of evangelical recovered alcoholic and addict physicians” has increased dramatically  (outnumbering Addiction Psychiatry by 4:1)  and their involvement in “ medical society and treatment programs” has been realized and enforced through the state Physician Health Programs and their “PHP-approved’ assessment and treatment centers.

Their “ability to make authoritative pronouncements on physician impairment…based on their own claim to insider’s knowledge”  has become public policy and sanctified by Regulatory Medicine -essentially the Word of the Lord.

And the 1953 Alcoholics Anonymous prophecy that “With one arm around the shoulder of religion and the other around the shoulder of medicine, we might change the world” is also coming to pass.

But the world is not changing for the better as that arm around the shoulder of religion has its fingers deep in the pockets of the multi-billion dollar drug and alcohol testing and assessment and treatment industries.  And the arm around the shoulder of medicine has its fingers clamped tightly around its throat; a stranglehold in full throttle suffocating the Profession of Medicine with no meaningful opposition I can see.

Physician Health Programs:  The Need for Integrity and Accountability of Organizations

mllangan1 11 Comments

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Accountability, or answerability,  is necessary to prevent abuse and corruption.  This requires both the provision of information and justification for actions.  What was done and why?

Professional guidelines and standards of care, ethical codes of conduct and the law are all objective benchmarks that can be used to assess the actions and decisions of others.  In any free society this necessitates the existence of organizations of truly independent opinion capable of standing in this judgment.

State PHPs are Non-Governmental Organizations (NGOs) over which the state health department has no supervisory oversight.  There is no regulation, no transparency and no accountability.  There is no public scrutiny and they police themselves.

In Ethical and Managerial Considerations Regarding State Physician Health Programs Drs. John Knight and J. Wesley Boyd call for greater oversight and scrutiny of PHPs by the medical community at large.   They recommended periodic auditing, national standards and regulation.  They also attempted to convince the Massachusetts Medical Society to implement changes at PHS where they served as Associate Directors with over two decades of collective experience.

These efforts to promote transparency and accountability at both local and national levels, however,  fell on deaf ears.

State PHPs have systematically removed those not conforming to groupthink.  Threatening them with litigation if they breached “peer-review” statutes and confidentiality agreements has effectively silenced them from reporting any misconduct, abuse or even crimes they may have witnessed.

In Massachusetts John Knight was removed in 2009 and J. Wesley Boyd in 2010.  In Ethical and Managerial Considerations Regarding State Physician Health Programs  they comment “if a PHP highlights a physician as particularly problematic, the evaluation center might–whether consciously or otherwise—tailor its diagnosis and recommendations in a way that will support the PHP’s impression of that physician.”  So too will the clinical laboratories.  

How is this any different from the case of Dr. Farid Fata, the Michigan oncologist who intentionally diagnosed healthy patients with cancer so he could charge them for unneeded chemotherapy?  The U.S. Attorney called it the “most egregious” case of health care fraud ever. His acts may have contributed to one patient death.   The institutional injustice of the PHP system is causing countless deaths of physicians.

To consciously “tailor” a diagnosis is fraud.  To tailor a diagnosis of substance use disorder or any other psychiatric diagnosis is the political abuse of psychiatry.  Misrepresentation, dishonesty, deception, and distortion play no role in the Profession and Guild of Medicine.  To do so violates the basic moral principles of Medical Ethics–Autonomy, Beneficence, Non-Maleficence and Justice.

The “PHP-approved” assessment and treatment centers are all staffed by doctors of “like-mind.”  It is a rigged game.

An audit of the North Carolina PHP found essentially no oversight from the Medical Board or Medical Society.  The audit found that “abuse could occur without being detected,” and this is by design.  By removing and blocking the provision of information necessary for accountability, restricting the liberties and freedoms of physicians, and increasing their power and control they have erected a framework of hidden abuse.

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The situation in North Carolina is standard operating procedure for PHPs under the Federation of State Physician Health Programs (FSPHP).  It is not the exception but the rule.

While outspoken in denouncing what they regard as unethical and unprofessional behavior by other doctors, they are resistant to apply even the most minimal standards to their own activities.

To whom are the PHPs accountable? Whom do they represent? There are legitimate concerns.

scotty

Article by Pamela Wible, M.D. discussing physician suicide and addressing the role of Physician Health Programs (PHPs)

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Physician Suicide–What to do When Your Doctor Dies Suddenly by Pamela Wible, M.D.

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Physician Suicide 101: Secrets, Lies & Solutions by Dr. Pamela Wible, M.D

Physician Suicide 101:  Secrets, Lies & Solutions  By Dr. Pamela Wible, M.D. will hopefully serve as a stepping-stone to start discussing Physician Health Programs (PHPs) and their relationship to physician suicide.    (click on photo above to access article).

The current state-of-affairs is one of unrestrained  managerial authority and absolute power with no meaningful oversight, regulation or accountability.    Moreover, the authority bestowed on this group is both illegitimate and irrational.  The Federation of State Physician Health Programs is composed of American Society of Addiction Medicine “specialists” in “Addiction Medicine.”    The ASAM is not even recognized by the American Board of Medical Specialties as a bona fide specialty.  It is a Self-Designated-Medical-Specialty;  an AMA  term used to keep track of what any group of doctors is calling themselves.    American  Board of Addiction Medicine (ABMS) “board certification” is little more than a diploma mill.   Yet these “specialists” are now in charge of ALL things in PHYSICIAN HEALTH.    Many of the physicians running these programs had their licenses revoked and got them back by claiming salvation through the good graces of Alcoholics Anonymous and other 12-step methodology.  Many have felony convictions.  Some have double felonies.

At best we have unqualified zealots.   But one major problem I have heard over and over again from physicians forced into these programs is an absolute lack of justice, empathy and even civility by those in charge.  Misconduct, fraud, and even crimes are being reported.   Perhaps the 12-step salvation is just a ruse for some of them; a convenient cloak under which to hide all manner of abuse with impunity and immunity.

The majority of physicians would never do many of the things those now in charge have done no matter how inebriated, intoxicated or otherwise “impaired.”

Most doctors would never think of selling the “date-rape” drug to DEA agents or pilfering IV narcotics from cancer patients who need them.    But if you do a search of some of the doctors who run these PHP programs you’ll find this type of repugnant behavior is all represented.  “i’ve changed.”  “Give me a second chance.”     History will eventually look upon this like the lobotomy.  What the hell were they thinking.  Some of these people should never have gotten their licenses back.   They not only did but were put in charge. Brilliant!

And these are the individuals who have been granted unrestrained managerial prerogative and absolute power over all of doctors.  They decide not only who to monitor but how that monitoring proceeds in every last detail.  Our fates, literally, lie in the hands of this group.   No more physicians should die by this system of institutional injustice, bullying and pseudoscience.  The conflicts-of-interest are abhorrent and would be incomprehensible in any other venue.  Isn’t it time we take charge?  And the solution is fairly simple.  Oversight, regulation,  and auditing by OUTSIDE groups. That is how it’s done everywhere else.  Why do these guys get a pass?     Accountability is a rule not an exception.    Hopefully this article will succeed in framing certain questions for the medical profession; questions that we all need to think about now before the door closes for good.

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Thank you for your response. ✨

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

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

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

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

With over 20 years experience with the Massachusetts PHP, Physicians Health Services, inc., Harvard Medical Schools Dr.’s John Knight and J. Wesley Boyd wrote an article in the Journal of Addiction Medicine last year entitled  “Ethical and Managerial Considerations Regarding State Physician Health Programs.”

One of the issues they discussed was the conflicts of interest between the state PHPs and the “PHP-approved” evaluation centers.  The conflicts-of-interest between state Physician Health Programs and these “PHP-approved” assessment and treatment centers  were also uncovered in the recent state Audit of the North Carolina PHP. What was not uncovered, however, was just how absolute these conflicts of interest are.   It is a smoke and mirrors closed system of false choice  An elaborate charade of verisimilitude. Carnival hucksters in medical smocks.

One comment in Knight and Boyd’s article that I was surprised got past editorial review was that the treatment centers may “consciously or otherwise” tailor diagnosis and recommendations to the PHP’s impression of that physician. “consciously” tailoring a diagnosis is fraud. It is political abuse of psychiatry. It is unethical and unconscionable.  It is, in fact, a crime.  Political abuse of psychiatry right here in the United States.

And if you cross-reference the  medical directors of the “PHP-preferred facilities”  with this  list of Like-Minded Docs  it is a perfect match.

Therefore when the PHP refers a physician for an evaluation and gives them a choice of an assessment facility there is no choice. It is three card monte. A shell game. Heads I win tails you lose.  Isn’t it about time this unethical and unconscionable rigged referral process be exposed.

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