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

Hubris (/ˈhjuːbrɪs/, also hybris, from ancient Greek ὕβρις) means extreme pride or self-confidence. When it offends the gods of ancient Greece, it is usually punished. The adjectival form of the noun hubris is “hubristic”.

Hubris is usually perceived as a characteristic of an individual rather than a group, although the group the offender belongs to may suffer consequences from the wrongful act. Hubris often indicates a loss of contact with reality and an overestimation of one’s own competence, accomplishments or capabilities, especially when the person exhibiting it is in a position of power.

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


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.

IMG_9150 Unknown-3