Important New Paper–Systematic Abuse and Misuse of Psychiatry in Physicians’ Heath Programs Discussed in the Journal of American Physicians and Surgeons

Physicians Heath Programs (PHPs) are part of the medical regulatory-therapeutic complex intended to protect the public from impaired physicians. Initially, they were supposed to provide a benevolent means to treat physicians with substance use disorders and return them to the workplace. However, lacking professional or governmental oversight, they may now be abusing psychiatry and causing irreparable harm, write Robert S. Emmons, M.D., Kernan Manion, M.D., and Louise B. Andrew, M.D., J.D., in the winter 2018 issue of the Journal of American Physicians and Surgeons. Physicians referred to a PHP have no due-process rights, even though such a referral may carry the same stigma and have the same effect as an involuntary commitment, the authors write. One physician faced a likely 3 months of mandatory inpatient treatment costing $40,000, and the possible ruination of his career, simply because of an episode of depression 17 years earlier. Without probable cause, he was assumed to have a substance-use problem. PHPs’ coercive practices essentially nullify the principle of informed consent for treatment, or indeed any other form of autonomy for physicians referred to them, leaving them without recourse in the event of incompetent or unethical practice by a PHP’s evaluators or its preferred treatment providers. Dr. Emmons and coauthors suggest principles to be followed for the ethical evaluation of physicians and an expanded definition of misuse or abuse of psychiatry in physicians subjected to psychological fitness for duty evaluations. Physicians referred for evaluation and treatment without a fair and ethical process can suffer serious harm, including a false attribution of mental illness, unwarranted loss of professional reputation, and deprivation of wealth, livelihood, and well-being. The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.

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Yet Again . . .

Another mass murder in the only country where this is a routine occurrence.  Why does it continue to happen?  It is not because the US has more mentally ill individuals than other countries.  It is because we have more guns.  Rational gun control could quell this HORRIBLE epidemic of mass shootings.  Australia did it in the 1990’s.  Not impossible at all.  There is no way our founding fathers meant this in the 2nd amendment.  And on the super remote chance they did (Washington, Hamilton and Franklin making way for mass slaughter?  No way!) we need to amend the Constitution to prevent this slaughter.

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Doctors Who Use Weed Off-Duty Are Getting Their Licenses Suspended Even in states where cannabis is legal

Awesome piece at Vice news by Ankita Rao here. It is appalling that any entity would refer a physician to a state physician health program for an evaluation–that can cost $6000, and that’s before physicians are told to stay for 30 or 90 days of treatment–SOLELY on the basis of a positive test of marijuana, especially when there are no allegations of dangerous or concerning medical practice.

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Survey Finds Widespread ‘Moral Distress’ Among Veterinarians

Lisa Moses, Monica Malowney and I published this study last Monday.  It was covered by the Globe and by WBUR and NPR.

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Doctor Loses Medical License For Legally Treating Her Menstrual Cramps With Cannabis

See the story is reported by Tobias Coughlin-Bogue, and you can find it here.

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How broad are state physician health program descriptions of physician impairment?

My latest piece with co-author and Georgetown law student Nick Lawson is here.

All credit for this piece is due to Nick who conceived of the idea and ran with it.  Physician health programs (PHPs) are unknown to most physicians until they have been referred to one.  At that point, if a physician registers any concerns about the fairness of the PHP process that physician is generally seen as merely belly-aching or being in denial instead of having anything legitimate to say.

As I have written previously, PHPs have bidirectional financial conflicts of interest with the evaluation and treatment centers that they often refer people to.    Additionally, the centers themselves–which charge thousands of dollars for evaluations that could easily happen in outpatient facilities or at academic medical centers for a fraction of the cost and minimal hassle–often decide people need to stay for treatments of various sorts at a cost of tens of thousands of dollars.  Why don’t PHPs routinely refer folks to academic medical centers for evaluation?  And, as we ask in our piece here, why are their criteria so broad?



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Immigrants cost the health care system less than US-born Americans: Study

ABC news story is here:

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Are Immigrants Health Care ‘Moochers’? On The Contrary, Boston Researchers Say

See the whole piece here:

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Forcing Psych Meds on Detained Children Perpetuates Distrust About Mental Health Care

The unethical treatment not only affects these kids, but it could have lasting impacts on people of color seeking mental health treatment.

See the whole article here:

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Don’t Trust Data and Statistics about PHP Success Rates

Nicholas Lawson, fellow physician and incoming Georgetown Law student, and I penned this letter in General Hospital Psychiatry Lawson Boyd Letter Gen Hosp Psych on PHPs which makes clear the myriad reasons why the success and satisfaction rates that Physician Health Programs tout ought to be viewed with skepticism.  Total kudos to Nick for doing the heavy lifting on this piece!

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