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!
This November you must vote–even if or especially if you think it doesn’t matter. IT MATTERS. Even a slim majority of Dems in the House will inject SO much accountability into the federal government right now. Jeff Sessions’ most recent action will literally kill many individuals who are fleeing for their lives and your vote might make a difference.
Sessions was refused a federal judgeship years ago because he was a racist. His actions on this matter are dramatically more lethally effective than even the most blood-thirsty, racist, fascist could hope for. We need to do everything we can to stop him–and his boss.
Just back from the national meeting of the APA. While there I presented in 3 workshops: the first on immigration and asylum, the second on everyday racism in the workplace, and the third on the ways in which the insurance industry makes it difficult to provide mental health care for those who need it. This piece appeared today to my surprise, detailing our presentation in the last session.
We need to keep a focus on what the duties are of physicians and other health care personnel are during times of war:
See video here.
The fact that health care personnel actively participated in torture during our war on terror is going to be one of the largest stains on the US for the next century.
Just posted on KevinMD. The piece is here. Some state PHPs are advocating a zero tolerance policy for any positive marijuana test and also often have a de facto zero tolerance policy for any positive test for metabolites of alcohol. That means that even if physicians have never used marijuana or alcohol before going to work and have never even remotely practiced medicine under the influence, physicians might be accused of having a substance use disorder and forced into expensive evaluations and rehab (which often have financial ties to state PHPs) or else run the risk of losing their ability to practice medicine.
Since the national federation of PHPs has not taken action to sever the financial ties between PHPs and their “vetted eval/treatment centers” and eliminate conflicts of interest, all physicians ought to begin to pressure their state medical boards societies and the AMA to effect change.
Hot off the presses with co-author Nick Lawson in the International Journal of Law and Psychiatry is this article entitled “Do state physician health programs encourage referrals that violate the Americans with Disabilities Act?” A PDF of the paper is available by clicking this link: Do PHPs Violate the ADA. And supplemental material for the paper is available by clicking here: Supplementary Material for ADA PHP Paper 2018
The abstract states: The websites of many physician health programs provide lists describing signs of impairment or indications to refer physician-employees for evaluation and possible treatment. This study aimed (1) to determine how many of these descriptions likely provide physicians’ employers with sufficient evidence to legally request mental health examinations under the general regulations of the Americans with Disabilities Act (ADA); and (2) to find out who they described. The authors applied US Equal Employment Opportunity Commission guidance documents and sought expert legal advice to evaluate the descriptions for their consistency with the ADA. They used directed content analysis to review and code these descriptions into categories. Very few, if any, of the 571 descriptions appeared to provide sufficient evidence for employers to request an examination under the ADA. About 14%, however, could refer to physicians attempting to defend themselves, assert their ADA rights, or otherwise complain about the hospital; and 27% either described physicians who complain or else had discriminatory effects in one of several different ways. Leaders within the medical field should ensure that their policies and state laws pertaining to physician impairment comply with and incorporate the language of the ADA. They should also reevaluate the functions of these policies, laws, and physician health programs, and the implications for patient safety, physician wellness, suicide, and other important issues.
We are the only country where these mass killings happen regularly. Even though some say “How can we prevent this?” the answer is quite clear and has worked in every other country in the world. No way the men who wrote the Second Amendment would stand for this horror. And why on Earth would anyone sanctify the Constitution (which was meant to be amended!) if anyone thought otherwise?
Co-author Emily Nagisa Keehn and I just published this piece about the extensive health toll that incarceration exacts. The AP just picked it up!
Pat Lawrence interviews J. Wesley Boyd., M.D., Ph.D., a psychiatrist at Harvard Medical School. They discuss the crisis in mental health care, focusing on difficulty in getting insurance coverage, substance abuse issues, and advances in treatment. The interview can be found here.