Colleagues and I have written a letter in support of access to health care and human rights more generally. Please feel free to sign the letter and, as importantly, forward the letter to all of your colleagues.
We need to legalize marijuana and begin regulating and taxing it. Here is a piece covering a press conference yesterday morning on the step of the State House in Boston in support of legalizing marijuana. Marijuana is far from safe–whether someone is underage with a still-developing brain or a mature adult who still needs to drive home–but legalizing it is far overdue. Do we really want to continue to jail users or have kids see the police as the enemy?
Here is a newly published piece for the Conversation about physician health programs and the ways in which physicians who are suspected of having substance use disorders are treated.
See the op-ed here that Sunny Patel and I wrote in the Springfield (MA) newspaper in support of legalization of cannabis.
The letter can be found here . The fact that the US engaged in torture–by any international definition of torture– during our “war on terror” will go down as one of our most egregious ethical lapses. Even calling it a “lapse” is too polite . . . To be blunt: we have stooped to the level of many of the world’s worst dictators ever. Black sites. Beatings. Stripping naked. Dowsing with cold water. Threatening with death. Waterboarding. And even killing.
Given that Eleanor Roosevelt helped draft the Universal Declaration of Human Rights that was approved by the UN in 1948, we came full circle in committing multiple crimes against humanity under Bush. To think that the leadership of the American Psychological Association colluded in this endeavor is appalling. To know that its Ethics Office–headed by a brilliant JD, PhD–facilitated and lubricated all of these dealings is Orwellian.
Co-author Alice LoCicero, PhD, and I wrote a piece in Psychology Today decrying CVE.
We start by asking whether or not CVE is the new Cointel-Pro. And just what is Cointel-Pro?
“Cointel-Pro (short for Counterintelligence Program) was launched “…in 1956 to disrupt the activities of the Communist Party of the United States. In the 1960s, it was expanded to include a number of other domestic groups, such as the Ku Klux Klan, the Socialist Workers Party, and the Black Panther Party . . . Cointel-Pro was later rightfully criticized by Congress and the American people for abridging first amendment rights and for other reasons” (1).
But if the FBI learned anything from the rightful criticism of its Cointel-Pro, it has since apparently forgotten it.”
You can find the whole piece here.
A piece in US News and World report about mental illness and violence:
The British Medical Journal (BMJ) recently printed a piece highlighting many of the problems with state Physician Health Programs (PHPs) that I have been writing about for several years. You can find the BMJ piece here:
I am so grateful that these issues are finally getting the attention they need. My own work was cited twice in the piece, which was nice also, but mostly it feels like there might be some light at the end of the tunnel. All that is needed is for PHPs to begin to operate transparently, with real oversight, create and adhere to national standards of operation, and cease their ties to evaluation/treatment centers with whom they have significant financial (and other) conflicts of interest.
I had a letter published in the Globe today:
Re “How to provide Medicare for all” (Opinion, May 18): As Dr. Marcia Angell notes, the insurance industry profits by refusing to pay for needed care or else simply denying claims.
Insurers also have more insidious ways of turning a profit. One of these ways is to require time-consuming prior authorizations for certain services in apparent hopes that clinicians will be discouraged from trying to access those services.
In a study colleagues and I conducted, we found that emergency mental health care workers spent an average of one hour on the phone with insurers, obtaining permission to hospitalize suicidal youth. Given that authorization ultimately was granted in every single case, this is an administrative hassle whose sole purpose seems to be to dissuade clinicians from seeking care they deem necessary for their patients, even though every extra minute spent in an emergency room increases risk for both the patient and health care workers.
Another way insurers profit is by not maintaining accurate lists of providers who are in their network and accepting new patients. In a separate study, we used insurer databases of supposedly “in-network” providers and found that many practices were full and that the list was replete with wrong numbers. We were only able to secure appointments 26 percent of the time.
Insurers have no incentive to ensure that people receive timely, needed care. As Angell so eloquently notes, they need to be removed from health care entirely and replaced by a not-for-profit system whose sole motivation is to get people the care they need.
Dr. J. Wesley Boyd
The writer is an associate professor of psychiatry at Harvard Medical School and a faculty member at the school’s Center for Bioethics.
State Physician Health Programs: Where is the Science Behind Demanding Multi-Day Evaluations and Lengthy Treatment Stays?
I recently posted another slide presentation on QuantiaMD, this time about physician health programs entitled State Physician Health Programs: What You Need to Know. You can find it here.
In the comment section following my presentation, one respondents writes the following: “I was, as far as I know, physician #1 in the State of Wisconsin physician health program, and later served on our county medical society PHP. Still later, after moving to the RI/MA area, I served on both of those states’ PHPs. I am now retired and no longer actively involved with them. I think Dr. Boyd fairly states the positives and negatives of these committees, but perhaps understates the issues related to both lack of a fair due process, as well as the tremendous conflicts of interest that result in virtually 100% of referrals being considered impaired or in need of “further diagnostic evaluation.” As a physician who has worked in chemical dependency treatment for over 30 years, I do not need that level of time, effort or expense to do a totally satisfactory evaluation of my patients, both health professionals and others. The drawn-out, very expensive and usually very 12-step driven treatment has no comparator in any evidence base. We treated over 20 physicians at our community hospital program, with 18 of them highly successful, without the rigamarole of a 90+ day >$100.000 referral to Big Name Treatment Centers (our average cost, which included family involvement and either a 2 week Day Treatment Program or a 6 week Evening Treatment Program, followed by 1:1 counseling for at least 6 months, was about $10,000. Unfortunately, our PHP has chosen to only use the very expensive programs for both diagnostic and treatment referral, and unsurprisingly they continue to believe every physician referral has a problem and are all in denial. Many area, but many are not, and I do not find that these programs make the necessary efforts to contact collaterals and chase down the facts.”