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?

 

 

Posted in Miscellaneous | Tagged , , , , , | Leave a comment

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

ABC news story is here:  https://abcnews.go.com/Health/immigrants-cost-healthcare-system-us-born-americans-study/story?id=57128979

Posted in Miscellaneous | Leave a comment

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

See the whole piece here:

http://www.wbur.org/commonhealth/2018/08/08/immigrants-health-care-cost

Posted in Miscellaneous | Leave a comment

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:

Posted in Miscellaneous | Leave a comment

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!

Posted in Miscellaneous | Tagged , , , , , , , | Leave a comment

New York Times letter about Jeff Sessions and Asylum–What Sessions Did 2 Days Ago is Beyond Abhorent

Here it is:

To the Editor:

Re “Sessions Shrinks Paths to Asylum” (front page, June 12):

The ruling that Attorney General Jeff Sessions handed down saying that fleeing domestic or gang violence isn’t reason enough to qualify someone to receive asylum here in the United States is tantamount to holding a gun to someone’s head and pulling the trigger.

I am a psychiatrist who has performed scores of evaluations of asylum seekers over the last decade and can attest to the fact that asylum seekers overwhelmingly face death if they are sent back to their country of origin.

For example, if a Central American gang has recruited an adolescent male and he refuses to join, he will be killed. Or if an adolescent girl refuses a gang’s request that she become a sex slave for the gang (no matter how they phrase the request), she will be killed. I have seen mothers who fled Central America only after not one but two of their children were killed for refusing to comply with gang requests.

Mr. Sessions’s decision will be analogized to the United States’ turning away boats filled with Jews trying to escape Nazi Germany. Those who support the administration that made this happen will find themselves on the wrong side of history.

J. WESLEY BOYD, BOSTON

The writer is an associate professor of psychiatry and on the faculty of the Center for Bioethics at Harvard Medical School.

Posted in Miscellaneous | Tagged , , , , , , , , , | Leave a comment

Vote!

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.

Posted in Miscellaneous | Leave a comment

Single-Payer System Is the Solution for Mental Health Care, Panelists Say

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.

Posted in Miscellaneous | Leave a comment

Still Worth a Look–Duties of Doctors During Times of War

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.

Posted in Miscellaneous | Leave a comment

Using marijuana 2 times a month cost this doctor his license

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.

Posted in Miscellaneous | Leave a comment