Kudos to Amina Rahimi, a first year Harvard Medical Student. She and I co-authored this piece on immigration in Psychology Today. As the subtitle states: “Our greatest threat is not immigrants. It is ourselves.” Interesting that some of the early feedback we’ve received has skirted around some of the facts about immigrants–including undocumented immigrants– regarding employment, health care, or rates of crime and largely failed to mention the data about our own health habits. I would ask folks to think about the 5 worst/hardest things that they have endured in their lives (loss of a job, a broken relationship, the death of a loved one, etc) and then remember that for almost all of us, undocumented immigrants had nothing to do with any of those things.
Blaming Others: What’s Really Behind the Talk about the Wall
Letter in the Globe about Drug Testing for Marijuana in the Workplace Entitled “No place for overreach in marijuana crackdowns in the workplace”
Michael Alpert and I published this letter about individuals who have been fired for testing positive for marijuana in states where its use is legal, even though there have been no concerns raised about their ability to practice safely or allegations of impairment in the workplace.
Physician Health Program Outcome Data Should Be Viewed with Caution–Letter in the Judges’ Journal by Nicholas Lawson and myself
Georgetown law student Nicholas Lawson and I published Lawson Boyd Judges Journal Letter on PHP Outcomes 2018 in the Judges’ Journal last month. We make the case in this letter that we have previously made about how PHP outcome data need to be viewed with caution. Authors often run the PHP programs that they write about and therefore might be motivated to design their studies in ways to maximize positive results.
Important New Paper–Systematic Abuse and Misuse of Psychiatry in Physicians’ Health 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.
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.
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.
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.
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.
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?
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