J. Wesley Boyd, MD, PhD

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.