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If by "hard evidence" you mean evidence of the "diagnosis-rigging" and forensic fraud that is occurring in this system there is actually quite a bit and the specific misconduct the state PHPs are engaging in is becoming quite clear. The primarily problem is there is no one to report it to as the state and federal agencies that are responsible for investigating this manner of misconduct do not take the complaints from medical students or physicians seriously and consider it a parochial issue best handled by medical school administrators or medical licensing boards. Allegations of very serious misconduct that in many cases constitute clear-cut crimes are dismissed at the outset with no investigation and no real inquiry.

There is ample evidence that they are engaging in false diagnoses and over diagnoses at the "PHP-approved" facilities they use. These facilities are giving diagnoses of Substance Use Disorder (SUD) and other mental health diagnoses when the person being evaluated does not meet the diagnostic criteria for the SUD or psychiatric disorder and most of these individuals have 2nd 3rd and even 4th opinions from bona fide experts documenting they do not. The diagnostic rigging involved in providing these false diagnoses involves the use of non-validated neuropsychological testing ( the "360 degree assessment, "modified Rorschach, etc.), polygraphs, and a variety of 12-step oriented "character defect" gibberish. The problem is none of the valid diagnoses (no matter how qualified the evaluator or how extensive the testing) ever gets seen by the full medical board as the state PHPs (in many states such as North Carolina and Massachusetts) have placed PHP affiliated attorneys within the boards and these attorneys act as their own "hearing officers" on cases. Evidence on both sides must be presented directly to these attorneys who pick and choose what is then presented to the board to induce wrong and unjust decisions. The misconduct of these attorneys is uniquely egregious and serious as they are able to manufacture entire cases supporting the PHP's narrative and that is precisely what they do. The primary barrier to exposing this is obtaining the evidence to prove it as its disclosure is intentionally blocked, deflected and refused.

These board attorneys not only omit exculpatory evidence (as has been seen primarily in prosecutorial misconduct cases in the criminal justice system) but they make affirmative representations to boards. Massachusetts State Auditor Suzanne Bump officially began an investigation of the Massachusetts medical board's Physician Health and Compliance (PHC) Unit 4-weeks ago. It is necessary that this be done transparently and the allegations must be taken seriously. The PHPs are also engaging in forensic fraud in collusion with the out-of-pocket for profit labs they contract with using non-FDA approved "laboratory developed tests" that were, in fact, introduced and promoted by state physician health program physicians (and former clients who reintroduced themselves as "addiction medicine" physicians after having their licenses revoked).

These tests are not FDA-approved and have no regulation or oversight. There validity is unknown and the absence of any accountability to outside agencies make them susceptible to abuse. PHPs are not clinical treatment providers and the drug and alcohol testing they perform is forensic and subject to strict chain-of-custody procedures. "Hard-evidence" of the forensic fraud they are engaging in is evinced in the attached documents. A simple fact-check of the time-line and the documents show clear collusion between the PHP, the lab and the MA medical board attorney. http://bit.ly/2Q0E6wg

I have been told by multiple experts in both toxicology and law enforcement that the documents here provide the clearest and most complete example of forensic fraud they have ever seen. The problem is getting the truth and facts seen and acknowledged has been blocked as the PHC Board attorneys concealed all of it for over 6-years. Updated Public Records Law in Massachusetts (effective January 1, 2017) has revealed that all of the documents making the fraud plainly clear are either absent from the board's records or date-stamped long after the proceedings for which they were submitted to be heard. All of this evidence was necessarily submitted directly to these medical board attorneys who by board policy act as their very own hearing officers. They receive all evidence from both sides of the aisle and pick and choose what they present to the board.

As higher courts (administrative, superior, supreme) only look at issues of law (i.e was procedure followed) judicial review is unable to detect intentional fraud which, as seen here, is typically a matter of fact. In this matter the board attorneys omitted all of this evidence from the certified administrative record and bald face lied to the highest court in Massachusetts. A spotlight needs to be put on them to expose board attorney misconduct in the same manner that the Duke Lacrosse case brought prosecutorial misconduct into the public eye. The problem is pervasive and these attorneys appear to be following a script dictated by the PHPs as the patterns of misconduct are specific and clear.

The fraud they are engaging in is specific, serious and egregious and that which is seen here has all been turned over to the state auditor. It is necessary that this audit be conducted transparently and that the allegations be taken seriously. What is seen here is representative of the systemic abuse of administrative process that is occurring across the country. I hear from an average of 4 individuals per week who are victims of this system and they currently have no one to turn to and that needs to change. The forensic fraud just as seen here is being done here over 6-years ago continues to be done blatantly and with no fear of repercussions. A "litigation packet" from a medical student sent to me just 2-months ago showed that the donor ID # of his specimen was changed and the chain-of-custody was fabricated plain as day but there is no one to report it to who will take it seriously. The individuals perpetrating these acts need to be specifically called out and exposed. That will happen eventually but we need to make sure it occurs sooner rather than later. A reckoning needs to occur with dispatch as there are too many innocent lives and livelihoods being destroyed by a small number of sick and sociopathic individuals. The entire system needs to be destroyed and built anew.
I recently recommended this thread to an MS 4 in the clinical forums who is being asked to have a psych evaluation and it reminds me to ask if there's an update to the PHP audit in the state of MA @OrestesWeed ?
 
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This story is 100% accurate and not enough is being done about it. A girl wrote a fake anonymous letter about me at the end of my residency claiming that I was a drug addict over an act of revenge because she blamed me for “stealing her boyfriend”. The letter prompted a drug test of which I came back positive for weed (which is now legal in my state.) I was forced to go out of state to get a $5,000 2 day evaluation at this place called the positive sobriety institute who claimed I had a substance abuse problem with absolutely no evidence even when everyone of my friends and family also stated that I didn’t have a substance abuse problem. I never had any problems at work, never had any legal problems, and my hair test only came back positive for adderall which I had a prescription for for 15 years, a light amount of alcohol, and a VERY light amount of weed. These programs will use any excuse to say you have a problem to FORCE you to get 6-8 weeks of inpatient treatment for $30,000. They have absolute authority and there’s nothing you can do about it if you want to keep your license. It’s incredibly corrupt and I have no idea how this is legal. I did everything they said and am now in a 3 year contract which includes EXTREMELY pricey drug testing, forced substance abuse meetings 3 times a week, weekly therapy, and I can’t get medications I actually need anymore including nasal decongestants, adderall, Benadryl, and anything to help me sleep. They treat you like a criminal. They even randomly started testing for Kratom, which is legal and sold in any smoke shop, without telling us that they were testing for it or that it wasn’t allowed and then added 6 months to my contract for it. It’s so incredibly corrupt. Why was I only given one facility to do my evaluation at and to get treatment at? You’re telling me there isn’t some quid-pro-quo thing going on there??? Of course there is. But if I don’t comply then I lose my license so I literally have no choice. I could hire and spend years in a lawsuit that would cost me untold amounts and probably take the length of my contract anyways. I got fired from my fellowship that I spent years working towards and was one of the most competitive in the country because I physically did not have enough time in the week to meet all the contract requirements and do that 80 hour a week fellowship. I almost killer myself trying to do both. Luckily I still got a job anyways which i love very much but I have so much anger over everything that happened and I want to tell everyone that will listen because something needs to be done about this.

I wanted to get the community opinion on this news story in my city. Apparently, local hospitals are using the Physicians Health Program to push out doctors with disabilities or who may make a patient safety claim. Physicians with no addiction issues were being forced into 60-90 days of in-patient rehab programs to keep their license. I know these programs are intended to help healthcare workers with addiction issues but this report is concerning. New Story on residents sent to PHPs below:
Doctors fear controversial program made to help them

Is this going on at your hospital and a common thing nationwide?
 
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This story is 100% accurate and not enough is being done about it. A girl wrote a fake anonymous letter about me at the end of my residency claiming that I was a drug addict over an act of revenge because she blamed me for “stealing her boyfriend”. The letter prompted a drug test of which I came back positive for weed (which is now legal in my state.) I was forced to go out of state to get a $5,000 2 day evaluation at this place called the positive sobriety institute who claimed I had a substance abuse problem with absolutely no evidence even when everyone of my friends and family also stated that I didn’t have a substance abuse problem. I never had any problems at work, never had any legal problems, and my hair test only came back positive for adderall which I had a prescription for for 15 years, a light amount of alcohol, and a VERY light amount of weed. These programs will use any excuse to say you have a problem to FORCE you to get 6-8 weeks of inpatient treatment for $30,000. They have absolute authority and there’s nothing you can do about it if you want to keep your license. It’s incredibly corrupt and I have no idea how this is legal. I did everything they said and am now in a 3 year contract which includes EXTREMELY pricey drug testing, forced substance abuse meetings 3 times a week, weekly therapy, and I can’t get medications I actually need anymore including nasal decongestants, adderall, Benadryl, and anything to help me sleep. They treat you like a criminal. They even randomly started testing for Kratom, which is legal and sold in any smoke shop, without telling us that they were testing for it or that it wasn’t allowed and then added 6 months to my contract for it. It’s so incredibly corrupt. Why was I only given one facility to do my evaluation at and to get treatment at? You’re telling me there isn’t some quid-pro-quo thing going on there??? Of course there is. But if I don’t comply then I lose my license so I literally have no choice. I could hire and spend years in a lawsuit that would cost me untold amounts and probably take the length of my contract anyways. I got fired from my fellowship that I spent years working towards and was one of the most competitive in the country because I physically did not have enough time in the week to meet all the contract requirements and do that 80 hour a week fellowship. I almost killed myself trying to do both. Luckily I still got a job anyways which i love very much but I have so much anger over everything that happened and I want to tell everyone that will listen because something needs to be done about this. These physician monitoring program has a COMPLETE lack of oversight

I wanted to get the community opinion on this news story in my city. Apparently, local hospitals are using the Physicians Health Program to push out doctors with disabilities or who may make a patient safety claim. Physicians with no addiction issues were being forced into 60-90 days of in-patient rehab programs to keep their license. I know these programs are intended to help healthcare workers with addiction issues but this report is concerning. New Story on residents sent to PHPs below:
Doctors fear controversial program made to help them

Is this going on at your hospital and a common thing nationwide?
What would your answer be if it was alcohol? Also, was he impaired because of depression or because of a benzo addiction? Those two things aren't the same and benzos aren't used to treat depression. So if it was his depression that caused concern and he was on benzos for a co-morbid anxiety disorder and using them properly, then benzos shouldn't have even been a part of the discussion.



Why does it seem wrong? It's an illness and he received inpatient help. Also PHPs require 90-day rehabs in a lot of cases (which is total BS). They create a different standard for doctors than for the general public and you're proposing expanding that standard, not just to treatment but recovery.



Ah, but not with PHPs. The facilities they work with don't take insurance. That's why it's a scheme and why it should be toppled and the financial records of every person involved investigated. If it turns out they were receiving kickbacks and applying subjective non-evidence-based standards to physicians, I'd argue that's criminal.



Totally agree with this. Residents should not be made to pay insane amounts of money under threat of loss of licensure.



It would be fantastic if PHPs were totally revamped WITH OVERSIGHT and a physician could legitimately turn to them for referrals rather than forfeiting their autonomy. I wish they could be there for these types of referrals and not just for mental health issues either. The idea behind them is great. The problem is corruption.



Agree with this. While benzos aren't the best medications, there are people on them chronically and if there is no impairment, this shouldn't be an issue.



But this happens everyday in court. One medical expert says one thing. Another medical expert says another. Judges are tasked with making the best decision they can based on the law. Is the physician impaired? If so, how? Are there poor patient outcomes that could have been avoided if the physician weren't "impaired"? We're not asking judges to go above and beyond their daily duties; we're just trying to take the politics and corruption out of physician treatment.



Just whatever was on the MA website. Not sure. I am glad to hear there's an audit going on, regardless, and I'm eagerly awaiting the results. I'm curious what happens to all the docs currently caught up with the MA PHP. If there is corruption found, I assume all the docs caught up in a current PHP contract will have case reviews. Also, I just read Suzanne Bump disclosed her connection to addiction and drug-testing facilities in MA (found with a Google search).

Another thing I want to mention is that PHPs should be used for legit medical reasons. Residents being referred for being behind on notes or being disruptive or nonsense like that sounds very much like discipline.
 

Raryn

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This story is 100% accurate and not enough is being done about it. A girl wrote a fake anonymous letter about me at the end of my residency claiming that I was a drug addict over an act of revenge because she blamed me for “stealing her boyfriend”. The letter prompted a drug test of which I came back positive for weed (which is now legal in my state.) I was forced to go out of state to get a $5,000 2 day evaluation at this place called the positive sobriety institute who claimed I had a substance abuse problem with absolutely no evidence even when everyone of my friends and family also stated that I didn’t have a substance abuse problem. I never had any problems at work, never had any legal problems, and my hair test only came back positive for adderall which I had a prescription for for 15 years, a light amount of alcohol, and a VERY light amount of weed. These programs will use any excuse to say you have a problem to FORCE you to get 6-8 weeks of inpatient treatment for $30,000. They have absolute authority and there’s nothing you can do about it if you want to keep your license. It’s incredibly corrupt and I have no idea how this is legal. I did everything they said and am now in a 3 year contract which includes EXTREMELY pricey drug testing, forced substance abuse meetings 3 times a week, weekly therapy, and I can’t get medications I actually need anymore including nasal decongestants, adderall, Benadryl, and anything to help me sleep. They treat you like a criminal. They even randomly started testing for Kratom, which is legal and sold in any smoke shop, without telling us that they were testing for it or that it wasn’t allowed and then added 6 months to my contract for it. It’s so incredibly corrupt. Why was I only given one facility to do my evaluation at and to get treatment at? You’re telling me there isn’t some quid-pro-quo thing going on there??? Of course there is. But if I don’t comply then I lose my license so I literally have no choice. I could hire and spend years in a lawsuit that would cost me untold amounts and probably take the length of my contract anyways. I got fired from my fellowship that I spent years working towards and was one of the most competitive in the country because I physically did not have enough time in the week to meet all the contract requirements and do that 80 hour a week fellowship. I almost killer myself trying to do both. Luckily I still got a job anyways which i love very much but I have so much anger over everything that happened and I want to tell everyone that will listen because something needs to be done about this.
I feel for you. I truly do.

But let this be a lesson for anyone reading that Marijuana, while "legal" on the state level in many places remains illegal on a federal level. There are numerous examples of physicians getting in trouble for using it, and I would advise anyone who has a current or plans to get a future medical license to abstain.
 
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Still not a reason to force someone into 30,000$ inpatient treatment and force them to endure years of torture to prove they’re not an addict. Plus why is alcohol allowed but not marijuana? It’s all political. It’s not like I was shooting up heroin

I feel for you. I truly do.

But let this be a lesson for anyone reading that Marijuana, while "legal" on the state level in many places remains illegal on a federal level. There are numerous examples of physicians getting in trouble for using it, and I would advise anyone who has a current or plans to get a future medical license to absta
 
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Still not a reason to force someone into 30,000$ inpatient treatment and force them to endure years of torture to prove they’re not an addict. Plus why is alcohol allowed but not marijuana? It’s all political. It’s not like I was shooting up heroin
because the federal govt considers alcohol a legal substance...but have a problem with it, same thing can happen.

It’s sucks, but your choice to use marijuana is how this started.
 
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It doesn't surprise me at all. Programs used to be vaguely referred to as means for physicians in trouble to seek help. Now they advertise like pharmaceutical companies. Every year we get talks from the PHP talking about how they're "just here to help" and giving out free water bottles, pens, hand sanitizers, etc. The whole thing smells of an industry trying to recruit customers, not trying to help physicians. Any programs that limit treatment to one or two centers is ridiculous.

I know someone that does PHP evals parttime. It's a 1-2 hr diagnostic, makes recommendations for the "types of treatments" that may be considered, then the PHP decides what the physician has to do. At no point can you, as the "impaired" physician, suggest other treatment options, and the physician who does the eval doesn't even have the ability to review other treatment facilities that you suggest to see if they're reasonable. Feels rigged to be honest.
 

calvnandhobbs68

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Still not a reason to force someone into 30,000$ inpatient treatment and force them to endure years of torture to prove they’re not an addict. Plus why is alcohol allowed but not marijuana? It’s all political. It’s not like I was shooting up heroin
Take a look at your hospital/residency contract or your hospital policies. Likely says somewhere in there that they can drug test you at any time. Hell, a decent amount of hospitals have no nicotine policies that they can fire you over. You're just lucky they didn't fire you over it. Also, doesn't sound like marijuana was legal in your state when you actually had the testing done anyway.

The real lesson here is that any resident can get drug tested at any time for any random reason. So don't do drugs kids.

The whole "why is alcohol allowed but not marijuana" defense is something I'd expect a high schooler to say. Not a doctor. Yeah, everyone gets it, it's not super logical. That's not a defense for use. You can't say "hey officer I don't agree that the speed limit is 25 here when it's 45 down the road, it's all political and it's a speed trap". Well yeah duh...you're still gonna get the ticket.
 
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I understand that and I would’ve offered to do weekly drug testing for the rest of my life if that is what they wanted, still not my point. My point is that they have overreaching authority with complete lack of oversight and in no way used evidenced based medicine to decide my “treatment”. They literally made up a diagnosis based on 0 facts as a way to make money off of me. There are DSM criteria for substance abuse and I didn’t meet them. When I said that over and over they just kept saying “we’ve been doing this for 30 years” but still provided me with 0 facts to back up their diagnosis. You can’t make a diagnosis like that after meeting someone for one hour, especially when nothing they told you supports it. But they can basically do whatever they want. If they drug tested everyone in my residency at that time half of them would’ve ended up in my same position. And 30,000$ for rehab??? That i never even needed? And to force me to go to all those meetings while working 80-100 hours a week? I told them all that I Physically didn’t have enough time to meet all of those requirements and do my job but no one cared. Everyone that gets in the contract for any reason, whether it be weed or heroin, gets exactly the same contract which isn’t individualized at all. They took away medications that I needed and when I complained to my doctors about it they would just say “there’s nothing I can do, it’s up to the program not me”. The program is not my doctor, why do they get to make health decisions about me? There is 0 oversight


Still not a reason to force someone into 30,000$ inpatient treatment

I feel for you. I truly do.

But let this be a lesson for anyone reading that Marijuana, while "legal" on the state level in many places remains illegal on a federal level. There are numerous examples of physicians getting in trouble for using it, and I would advise anyone who has a current or plans to get a future medical license to absta
Take a look at your hospital/residency contract or your hospital policies. Likely says somewhere in there that they can drug test you at any time. Hell, a decent amount of hospitals have no nicotine policies that they can fire you over. You're just lucky they didn't fire you over it. Also, doesn't sound like marijuana was legal in your state when you actually had the testing done anyway.

The real lesson here is that any resident can get drug tested at any time for any random reason. So don't do drugs kids.

The whole "why is alcohol allowed but not marijuana" defense is something I'd expect a high schooler to say. Not a doctor. Yeah, everyone gets it, it's not super logical. That's not a defense for use. You can't say "hey officer I don't agree that the speed limit is 25 here when it's 45 down the road, it's all political and it's a speed trap". Well yeah duh...you're still gonna get the ticket.
 

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The real lesson here is that any resident can get drug tested at any time for any random reason. So don't do drugs kids
Actually, I think the real lesson is that there are corrupt organizations/institutions that won't hesitate to make money off troubled docs. When was the last time you sent someone to inpatient rehab, cash only, 30K for marijuana use? Their treatments are not evidence based and fraught with the appearance of impropriety and corruption.

The dialogue needs to change among physicians of we'll all be vulnerable to the whims of these places.
 
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Exactly. Once they get ahold of you they will use ANY reason to keep you there. One DUI, one time getting caught using an adderall or Xanax you didn’t have a prescription for, one anonymous letter written by a spiteful ex, or I even know someone who got reported by an attending who overheard them talking about how drunk they got the weekend before. I’ve met many people in my exact situation now but everyone else is too embarrassed to speak out about it. They prey on doctors because of our potential income, and suddenly we have no rights or due process. I almost committed suicide twice during this ordeal because I thought my career was over and after everything that happened I was broke, penniless, and jobless, with no hope. All because of marijuana which I used occasionally on the weekends.

Actually, I think the real lesson is that there are corrupt organizations/institutions that won't hesitate to make money off troubled docs. When was the last time you sent someone to inpatient rehab, cash only, 30K for marijuana use? Their treatments are not evidence based and fraught with the appearance of impropriety and corruption.

The dialogue needs to change among physicians of we'll all be vulnerable to the whims of these places.
 
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Raryn

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Actually, I think the real lesson is that there are corrupt organizations/institutions that won't hesitate to make money off troubled docs. When was the last time you sent someone to inpatient rehab, cash only, 30K for marijuana use? Their treatments are not evidence based and fraught with the appearance of impropriety and corruption.

The dialogue needs to change among physicians of we'll all be vulnerable to the whims of these places.
Right, but that lesson is not actionable for the individual. What is actionable is to not use any illicit drugs OR get a DUI.
 
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Mass Effect

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Right, but that lesson is not actionable for the individual. What is actionable is to not use any illicit drugs OR get a DUI.
That's exactly my point. It's not actionable for the individual in trouble, which is why the rest of us - those of us who've never been in trouble -- need to advocate for ethical actions/practices against our colleagues. Should this individual have smoked marijuana? No. But that doesn't mean the PHP should get to do whatever they want with zero boundaries or regulation. And if you think it's just about substance abuse where the answer is "just don't do drugs or drink and drive," think again. There are a lot of docs in trouble for being "disruptive" and there's no actual definition of what that word means. It's a catch-all for docs who others have reported as grumpy and come with the same strings described above - costly, cash-only inpatient evaluation, followed by costly groups or monitoring to make sure you're no longer rude.

Shame on us for not doing more to insure our colleagues are being dealt with in a professional, evidence-based way.
 

Crayola227

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Right, but that lesson is not actionable for the individual. What is actionable is to not use any illicit drugs OR get a DUI.
I think you miss the point that these programs are in a position to mete out "consequences" that don't meet the "crime."

Regardless of what any patient does, they are entitled to accurate evidence-based diagnosis and treatment, with an eye for patient well-being and acting as a steward of healthcare resources and those of the patient. Surely we can agree that is the proper practice of medicine?

Part of that proper practice, is that regardless of the perception of patient "fault," whether we are dealing with childhood leukemia or IVDU, is that practice be subject to oversight.

It doesn't matter even whether or not these programs are abusive. Even being in a position for abuse or poor outcomes to occur, warrants oversight to prevent those outcomes.

Or is that not why every physician that graduates med school in good standing and practices is subject to board oversight?

Just the position of power warrants oversight.

Saying the solution to a lack of oversight, conflicts of interest, appearance of corruption, financial incentives, is just for physicians to never do drugs, really misses the point.

Others have pointed out that much of the process described here applies to other mental health conditions, none of which violate any law. Since when should mental health be treated the way people report being treated? And there's a punitive quality in my opinion, of what's described that seems to the average doc to be outside the standard of care.

Even if one argues they are not treated as criminals, we know that a key piece of treating mental health and substance use disorders is access. Does it sound like that is what these programs are maximizing?

Of course, we'll never know without better oversight and a consideration of an overhaul to the system.
 

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It's a very complicated issue. BoM's want a way to assess whether physicians are impaired or not, and when they are OK to return to practice. Most BoM's and PHP's are not funded / staffed to manage this problem. So private programs opened up to deal with the issue, offer to address the problems for BoM's at no cost to them. But they are free to pass the cost on to the physician. The BoM and the program wants the "error rate " (i.e. impaired physician is returned to practice) to be very low, so aggressive treatment is recommended for everyone. Plus, these private companies have a financial incentive to treat everyone aggressively. "Impaired" physicians developing their own treatment plans is a bad idea. We (perhaps) could have some sort of "second opinion" type of system -- but as soon as you tell the second opinion assessor that they will be held responsible for any future poor outcomes, I expect you'll end up with the same assessment.

But that's not necessarily in the physician's best interest.

There are lots of parallels to the private prison system -- i.e. financial incentives to keep prisoners longer, violate them for minor offences, avoid releasing someone early whom might reoffend, etc.

MJ is a complicated issue. It's illegal federally. If it's found in your system, in any amount, you technically have a drug abuse problem. Perhaps you don't agree with that, but it's the way it is. Same if you are found with cocaine in your system -- arguing that you only use it intermittently at parties when you're not working isn't going to float.
 

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It's a very complicated issue. BoM's want a way to assess whether physicians are impaired or not, and when they are OK to return to practice. Most BoM's and PHP's are not funded / staffed to manage this problem. So private programs opened up to deal with the issue, offer to address the problems for BoM's at no cost to them. But they are free to pass the cost on to the physician. The BoM and the program wants the "error rate " (i.e. impaired physician is returned to practice) to be very low, so aggressive treatment is recommended for everyone. Plus, these private companies have a financial incentive to treat everyone aggressively. "Impaired" physicians developing their own treatment plans is a bad idea. We (perhaps) could have some sort of "second opinion" type of system -- but as soon as you tell the second opinion assessor that they will be held responsible for any future poor outcomes, I expect you'll end up with the same assessment.

But that's not necessarily in the physician's best interest.

There are lots of parallels to the private prison system -- i.e. financial incentives to keep prisoners longer, violate them for minor offences, avoid releasing someone early whom might reoffend, etc.

MJ is a complicated issue. It's illegal federally. If it's found in your system, in any amount, you technically have a drug abuse problem. Perhaps you don't agree with that, but it's the way it is. Same if you are found with cocaine in your system -- arguing that you only use it intermittently at parties when you're not working isn't going to float
It's actually not that complicated at its core because what I think the majority on this side of the fence are asking for is very simple: treat physicians as you would treat anyone else and establish oversight so that we know that's what's happening.

I'm a psychiatrist. If I have a cop in my office, I am going to evaluate him and offer him an evidence-based treatment plan. That might mean that if I'm doing a fitness-for-duty eval, I'll recommend he not return to work, go to rehab, etc., but I am not going to recommend inpatient rehab at an unaccredited cash-only facility for 8 weeks for marijuana when I just sent the teacher I just evaluated to an accredited, insurance-funded outpatient rehab for an alcohol problem.

You're right, these places want the money, so why are PHPs feeding physicians to them when it's clear they're not abiding by the standard of care we would employ for any of our patients? Why can't physicians go to any rehab facility, the same way Patient John Doe would?
 

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Or or they could have just straight up fired him for smoking weed given that it was probably against hospital policy anyway.
 
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hamstergang

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It's very possible for these 2 points to be true simultaneously:

1) These programs need more oversight and, while something like this is necessary, these have ruined many physicians.

2) Using marijuana as a resident is a stupid idea. Using kratom while in a substance program is a stupid idea.
 

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It's very possible for these 2 points to be true simultaneously:

1) These programs need more oversight and, while something like this is necessary, these have ruined many physicians.

2) Using marijuana as a resident is a stupid idea. Using kratom while in a substance program is a stupid idea.
This is where I lost sympathy for that person's rant and understood they did in fact have a substance abuse issue.
 
Nov 7, 2019
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That is by no means a "flip side". That brief article was about a physician whose conduct made it obvious that he was impaired on-the-job and unable to fulfill his responsibilities. This article
I am a huge proponent of PHP oversight, and these distant referrals to "expert centers" are crazy.

But the linked article is poor reporting and seems very biased.

I get the sense from the article and what happened that this physician was prescribing benzo's to himself. That's a huge problem.

Article mentions that withdrawing from benzo's is dangerous, also that he was on "low dose". Benzo withdrawal is uncomfortable, but not really dangerous (other than risk of suicide). And if he was on low dose, really shouldn't have been an issue at all.

Mentioned that he was a doc for 30 years, and then spent his life savings of $50,000. This suggests deeper problems here.

Also, article seems to mention that they were going to let him come back to work, but that he would have to pay for monitoring which was $1200 per month, and he couldn't afford that. Should be affordable for most physicians, I would think. Esp if your whole career is on the line.
I assume you're referring to the physician who was made impoverished by his board. There is more to that story. This physician self-treated precisely because he was afraid that his board would find out that he had a "mental illness". Definitely there's a perverse incentive operating here. Not long after he returned to practice, his board suspended his license. One year shy of completing his contract, after cashing in his retirement and selling his home, he could no longer pay the required $1200 per month. He appealed to the board to either forgive the last year of his consent order or find some way to help financially strapped physicians but his board denied his appeal. In essence, this physician's license was permanently revoked because he ran out of money. In total, he spent almost $300,000 trying to comply with unnecessary treatment and monitoring.
 
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Half of my residency would’ve been fired then. Man you guys all sound like stuck up pricks. Have you ever had a day of fun in your entire life? I can’t do drugs or drink but I’m still having the time of my life. I rented an adult sized bounce house last weekend and had a party with 100 people there. Loosen up. Life is much more complicated then you’re making it seem. Doctors are people too. Have you ever taken a controlled substance? Well they could use that against you. They said I had a “severe stimulant” addiction because I took a daily adderall as prescribed for 15 years. They will look for ANY reason to admit you and take your money. Who cares if I smoked weed on the weekends if it wasn’t interfering with my life? I know a lot of doctors that binge drink regularly. Anyone could be in my position with an anonymous letter at anytime for any reason. They will find one.

Or or they could have just straight up fired him for smoking weed given that it was probably against hospital policy anyway.
 
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Well what the hell do you do when you have severe migraines and aren’t allowed to take anything that would actually help? Be in pain every day? I have literally tried every migraine treatment known to man. Suddenly I’m not afforded basic rights or ethical treatment. My pain no longer matters because I am doctor and am expected to just live with severe pain.


It's very possible for these 2 points to be true simultaneously:

1) These programs need more oversight and, while something like this is necessary, these have ruined many physicians.

2) Using marijuana as a resident is a stupid idea. Using kratom while in a substance program is a stupid idea.
 
Nov 5, 2019
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why do I even try. I hate people. This is why I became a radiologist. You are all miserable mean people. Get off your computers and maybe try to be nice to someone for once in your life.

This is where I lost sympathy for that person's rant and understood they did in fact have a substance abuse issue.
 

calvnandhobbs68

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Half of my residency would’ve been fired then. Man you guys all sound like stuck up pricks. Have you ever had a day of fun in your entire life? I can’t do drugs or drink but I’m still having the time of my life. I rented an adult sized bounce house last weekend and had a party with 100 people there. Loosen up. Life is much more complicated then you’re making it seem. Doctors are people too. Have you ever taken a controlled substance? Well they could use that against you. They said I had a “severe stimulant” addiction because I took a daily adderall as prescribed for 15 years. They will look for ANY reason to admit you and take your money. Who cares if I smoked weed on the weekends if it wasn’t interfering with my life? I know a lot of doctors that binge drink regularly. Anyone could be in my position with an anonymous letter at anytime for any reason. They will find one.
:rofl::rofl:
Sweet bounce house story bro
 
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speaking of oversight, did you know the people who did my evaluation were the same people who owned the rehab center and profited 30,000$ from me being admitted??? HOW IS THAT LEGAL? We should be evaluated by someone who has nothing to financially gain from my admission

It's actually not that complicated at its core because what I think the majority on this side of the fence are asking for is very simple: treat physicians as you would treat anyone else and establish oversight so that we know that's what's happening.

I'm a psychiatrist. If I have a cop in my office, I am going to evaluate him and offer him an evidence-based treatment plan. That might mean that if I'm doing a fitness-for-duty eval, I'll recommend he not return to work, go to rehab, etc., but I am not going to recommend inpatient rehab at an unaccredited cash-only facility for 8 weeks for marijuana when I just sent the teacher I just evaluated to an accredited, insurance-funded outpatient rehab for an alcohol problem.

You're right, these places want the money, so why are PHPs feeding physicians to them when it's clear they're not abiding by the standard of care we would employ for any of our patients? Why can't physicians go to any rehab facility, the same way Patient John Doe would?
 
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in Indiana the entire physician monitoring program is just ONE person. No appeals process, no oversight at ALL


speaking of oversight, did you know the people who did my evaluation were the same people who owned the rehab center and profited 30,000$ from me being admitted??? HOW IS THAT LEGAL? We should be evaluated by someone who has nothing to financially gain from my admission
 

Raryn

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Well what the hell do you do when you have severe migraines and aren’t allowed to take anything that would actually help? Be in pain every day? I have literally tried every migraine treatment known to man. Suddenly I’m not afforded basic rights or ethical treatment. My pain no longer matters because I am doctor and am expected to just live with severe pain.
Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.
 

Mass Effect

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Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.
Meh, there's quite a bit of overlap between tension headache and migraines and Fioricet is FDA-approved for tension headaches. If someone with migraines gets relief from it, I tend to think what they're calling a migraine is a tension headache and/or people with migraines can benefit from it, despite being off-label.

We use off-label meds a lot and people benefit -- spironolactone for acne and hirsuitism, prazosin for PTSD-related nightmares, clonidine for ADHD, octreotide for chemo-related diarrhea, gabapentin for diabetic neuropathy and for hot flashes, propranolol for anxiety, lorazepam for nausea or for sedation, on and on and on.
 
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I’ve tried literally everything. Botox for 2 years, Injections for the last 6 months. Even lidocaine injections into my sphenopalanine ganglion. Next step- brain surgery



Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.



Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.
 
Nov 5, 2019
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Plus you guys are missing the whole fricking point. They gave me two centers and the people doing my evaluation owned the rehab. There was ONE lady in charge of everything. Now does that sound kosher to you? You think that should be legal? Absolutely no oversight?

Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.
 
Nov 5, 2019
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QUOTE="hamstergang, post: 21361138, member: 468003"]
It's very possible for these 2 points to be true simultaneously:

1) These programs need more oversight and, while something like this is necessary, these have ruined many physicians.

2) Using marijuana as a resident is a stupid idea. Using kratom while in a substance program is a stupid idea.
[/QUOTE]
 

hamstergang

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Plus you guys are missing the whole fricking point. They gave me two centers and the people doing my evaluation owned the rehab. There was ONE lady in charge of everything. Now does that sound kosher to you? You think that should be legal? Absolutely no oversight?
I don't think most of us are missing anything. If you re-read my post at least, I'm explicitly pointing this out. Just because we think it's a bad idea to use marijuana as a resident (which is almost surely against your hospital policies, is federally illegal, and which upsets the DEA who grants you a license to prescribe some things) doesn't mean that these programs are good or ethical.

Criticizing you isn't supporting these programs. I don't know why you're looking at this in such black-and-white terms.
 
Mar 11, 2019
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I recently recommended this thread to an MS 4 in the clinical forums who is being asked to have a psych evaluation and it reminds me to ask if there's an update to the PHP audit in the state of MA @OrestesWeed ?
The Massachusetts audit officially started May 7, 2019. Office of State Auditor (OSA) Suzanne Bump’s Director of Audit Planning and Review Billy Keefe refused to address any of the evidence of fraud prior to the start of the audit. Now that the audit has started he decided to disregard and exclude all of the evidence provided to him over the past 4-years (claiming it would bias the results!) and this month he has taken a new position outside the OSA.

Article from The Valley Patriot Newspaper: “State Auditor’s Office Protects The Big Swamp From The Law.”

It appears state agencies (AGOs. DAs, auditors, medical boards, judiciary -i.e. administrative, superior and supreme courts) are not an effective means of exposing this corruption but there is some hope from federal agencies (particularly FTC and DOJ--they have both taken an interest and are aware of the corruption.

 

aProgDirector

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speaking of oversight, did you know the people who did my evaluation were the same people who owned the rehab center and profited 30,000$ from me being admitted??? HOW IS THAT LEGAL? We should be evaluated by someone who has nothing to financially gain from my admission
This is wrong, I expect most/all of us would agree this is unacceptable. the process clearly needs improvement, at least in some states.
 
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Exactly. Me being right or wrong in smoking marijuana is not the point I was trying to make. The whole point of my story was just to point out the corruption and hope that someone reads this and does something about it because I have been trying for years to expose this in any way I can. I understand there are consequences for my behavior but I was taken advantage of by a corrupt institution and this could happen to anyone and these people need to be stopped. They are literally ruining lives. I myself almost committed suicide during this whole ordeal and completely understand why other doctors have. Doctors are people too and these people are exploiting us for personal gain. If at least I can help someone else by telling my story that’s all I care about. Any one of us is vulnerable to this.

This is wrong, I expect most/all of us would agree this is unacceptable. the process clearly needs improvement, at least in some states.
 
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KnuxNole

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Half of my residency would’ve been fired then. Man you guys all sound like stuck up pricks. Have you ever had a day of fun in your entire life? I can’t do drugs or drink but I’m still having the time of my life. I rented an adult sized bounce house last weekend and had a party with 100 people there. Loosen up. Life is much more complicated then you’re making it seem. Doctors are people too. Have you ever taken a controlled substance? Well they could use that against you. They said I had a “severe stimulant” addiction because I took a daily adderall as prescribed for 15 years. They will look for ANY reason to admit you and take your money. Who cares if I smoked weed on the weekends if it wasn’t interfering with my life? I know a lot of doctors that binge drink regularly. Anyone could be in my position with an anonymous letter at anytime for any reason. They will find one.
Half of your residency smoked weed? Dude I highly doubt that. Half of your residency would NOT be fired, trust.

Having fun =/= smoking weed.

Weed is federally illegal. Anyone graduating medical school should know that...I hope. They know that hospitals drug test everyone, and as a career move, are smarter than that. It's ok to make mistakes, everyone does. As long as you have insight that smoking weed as a physician is bad and that no one on the board of medicine would agree at the current time.

Alcohol is legal. Marijuana is federally illegal.

If they got a DUI, then yes, they are 100% liable and we would all agree they messed up, and probably need help.
 
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KnuxNole

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Same thing I'd tell any other patient with migraines. There's no indication for any controlled substance for migraines - not opiates, not barbituates (though they're often prescribed inappropriately), not marijuana, not kratom (that hasn't been studied for it at all). Try all the usual preventative agents, up to and including preventative botox injections and the new CGRP agents.

Using illicit substances off label is illicit even if it's for a purported medical purpose.
This. I never write controlled substances for anything anyway, so it's a moot point, but there are lots of options.
 
Nov 5, 2019
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For the 100th time, smoking weed is not the issue here. The issue is that these physician monitoring programs have overreaching, unregulated and unmonitored, complete control over our lives. They are corrupt by financial greed And not using evidence-based medicine to make decisions. I understand there are consequences for smoking weed. Mandatory inpatient 30,000$ rehab at a specific center chosen by them should not be one of them. Indiana also lied and said it was a “doctors only rehab” when in reality it had lawyers, politicians, even cops and construction workers there. Basically anyone who wanted to pay. They hid my initial evaluation from me which I later found out had frank lies and gross exaggerations in it and would not tell me my drug test results, which they also lied about to me. It is incredibly corrupt and unmonitored and should not be legal. And no one is doing anything about it




QUOTE="KnuxNole, post: 21365597, member: 98583"]
Half of your residency smoked weed? Dude I highly doubt that. Half of your residency would NOT be fired, trust.

Having fun =/= smoking weed.

Weed is federally illegal. Anyone graduating medical school should know that...I hope. They know that hospitals drug test everyone, and as a career move, are smarter than that. It's ok to make mistakes, everyone does. As long as you have insight that smoking weed as a physician is bad and that no one on the board of medicine would agree at the current time.

Alcohol is legal. Marijuana is federally illegal.

If they got a DUI, then yes, they are 100% liable and we would all agree they messed up, and probably need help.
[/QUOTE]
 
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Indiana had ONE lady in charge of the program. NO appeals process, no chance for a second opinion. $5,000 initial evaluation for every physician who gets reported to them for any reason. Now does that sound kosher to you?

[
QUOTE="Squirtlecharmanderr, post: 21366143, member: 1017228"]
For the 100th time, smoking weed is not the issue here. The issue is that these physician monitoring programs have overreaching, unregulated and unmonitored, complete control over our lives. They are corrupt by financial greed And not using evidence-based medicine to make decisions. I understand there are consequences for smoking weed. Mandatory inpatient 30,000$ rehab at a specific center chosen by them should not be one of them. Indiana also lied and said it was a “doctors only rehab” when in reality it had lawyers, politicians, even cops and construction workers there. Basically anyone who wanted to pay. They hid my initial evaluation from me which I later found out had frank lies and gross exaggerations in it and would not tell me my drug test results, which they also lied about to me. It is incredibly corrupt and unmonitored and should not be legal. And no one is doing anything about it




QUOTE="KnuxNole, post: 21365597, member: 98583"]
Half of your residency smoked weed? Dude I highly doubt that. Half of your residency would NOT be fired, trust.

Having fun =/= smoking weed.

Weed is federally illegal. Anyone graduating medical school should know that...I hope. They know that hospitals drug test everyone, and as a career move, are smarter than that. It's ok to make mistakes, everyone does. As long as you have insight that smoking weed as a physician is bad and that no one on the board of medicine would agree at the current time.

Alcohol is legal. Marijuana is federally illegal.

If they got a DUI, then yes, they are 100% liable and we would all agree they messed up, and probably need help.
[/QUOTE]
[/QUOTE]
 

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For the 100th time, smoking weed is not the issue here. The issue is that these physician monitoring programs have overreaching, unregulated and unmonitored, complete control over our lives. They are corrupt by financial greed And not using evidence-based medicine to make decisions. I understand there are consequences for smoking weed. Mandatory inpatient 30,000$ rehab at a specific center chosen by them should not be one of them. Indiana also lied and said it was a “doctors only rehab” when in reality it had lawyers, politicians, even cops and construction workers there. Basically anyone who wanted to pay. They hid my initial evaluation from me which I later found out had frank lies and gross exaggerations in it and would not tell me my drug test results, which they also lied about to me. It is incredibly corrupt and unmonitored and should not be legal. And no one is doing anything about it
Let's assume all of what you said is true about the lies - why not file a lawsuit alleging fraud? If you can prove it's detrimental to you career with lost earnings that should be an easy $5mil+ settlement... then you can come back here with vindication in hand.
 

Mass Effect

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Let's assume all of what you said is true about the lies - why not file a lawsuit alleging fraud? If you can prove it's detrimental to you career with lost earnings that should be an easy $5mil+ settlement... then you can come back here with vindication in hand.
You're new to this topic, aren't you? Google physician health programs. Start with NC, where there was a lawsuit that ended with inconclusive results about wrongdoing. They couldn't say definitively there was corruption, but also couldn't say there wasn't. Go then to MA, where it's gotten a lot of press, particularly around a few cases. The end result is always the same - courts don't want to get involved for the same reason state auditors don't, which was mentioned earlier in the thread. Then go to MI, where a class action lawsuit was filed against the PHP there. Then go to KS (or was it MO?), where a television news broadcast did a multi-part series on PHPs and how their ruining doctor's lives.

At no point has it ever been an "easy" settlement. Or any settlement at all. Part of this is because the courts want nothing to do with dictating how medical boards discipline physicians and PHPs are arms of the board (read the Disrupted Physician). Other part is that docs are terrified of retribution.

I don't think most of are disputing that most of the docs mixed up in all this, at some point, likely did something they shouldn't have, but the punishment doesn't fit the crime and screams abuse of power, and THAT'S the point.
 

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You're new to this topic, aren't you? Google physician health programs. Start with NC, where there was a lawsuit that ended with inconclusive results about wrongdoing. They couldn't say definitively there was corruption, but also couldn't say there wasn't. Go then to MA, where it's gotten a lot of press, particularly around a few cases. The end result is always the same - courts don't want to get involved for the same reason state auditors don't, which was mentioned earlier in the thread. Then go to MI, where a class action lawsuit was filed against the PHP there. Then go to KS (or was it MO?), where a television news broadcast did a multi-part series on PHPs and how their ruining doctor's lives.

At no point has it ever been an "easy" settlement. Or any settlement at all. Part of this is because the courts want nothing to do with dictating how medical boards discipline physicians and PHPs are arms of the board (read the Disrupted Physician). Other part is that docs are terrified of retribution.

I don't think most of are disputing that most of the docs mixed up in all this, at some point, likely did something they shouldn't have, but the punishment doesn't fit the crime and screams abuse of power, and THAT'S the point.
So you're saying the solution to the problem is to stop trying and let it happen? And then go to a forum to complain.

Change is hard, but someone needs to spur it. It's how change happens.
 
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I am a huge proponent of PHP oversight, and these distant referrals to "expert centers" are crazy.

But the linked article is poor reporting and seems very biased.

I get the sense from the article and what happened that this physician was prescribing benzo's to himself. That's a huge problem.

Article mentions that withdrawing from benzo's is dangerous, also that he was on "low dose". Benzo withdrawal is uncomfortable, but not really dangerous (other than risk of suicide). And if he was on low dose, really shouldn't have been an issue at all.

Mentioned that he was a doc for 30 years, and then spent his life savings of $50,000. This suggests deeper problems here.

Also, article seems to mention that they were going to let him come back to work, but that he would have to pay for monitoring which was $1200 per month, and he couldn't afford that. Should be affordable for most physicians, I would think. Esp if your whole career is on the line.
The physician in question had his license suspended pending "successful completion" of his program which would take 5 years. He completely ran out of money four years into his program, thus was unable to comply, and his board permanently suspend his license. Aphelanmd
 

Mass Effect

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So you're saying the solution to the problem is to stop trying and let it happen? And then go to a forum to complain.

Change is hard, but someone needs to spur it. It's how change happens.
You might want to actually read the thread. I never said to stop trying. Exactly the opposite. But what I'm telling you is that your statement "If you can prove it's detrimental to you career with lost earnings that should be an easy $5mil+ settlement" is ridiculously inaccurate for the reasons I stated.
 
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Believe me I have tried. I’ve met with several lawyers. 1. I can’t prove it’s fraud without a shadow of a doubt enough to win a lawsuit. 2. It would cost me a LOT of money and take years. Also I still have my job and make a ton of money so potential lost income actually isn’t that much. I’m not posting on here to try to get retribution for what they did to me, I’m posting on here to try to prevent this from happening to anyone else. I can’t change what happened to me and all in all my life turned out fine after all but it very well could not have and it didn’t for other docs. I just posted on here to confirm that all the allegations in these articles are 100% true and not exaggerations.

Let's assume all of what you said is true about the lies - why not file a lawsuit alleging fraud? If you can prove it's detrimental to you career with lost earnings that should be an easy $5mil+ settlement... then you can come back here with vindication in hand.