(If you’re coming from CPR’s December email, here’s the deeper dive. Delighted to know you’re a fan of long-form medical regulatory non-fiction. And if you’re just discovering us from word-of-mouth, welcome! )
Welcome – and Happy Holidays!
As I know amongst our group are those who celebrate diverse holiday traditions, Merry Christmas, Happy Hanukkah, and Abundant Kwanzaa to all!
Please Take A Moment of Appreciative Reflection …
I hope that you and yours are staying well and exercising utmost precaution in this unprecedented time. On behalf of CPR, I invite each of you to pause for a moment reading this and envision one or two physicians or nurses or any others in healthcare you know and offer a prayer of thanks and wishes for continued wellbeing to our deeply dedicated colleagues throughout healthcare who have so courageously used their extraordinary skills and deep compassion to selflessly respond to the COVID crisis. Collectively, they have treated millions of patients in unusually dangerous circumstances, patients whom we know have benefitted immensely from their selfless care.
[ … quiet reflection …]
To them, and especially to those whom we’ve lost to this pandemic, our heartfelt appreciation.
Medscape’s Favorable CPR Reference
I’m pleased to share that CPR gained some favorable visibility as Medscape just did another story on the dangers of being under medical licensing board (MLB) scrutiny. See “Dangers of a Medical Board Investigation: How to Protect Yourself”: https://www.medscape.com/viewarticle/940672#vp_1. (If you’re not yet a Medscape subscriber, do sign up – it’s free. And please do write a brief comment on the piece if only to affirm the dangers or just to “like" someone else’s comment. And be sure to share it widely. This is the best way to increase awareness of the MRTC* problem and get other physicians on board with our efforts.)
Physician Interrupted … Interrupted.
These have been extraordinarily challenging times for all of us, not just in the fact of an unprecedented global pandemic but in the array of overwhelming stresses, the varying impacts of which are unique to each of us. And especially for those facing medical licensing board (MLB), physician health program (PHP), and peer review/performance appraisal challenges, this sum total of stress can feel overwhelming. As many know, dealing with the too-often due process-deprived MRTC was already itself a stress factor equal to ten malpractice suits.
This past June, especially in the context of COVID, it was my desire to make CPR’s curbside consult and peer support services more accessible by developing a physician-only membership community entitled Physician Interrupted. Irony of ironies, that initiative itself got interrupted … and in quite an overwhelming way.
Most of those who follow CPR know how immersive and all-consuming is the experience of having to deal with any element of the MRTC. Whether it’s a disciplinary issue, a hospital-based peer review credentialing matter or an allegation of impairment in some domain, i.e. mental illness, substance abuse or behavioral, these matters quickly consume all one’s psychological resources, not to mention financial savings and all of one’s social and familial connection. And understandably so as one’s very career could be permanently derailed if not handled with utmost attention.
“What To Do When Your Board Gets Sued” (…By A Harmed Physician.)
The Answer’s Clear. Harm Them Some More.
As I was eagerly cruising ahead with a variety of initiatives for the new Physician Interrupted community including a peer support program and a self-guided course on how best to approach board and PHP issues, I learned through a CPR colleague that a national FSMB (Federation of State Medical Boards) presentation entitled “What To Do When Your Board Gets Sued” had been delivered by an NC Medical Board lawyer under that board’s identity to a national conference of board presidents and attorneys. It had been publicly posted and available internationally for download for nearly a year before I actually discovered it.
It presented detailed material including non-public PHI (protected health information) pertaining to my prolonged ordeal with that board and PHP. Identifying me by name (while concurrently mocking me with a degrading avatar), it made what I am reasonably certain are multiple legally impermissible, at that false, PHI disclosures which it presented as though settled fact. The accompanying “creatively re-scripted” narrative appeared not only to serve as a retroactively reconstructed vindication of this board’s behavior but also to provide an even further demeaning characterization than was in the original narrative.
After reflecting deeply on my choices on whether to confront them and how best to proceed, I realized that I yet again had to confront this abuse as the presented material not only set a new low for MLB abusiveness, I believe it egregiously violated multiple federal laws. Its assaultiveness had far-reaching implications not just for me but was representative of the plight of all physicians subject to such. I simply had to drop what I was doing and devote all attention to designing a well thought out response.
Like every one of the hundreds of physicians I’ve spoken with, dealing with MLBs, PHPs, and peer review entities – especially those which skirt the law in their deprivation of due process – is almost invariably a painful and protracted ordeal. Nor is it a fair system. One party sits as complainant, investigator, infallible fitness-for-duty diagnostician, and prosecutor … and runs the court too!
So the prospect of now, ten years since the onset of this MRTC intrusion and two years since finally washing my hands of any further involvement, having to re-engage with this bullying and non-overseen entity where the game is entirely rigged in their favor evokes a cascade of intense visceral emotions – anger and hurt, even immobilizing dread.
I had to make a decision on whether to challenge this latest abuse.
I could try to simply ignore this renewed assault with its poison pen letter content concealed in an otherwise legitimate-appearing legal presentation and continue to focus on moving forward with the various CPR initiatives. Or I could put everything on hold and invest what would yet again require immense time and effort – not to mention megatonnage of psychic energy – to confront and try to rectify this MRTC bullying.
Armed now with much deeper knowledge of the MRTC’s operations and pertinent laws acquired over these last ten years of Kafkaesque ordeal, I ultimately decided I had to initiate several courses of action alleging specific violations of HIPAA, 42 CFR Part 2 and the ADA.
Hundreds Of Hours, Reams Of Research and Correspondence – Will It Amount To Anything?
I don’t know. But I do feel it was mandatory that I detail in a written federal complaint the cascade of abuses. Whatever the outcome of this nearly four-month non-stop effort, I know this for certain from my own experience as well as from that of the hundreds of physicians similarly victimized: you stand no chance of justice if you don’t stand up for your rights. They know that, and they know how arduous and costly the process is. And they know that many physicians, severely traumatized by their unfairness and apathetic harshness, will have experienced such harm that they will avoid any further engagement with them. Boards like this introduce a unique variant of PTSD and moral injury melded into one.
But to stand any chance of prevailing against these arrogant abusers of state power and defiers of federal law and achieving justice requires sustained effort and mental composure. It requires becoming as thoroughly knowledgeable as possible both of the laws which should protect our rights and of the array of legal mechanisms potentially available to seek definitive remedy and impose accountability.
Clearly there are more strategies than simply individual litigation which itself has a very poor track record. Getting docs to become aware of the unlawful infringements; understanding how the obscure workings of the medical licensing regulatory system have been so successfully used against physicians; and learning how to stand up for ourselves and demand accountability are just a few.
“Fight for the things that you care about, but do it in a way that will lead others to join you.” Ruth Bader Ginsburg
So actually, this unsolicited diversion is really not so much a derailment as much as it is “field research” toward further understanding how this previously obscure MRTC system works so as to better convey the hurdles of challenging this non-overseen and non-accountable machine to the uninitiated.
All said, I’m hoping I’ve sufficiently alerted the appropriate regulatory authorities.
Now, with nearly four months of all-out effort more or less out of the way (at least, the heavy lifting part), I’m eager to resume the planned Physician Interrupted site. More on this later.
Increased Awareness
And I’m eager to share with you my now strengthened optimism about CPR’s physician rights efforts. With Medscape and other journalists taking a closer look, physician and public visibility of the MRTC powers and its previously normalized cascade of abuses is increasing. More licensees – and their counsel – are becoming aware of the crucial role the ADA can play and are engaging suitably expert counsel. And journalists are increasingly inquiring “why are doctors so afraid to seek mental health help or even to acknowledge such on their licensing/credentialing applications?” Be assured, I and CPR colleagues have shared an earful with incredulous investigative journalists.
Getting Help Is Still Dangerous
On a related note, examining the psychological fallout from COVID affecting our physician colleagues on the pandemic’s frontlines, I was invited to present on the very real dangers of getting mental health help, especially in view of MLBs’ and PHPs’ boundarylessness. I argued that the occupational stress issues docs are seeking help with should not be mislabeled in therapists’ notes and billing codes as their having sought “treatment for mental illness.” A stress response syndrome, no matter how intense, is not equivalent to a mental illness. I laid out the ways that such erroneous diagnostic labeling occurs and its danger-laden MRTC consequences. If you’re a physician receiving – or providing – such therapeutic services, I believe you’ll find it a helpful new perspective. (See below for the link.) But make no mistake – given boards’ and PHPs’ immense power and lack of oversight – getting help is still very risky. There are things that physicians seeking such help can do immediately to protect themselves. Notwithstanding these concerns, taking care of oneself in all ways needs to be priority # 1.
2021 Will Be A Pivotal Year
As we move toward 2021, surely many of us weary and shell-shocked, some perhaps even cynical and despairing, I want you to know of my conviction that we are making major inroads towards correcting the impermissible ways that boards and PHPs conduct themselves. I believe that there’s going to be a newly awakened sensibility and a recognition of boards’ and PHPs’ requisite compliance with state and federal law. I also believe that there will be newly imposed accountability both by governmental entities and the increasingly aware physician community. Until now, numerous parties have been naively intertwined with the MRTC’s abuses. But they are, in significant part due to your and our collective efforts in highlighting these harms, becoming increasingly aware of the breadth of illegal abuses of physicians’ rights. And, more informed and aware of how physicians and their patients have been harmed, I believe medical societies will insist on transparent governance. And they will ally with their physician constituencies demanding fairness and holding MLBs and PHPs accountable.
And I say this with confidence because, given the abundant abuses we’ve seen in their flagrant violation of laws, ethics and regulatory agency professionalism, it can’t be any other way. And now especially considering the looming personnel crisis caused by COVID attrition and clinician burnout, this unchecked pattern of harm to physicians’ careers simply cannot be sustained.
Immense THANKS !
Special thanks to the devoted cadre of CPR donors who are making monthly contributions. Please know that your commitment to CPR’s efforts through your monthly support means so much more than simply your donation. It’s an endorsement of our work, and it has been a tremendous boost to our morale.
We’d Welcome Your Support!
If you’re interested in learning more about CPR and would like to make your first contribution, please visit: https://chuffed.org/project/cpr-center-for-physician-rights.
And if you’ve already contributed and would like to make your contribution a monthly one (no matter how large or small the amount), simply select the monthly option on the donor page: https://chuffed.org/project/cpr-center-for-physician-rights.
Thanks for all YOU’RE doing to embrace and support the cause of physicians’ rights.
On behalf of CPR, wishing you and yours a safe and enjoyable holiday!
And may 2021 be a vibrant new year of advancement of physicians’ rights. I am hopeful – and confident – that significant changes are afoot.
Appreciatively, and with kindest regards,
Kernan
* MRTC = Medical Regulatory Therapeutic Complex, including medical licensing boards (MLBs), so-called physician health programs (PHPs), and peer review entities. For a fuller explanation, see Systematic Abuse and Misuse of Psychiatry in the Medical Regulatory-Therapeutic Complex on our website: https://www.physicianrights.net/articles.
** Are COVID related psychological syndromes mental illnesses? Kernan Manion, MD (for Association of American Physicians and Surgeons - 11 June 2020) Access at: https://bit.ly/k_manion_MH_syndromes