A well liked internist Dr. J. became alarmed about multiple episodes of erroneous diagnosis and patient jeopardy while covering her senior colleague’s practice with whom she had a strained relationship. He was also head of the department. Dr. J. reviewed these cases with a trusted colleague who concurred with her concerns. She conferred privately with the new Chief of Staff who promised to look into it.
Due both to the stress of her work situation and family issues, Dr. J. had recently started therapy and had been prescribed an antidepressant. To her surprise, she learned that her boss had informed the Chief that, on the basis of a recent flurry of anonymous staff reports concerning her, Dr. J. was herself the problem.
Under threat of termination, her boss ordered her to have a “fitness for duty” evaluation by the staff psychologist contracted by HR. Already under medical supervision, and fearing confidentiality breaches, she declined and her boss promptly removed her from the schedule, suspended her hospital privileges and reported this suspension as required to the state medical licensing board. The licensing board insisted she submit to examination by the state’s Physician Health Program.
After a 2 hour interview by a clinical social worker, the PHP would not divulge its conclusions to her, but ordered her to attend a four day evaluation out of state at a cost of $5K. When she refused, her medical license was suspended for non-compliance, and her licensure suspension was reported to the National Practitioner Data Bank making her virtually unemployable anywhere. Her professional license defense lawyer, a former board attorney, opined that she should have complied as the Board had the right to suspend her license.
Certainly this is a nightmare for the disciplined physician. And she faces nearly insurmountable odds in re-establishing her career. This is not only unjust and an immense loss of highly trained clinician, it is deeply traumatic to the harmed physician. Further, the impact on those patients in her practice who held her in high esteem is traumatic. The abrupt interruption of their care is a jeopardy seldom even considered by these agencies.
Sadly, this story is representative of an emerging epidemic of wrongful and irreversibly harmful behavior by Medical Licensing Boards, Physician Health Programs and corporate medical Peer Review Committees.
Until now, there has been no resource for physicians facing such challenges that offers knowledgable guidance and support.
Physicians are licensed by a medical licensing board (“MLB”) in the state(s) in which they practice and are often licensed in other states.. When they work in a hospital setting, they must also be credentialed to serve on that staff and may be subject to clinical performance review by a specialized peer review committee. A physician can be anonymously reported to a MLB, PHP or peer review committee for a variety of reasons.
If the allegation is of a substance abuse problem or a mental illness, or that the physician has engaged in unprofessional behavior, s/he may be reported to the MLB for discipline, referred by the MLB for a “fitness for duty” evaluation to be conducted by a Physicians Health Program (“PHP”) or subjected to an ad hoc “peer review.” (A “fitness for duty” evaluation is essentially a mandatory physical or psychiatric assessment. A “peer review” is a clinical performance assessment by fellow staff physicians.)
State MLBs, peer review committees and PHPs were created by state legislatures, hospitals and medical societies with three aims: to protect the safety of patients; to ensure quality of clinical care; and to provide non-punitive intervention with specialized diagnostic assessment, treatment and rehabilitative services where indicated to physicians who may have become impaired in the course of their careers.
Abundant evidence reveals that these disciplinary and assessment activities are too often not being conducted according to requisite professional or legal standards.
Many physicians in states across the country have revealed that they have been subjected unfairly to these procedures and have experienced utter powerlessness when contesting these entities’ actions. They have called attention to the strong potential for bias in the assessments by designated examiners, and the complete denial of any opportunity to contest the assessment’s findings, to appeal the decision or to seek a second opinion. Many have commented on what appears to be a pattern of “self-dealing” in making coerced referrals to private programs affiliated with the PHP.
Some of these powerful corporate and state government entities are abusing their authority and irreparably harming the careers of well qualified and compassionate physicians. Even worse, in doing so, they are needlessly and dangerously jeopardizing these physicians’ patients’ care when there is no valid concern registered about patient well-being.
Each physician, naive to the dangers of the process, goes into this immensely costly and career-jeopardizing journey essentially alone, too often without knowledgeable counsel. From the outset, they are placed in an inherently disadvantaged position and their inordinately costly legal challenge is almost invariably futile. There is no specialized advocacy organization yet in existence to support and advise these physicians and raise awareness of the imminent perils of this vulnerability.
The Center for Physician Rights is desperately needed – an organization well versed in the issues explicitly dedicated to challenging this administrative-legal abuse and to providing support, guidance and advocacy for the physician.
Having studied these issues for more than five years, we have noted that with each published article and commentary we write, with each blog post and webinar we do, affected physicians seek us out to share their plight and ask for our guidance.
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© Copyright Oct 1, 2018 by CPR - The Center for Physician Rights. All Rights Reseved.