C P R

The Center 

for 

Physician Rights

A New Resource for Physicians and Counsel In Dealing With

Regulatory Administrative Legal Matters

Silent Epidemic

An Under-recognized

Perilous Licensing Landscape

There is an emerging but hidden epidemic in American Medicine today.  

 

Caring and competent physicians are wrongfully being driven out of their careers by dishonest medical board investigations; unethical fitness for duty evaluations and intentionally biased peer review proceedings. 

 

Thousands yearly find themselves suddenly thrust into what can quickly amount to a life threatening struggle for career preservation.

 

They’re caught in a powerful regulatory system that operates with utterly no oversight, deprives them of due process and holds them guilty until they prove themselves innocent. 

 

Certainly this is a nightmare for physicians wrongfully subjected to these non-overseen but highly empowered regulatory administrative agencies. And too often, the proceedings drag on for years and those physicians may face nearly insurmountable odds in re-establishing their careers. 

 

My colleagues in the Physician Advocacy Study Group have been intensively studying these developments over the last five years. And the stories are remarkably similar in states across the country. In fact, numerous articles in the medical literature (Medscape, British Medical Journal et al.) confirm this travesty.

This injustice causes a needless loss of highly trained clinicians and leads to an unwarranted interruption of patient care. It is also deeply traumatic to the harmed physician.

 

This is simply not right, and it cannot be allowed to continue. 

Until now, there has been no resource for physicians facing such challenges that offers knowledgable guidance and support. Their counsel too have had to negotiate this very complex environment, invariably “reinventing the wheel” in advocating for their client.

 

CPR – The Center for Physician Rights will be a highly focused non-profit organization dedicated specifically to helping physicians who believe they have been wrongfully subjected to an unjustified and unfair medical board disciplinary process, physician health program fitness-for-duty evaluation or peer review process and have been deprived of due process or other protected legal rights. And CPR will aggressively pursue necessary changes in the administrative legal arena to ensure fairness, prevent abuse of power and, where indicated, promote ethical and compassionate treatment.

A Case Scenario

The cascade of complexities for any physician

can quickly accelerate.

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. 


Rationale for a Physician Rights

Advocacy Program

State Medical Licensing Boards, Physician Health Programs

and Peer Review Committees Operate

With No Oversight And With Dangerous Impunity

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. 

CPR's Mission

Our focus is to serve as the leading resource for physicians who feel that their established rights could be or have already been wrongfully infringed by these entities.

 

CPR will be the first of its kind to offer specialized informational, consultative and advocacy for physicians and their counsel focusing on ensuring that fair and transparent processes are undertaken by Medical Licensing Boards, Physician Health Programs and Peer Review entities in all of their disciplinary, rehabilitative and remedial actions.

 

CPR does not provide any medical or legal services. CPR is not an alternate “fitness-for-duty” evaluation or peer review service though it may offer referral to such resources. CPR does not dispense legal guidance or undertake legal representation. It is not designed to serve as a means of helping someone “get out of” a legitimate charge or assessment and referral or to avoid addressing a legitimately identified health, competency or professionalism concern.


  • Educating and creating awareness of these identified and yet-to-be identified perils jeopardizing physicians’ rights and their patients’ wellbeing; 

  • Monitoring the provision of due process in such consequential licensing matters; 

  • Pressing for government accountability and oversight and promoting system changes

  • Providing urgently needed support and focused guidance to affected physicians; and

  • Emphasizing the need for transparency of administrative judicial processes and prompt correction of flawed processes; 

CPR's Services

We have already begun laying out CPR’s working parts and developing a coordinated strategic approach to provide supportive and advisory services to affected physicians. The services and resources that CPR will provide are:

  • Free Confidential Case Review

    We offer to serve as an independent “sounding board” regarding a licensing board, PHP or peer review issue, offering straightforward feedback and an overview of pathways to move forward. (The Care Review service is now available.)

  • Offer Case Consultation and Coaching

    After a detailed case review, we provide straightforward feedback about a physician’s case and map out potential next steps. We will offer a tailored program (fee or scholarship-based) of one-to-one and group coaching providing informed guidance on essential principles in approaching these matters. (The Case Consultation / Coaching Program is now available.)

  • Serve As The Central Authoritative Informational

    and Consultative Resource

    CPR will develop an informational website and produce a monthly e-newsletter / blog updating subscribers of relevant developments. We will serve as the definitive “go to” knowledge resource by establishing a centralized reference library with essential resources based on our extensive research and cumulatively accruing knowledge of judicial decisions, case trends and operant MLB and PHP philosophies.

  • Pursue Organizational and Legislative Change

    We are determined to change the system that is currently depriving physicians of their rights. CPR will promote a variety of initiatives, for example advocating for a transparent system of independent national auditing of all state medical licensing board, medical staff peer review committees and Physician Health Programs to ensure compliance with all legal and ethical requirements.

  • Provide Vitally Needed Peer Support

    CPR will develop a protected and readily accessible forum for peer support, offering one-to-one dialog and creating a restricted access private forum for confidential support groups.


CPR’s Planned Approach To Implementation 

and Sustained Development

We recognize that, with any new initiative, you can't do everything at once. So, here's our plan of development.

  • Phase 1 (Underway)

    Create Awareness. We are building our medical community through active participation in professional forums; submitting timely comments on published articles in the medical and popular press; and informing the non-medical public through general readership articles.

    Offer free confidential preliminary case review as a neutral sounding board for confidential “case sounding out.” (Case Review program now operational).

  • Phase 2

    Develop a specialized Consultation / Coaching program for fee-based in-depth case consultation and ongoing guidance (Consultation / Coaching program now operational).

    Develop in-depth presentations for delivery at grand rounds, Continuing Medical / Continuing Legal Education events and other public speaking opportunities.

    Offer free and fee-based informational webinars on most immediately relevant content. (We recently offered a webinar “The Perilous Physician Licensing Landscape.”) (Provide link)

    Publish articles in the professional and lay press facilitating broader awareness of these issues. (An article on “Do’s and Don’ts of PHP Assessments” is awaiting publication; “Sham PHP Assessment As A Manifestation of Abuse of Psychiatry” is in process.)

    Establish non-profit organizational status and secure 501c3 tax deductibility designation.

    Seek relevant grants to pursue CPR’s objectives in a sustainable way.

    Build alliances with similar advocacy organizations, e.g. Association of American Physicians and Surgeons. (Actively underway.)

  • Phase 3

    Begin to build a consultative and referral network of ethically grounded, truly independent medical and legal professionals in states across the country. (In process).

    Research and publish guidelines for ethical fitness for duty evaluations of physicians by PHPs, providing a legally referenced document establishing the standard of care. Make available to all physicians as a pocket-card to assure compliance with standards prior to being evaluated. (In process.)

    CPR will establish an advisory board of directors whose members take an active role in consulting on the overall direction of CPR, actively participate in fundraising and grant-seeking, and oversee the financial health and mission-driven growth of the Center.

And, soon to be added ...

  • Blog Pages

    We'll be publishing a monthly newsletter and regular posts on board, PHP and peer review topics. We'll also be highlighting important news and commentary from around the web.

  • Peer Support Portal

    We're planning on offering one-to-one and group confidential peer support  

  • Resource Page

    The Resource Page will have links to webinars, articles, and useful checklists

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© Copyright Oct 1, 2018 by CPR - The Center for Physician Rights. All Rights Reseved.