CPR’s focus is to serve as a leading resource for physicians and physicians-in-training who feel that their established rights could be or have already been wrongfully infringed by Medical Licensing Boards, Physician Health Programs and/or medical peer review or performance appraisal committees.
CPR is the first of its kind to undertake specialized informational, consultative and advocacy efforts 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. CPR does not dispense legal guidance or undertake legal representation though we strive to culture relationships with law firms that are passionate about protecting physicians’ rights. CPR is certainly not designed to serve as a means of helping someone “get out of” a legitimate charge or warranted assessment and referral, or to avoid addressing a legitimately identified health, competency or professionalism concern.
Rather, CPR’s focus is on:
We recognize that, with any new initiative, you can't do everything at once. So, here's our plan of development.
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.)
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. (In process.)
Seek relevant grants to pursue CPR’s objectives in a sustainable way. (In process.)
And, more recently completed ...
The newsletter features a cluster of significant issues that affect physicians' rights. It also serves as a means to share a short synopsis of a post on the blog which goes deeper into a topical area. Be sure to opt-in to the newsletter here so you stay apprised of what CPR's up to. There's about one issue per quarter so you can be assured you're not going to be dewluged.
We're publishing posts and doing podcasts at Physician Interrupted highlighting important developments and commentary from around the web. Each blog post invites commentary as well as an opportunity to share that post with others. When you register on the Substack platform which hosts the blog, you'll get each issue as it is posted directly to your email.
Still in development is a peer support resource
We hope to offer one-to-one confidential peer support and to establish a private confidential forum both for 1-to-1 support and peer support training..
While physicians have been facing challenges in dealing with boards, PHPs and peer review entities for decades, only recently has it been seen that these three (and probably more) actually operate as an interrelated unit which has been newly termed the Medical Regulatory Treatment Complex (MRTC).
CPR has been following numerous physicians’ legal cases, court decisions, legislative initiatives and federal agencies enforcement of relevant law.
As we recognize that most physicians have very little knowledge of the profoundly career-consequential activities of these entities, CPR will be offering webinars and in-person presentations to state medical societies, specialty associations and any gatherings of physicians who would like to learn more.
If you’re interested in being kept apprised of these offerings, please be sure to opt in for our newsletter.
CPR is committed to changing the administrative medical regulatory system that has allowed the MRTC to operate so recklessly with no oversight and yet complete impunity.
The authority of administrative agencies like the state medical board (MLB) and its affiliated physician health program comes from the state through legislation. Every state has some variant of a “Medical Practice Act” spelling out the authority of the MLB.
However, the oversight of these agencies is not always clear. In fact, some seem to run as autonomous entities. Yet the courts treat them as implicitly having the requisite checks and balances inherent in a properly overseen government agency. And the abuses of these agencies have increasingly become visible.
Legislators in various states, especially with the guidance of investigative journalists, have responded to the plight of physicians, some even spurred on by calls of their state medical society advocating for protection of physicians' rights.
There are common themes that each of these state legislative initiatives are trying to address. Yet, until now, there has been no central resource bringing them together, highlighting their common efforts and enabling them to communicate with each other.
Legislation pertaining to reining in medical boards, PHPs and peer review activities is currently active or under consideration in Rhode Island, Louisiana (“Physicians Bill of Rights”), Oklahoma, Oregon, Washington State and Florida. These are indeed encouraging developments.
Residents & Med Students
CPR Also Helps PGYs and Med Students
We’re no strangers to the rigorous training required of today’s fellows, residents, interns and med students. We’ve been there and we know your plight. The perils you face as you prepare for physicianhood may even be greater than what we’ve faced.
Being a physician today can be exceedingly demanding and stressful. And so too can be the process of completing one’s medical school training and navigating internship and specialty residency, and subspecialty fellowship if one chooses that course.
Of course there are exceedingly high standards of professionalism that are expected of med students and PGYs (post graduate years after getting your MD). And professional decorum and ensuring patient safety and quality of care are of utmost importance. So too is being part of a healthcare team. And of course these are all things that one has to learn. In benchmark healthcare centers, a significant amount of attention is devoted to helping develop those skill and allowing leeway as one learns the art and science and business of healthcare.
However, the fact of the matter is that somewhere between 20-50% of med students and residents are going to experience anxiety, depression or burnout. A significant number may use alcohol or other substances excessively or inappropriately, some even using illicit substances (which, needless to say, is exceedingly risky to one’s career). Some others may respond suboptimally to prolonged stress and manifest behaviors that are problematic, like inappropriate anger or use of vulgar language in a patient care setting, or disrespect of an attending. But here's the thing. We’re all human, and med school and residency are like a boot camp few people have ever seen. We know that.
These missteps shouldn’t be career killers. This is, after all, a time of learning, adapting to a most stressful career choice and getting used to the rigors of the field (unrealistic at times though they are.)
Unfortunately, situations arise where one’s situational mental illness (such as depression or anxiety), one’s social life escape valve, or one’s ragged attitude run into an unforgiving system. And the current structures for medical educational and healthcare training institutions may, generally for appropriate cautionary reasons but sometimes not, insist that one be referred to a state medical board-affiliated physician health program (PHP) for some sort of assessment.
And this is where things can become very dangerously problematic, not to mention costly. They can in fact cause a prolonged interruption in one’s course of training and can even permanently derail one’s career.
As you will have seen from the remainder of CPR’s site, we’re all about helping physicians protect their rights from undue harm. We’ve studied the operational disciplinary and “impairment assessment and treatment” climate for over ten years. We know how harsh and non-forgiving it can be. And we’ve seen significant harms done leaving the physician and physician-in-training no recourse to justice.
We believe some of these approaches are deeply unfair. Some we believe are worse than unfair; they are predatory, abusive and corrupt.
And newer understanding as a result of our study of the Americans with Disabilities Act (ADA) and other federal laws leads us to believe that a significant number of these practices may be in serious violation of federal law
As we ourselves are physicians, we know well what goes into making a physician. We know the rigors of both the academic and clinical environments. We’re intimately familiar with the demanding healthcare environment. And at CPR, we have studied the dangerously broken administrative judicial system.
We came into existence specifically to make sure that physicians were able to get the help they needed in a respectful and fully confidential manner, and to get guidance and support should they find themselves in administrative proceedings in which their rights to fairness were thwarted and which had enormous career consequences.
CPR advocates for physicians to have access to confidential, respectful and independent professional assessment and, where indicated, treatment. We want to see physicians not only advance but thrive in their careers. We want to work toward an environment of collaboration around optimal patient care. And we want to ensure that there is a fair and transparent administrative and judicial process which adheres to all requirements of federal and state law, meets the needs of all stakeholders, and abides by all ethical guidelines pertaining to professionalism, not only of clinicians but also of the administrative entities which assess and regulate them.
Before CPR emerged, PGY residents and med students had utterly no guidance or support and no advocacy. There was no one to turn to. We are determined that we will be that resource. We will be the singular Voice that fights for the rights of medical students and physicians-in-training so that they can blossom into the caring clinicians and compassionate physicians they envisioned themselves to be and that we so urgently need.
We’re confident you agree with our vision and hope you will help us accomplish our mission.
Change often comes only after great resistance. And even then, it can be tenuous unless its implementation is rigorously enforced and regulatory organizations are held publicly accountable.
CPR will follow changes in each state as enacted by their legislature or identified by their state auditor or other enactor. By monitoring enacted changes, we intend to ensure that physicians’ rights are upheld.
To enable us to continue to guide and advocate for residents and med students, we need your help.
Please visit C P R's Fundraising Campaign below