Need for CPR

Many 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 multiple states. When they work in a hospital setting, they must also be credentialed to serve on that medical 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 an exclusively contracted 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, generally of the same clinical specialty.)

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 whose clinical performance is perceived to be suboptimal or who may be grappling with an impairing condition affecting their careers.

Abundant anecdotal evidence strongly suggests 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 pre-designated examiners, accompanied by 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 "preferred" 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 has been no valid concern documented about adverse impact on 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 counsel well versed in this unique regulatory system. From the outset, they are placed in an inherently disadvantaged position and their inordinately costly legal challenge is almost invariably futile.

Until now, there has been no specialized advocacy organization to educate the physician community, advise these physicians and their counsel, and raise awareness of the imminent perils they face.

Silent Epidemic

There is an emerging but hidden epidemic in American Medicine today, one that hardly anyone (including most physicians) is even aware of.

A significant number of caring and competent physicians are wrongfully being driven out of their careers by dishonest medical board investigations and unjust hearings; unwarranted and unethical fitness-for-duty evaluations; and intentionally biased and hostilely motivated peer review proceedings.

Throughout the country, thousands of physicians yearly find themselves suddenly thrust into what can quickly amount to a life threatening struggle for career preservation.

They’re caught in a powerful medical regulatory – compulsory treatment complex that too often operates with utterly no oversight, deprives them of due process and holds them guilty until they prove themselves innocent of allegations. An alarming number of these proceedings are initiated by anonymously submitted complaints.

The havoc wreaked is immense and costly. Nearly every physician ensnared in such proceedings describes it as a nightmare worse than any malpractice suit imaginable. Too often, these matters drag on for years almost invariably with unsatisfactory outcomes for the physicians charged who face nearly insurmountable odds in re-establishing their careers.

Beginning as a physician advocacy study group nearly a decade ago, we've been intensively studying physicians' stories. The patterns of abuse of physicians’ rights are disturbingly similar in states across the country. In fact, numerous articles in the medical literature (Medscape, British Medical Journal et al.) confirm this travesty. [see articles on our Resources page]

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

This is simply not right, and it cannot and must not 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 administrative medical regulatory environment, invariably “reinventing the wheel” in advocating for their client.

It was out of this need that CPR – The Center for Physician Rights emerged.

CPR is 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 and treatment, or peer review process and have been deprived of due process or other protected legal rights.

CPR aims to provide knowledge, guidance and support to physicians and their counsel. We hope to be the premiere organization aggressively pursuing necessary changes in the administrative legal arena toward restoring fairness and transparency, preventing abuse of power and, where indicated, promoting ethical and compassionate treatment and rehabilitation.

Kafkaesque Nightmare

An alarming, though not atypical, scenario:

A well liked cardiologist, Dr. J. became alarmed about multiple episodes of erroneous diagnosis and inappropriate care resulting in patient jeopardy which became apparent while covering her senior colleague’s practice both in clinic and while on call. As he was head of their well established group practice of which she was a recent member, he was also her boss. She as well as others in her group had had strained encounters with him but all felt fearful of retaliation if they challenged him.

Dr. J. reviewed these cases in depth with a trusted colleague who concurred with her clinical concerns and who encouraged her to speak with the Department Chair at the primary hospital where they operated. She conferred privately with him and he promised to discreetly look into it.

Due both to the stress of her work situation and family issues, Dr. J. had recently taken a brief medical leave during which she entered psychological counseling and had been prescribed an antidepressant. Upon return and to her alarm, she learned that her boss had informed the Department Chair, on the basis of a recent flurry of anonymously submitted staff reports critical of her performance that he had gathered, he felt that Dr. J. was posing a problem to staff cohesion and could be seen as a danger to patient safety.

Under threat of termination from her group, her boss ordered her to have a “fitness for duty” evaluation by the state Physician Health Program, a non-profit program to which both the hospital and her group contributed to yearly. Currently engaged in counseling and taking medication for depression, she both feared a confidentiality breach and sensed that such information could be used against her.

She declined to consent and her boss promptly removed her from the clinical schedule and suspended her hospital privileges and then reported this suspension to the state medical licensing board. The licensing board insisted under threat of license revocation that she submit to examination by the state’s Physician Health Program.

After a two hour interview by a clinical social worker at which she was also compelled without explanation to submit to a monitored-collection drug screen, the PHP would not divulge its report or conclusions to her, but wrote to her recommending that she attend a four day psychiatric evaluation out of state at a PHP-approved facility at an out-of-pocket cost of $5,000. When she refused, the PHP reported her refusal to the medical board which then suspended her medical license for non-compliance. Her medical license suspension was reported to the National Practitioner Data Bank making her virtually unemployable anywhere. She hired a professional license defense lawyer, a former board attorney, who matter-of-factly opined that she should have complied as the Board had the right to suspend her license.

While fictionalized, this scenario would be a Kafkaesque nightmare for any physician whose performance was alleged to be suboptimal or who was alleged to be impaired by mental illness. Dr. J. faces nearly insurmountable odds in re-establishing her career or in prevailing in any action against her boss, the healthcare organization employer, the PHP or the medical board.

Not only was it profoundly unjust, this cascade of events resulted in the loss of a highly trained clinician. Such scenarios are deeply traumatic to the harmed physician. Further, the impact on those patients in her practice who held her in high esteem and relied on her care is comparably traumatic. The combined abrupt interruption of ptients' care and the devastating career and psychological impact on the physician are jeopardies seldom even considered by these agencies.

Sadly, this story is representative of an emerging epidemic of wrongful and irreparably harmful behavior by medical licensing boards, so called physician health programs and healthcare organizational medical peer review committees. Many of these entities operate with no oversight and with complete impunity.

For the hundreds (if not thousands) of physicians facing such challenges yearly, until now , there has been no resource that offers knowledgeable guidance and support.

To learn more how you can help, please visit C P R's Campaign:

© Copyright April 12, 2022 by Center for Physician Rights, Inc.

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