What to know about what you don’t know you know. #1: Intuition is very efficient—if you don't overthink it.
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Dr. Boyd most aptly names the Physician Health Program (PHP) scam as extortion. Here we have an exclusively contracted entity financially supported in large part by the very medical licensing board (MLB) which sends it mandatory referrals to conduct career-altering psychological fitness-for-duty evaluations (FFDEs). In an apparent quid pro quo, the MLB reciprocally orders compliance without question with the PHP’s initial findings and its “recommendation” for out-of-state referral to one of their shared “preferred programs.” While conducting such weighty initial assessments, PHPs may not even be licensed to practice medicine in that state. And once their preliminary assessment is done, PHPs may refuse to give the physician evaluee their diagnostic report, or provide any means of grievance or even consider fully valid external professional evaluations which differ from their incontestable assessment.
This is all done in an environment devoid of any due process. For comment brevity, how this occurs must be addressed separately.
It is indeed extortion. But extortion of such a hideous nature as to be comparable to psychological torture. Extortion conveys the notion of covert robbery. “Give me this much money - directly or indirectly - and I’ll leave you alone.”
But this is not just a financial shakedown. It’s profoundly cruel and evil bullying. What Dr. Boyd does not convey in such a concise piece is that the extortion is often initiated using a false diagnosis that both the board and PHP refuse the physician to challenge. Not only may a false diagnosis be made and the evaluee humiliated publicly with their utmost confidential protected health information callously displayed, the physician may be forced into a sadistic treatment regimen that may not only be illegal but medically and psychologically harmful. If one has been falsely diagnosed with alcoholism, subjecting that person to degrading insults about their “denial” and exhortations to accept their powerlessness is hideously abusive. Clearly it should be considered psychiatric malpractice.
But perhaps the ultimate evil is that it is clear that many boards and PHPs along with their national trade groups and national medical associations such as AMA and APA know that these abuses are occurring and refuse to act. When any person is cornered into a state of anguish from which there is literally no escape, subjected to a cascade of abuses and then multi-institutional betrayal, the stage is set for profound and likely irreparable moral injury. New psychiatric illness will inevitably emerge.
Trapped in such extortion and humiliation and disbelief, faced with the impossibility of asserting one’s rights, and then marginalized from one’s job while living terrified of the prospect of losing one’s entire career and professional identity, this is the nightmare that thousands of physicians, most entirely naive to this pernicious evil, must endure every year. Is it any surprise that one’s incredulousness about their plight might lead to despair and even suicide?
CPR - The Center for Physician Rights is developing a variety of resources for physicians trapped in this Kafkaesque nightmare. We’re soon to release “Physicians’ Survival Guide For Dealing With Medical Boards, Physician Health Programs and Sham Peer Review.”
I too hope the day comes soon when frantic newly extorted physicians ensnared in this MLB-complicit RICO scam don’t need to seek out Dr. Boyd. But given that boards and PHPs have such a lucrative and powerful gig going, I doubt that phone’s going to stop ringing anytime soon. Rather, we may need to seek more physicians of Dr. Boyd’s caliber to conduct honest, ethical and compassionate FFDEs while collectively and courageously demanding accountability and independent oversight of PHPs.
Kernan Manion, MD
Executive Director, CPR – The Center for Physician Rights, Inc.
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