Physician Interrupted

Sexual harassment is a very significant problem in healthcare. My guest is Animah Kosai, a lawyer by training who has extensive experience in organizational ethics and compliance.  Seeing the need to help individuals in organizations victimized by sexual harassment or punished for their whistleblowing, Animah was inspired to start Speak Up At Work to empower employees to understand the processes and develop the skills to come forward to uphold their rights and hold wrongdoers accountable. As former general counsel for a large multinational oil and gas firm, she also recognized the need that organizations themselves have to create healthy organizational cultures which are in fullest compliance with law and which foster  environments of respect and inclusion.

There was a  piece posted in the popular physician-oriented website KevinMD.com by an anonymous physician entitled "I’m sorry: Why I lost my love for medicine.” Understandably, it generated a significant amount of comments and shares. But, as is the way with so much on the web, it’s very easy to miss some really important essays. And I didn’t see it until someone shared it with me only a month ago on the heels of a discussion we’d had about burnout, one of my key areas of interest.  As I read it, I identified immediately. It conveyed the sense of being overwhelmed, bombarded, put in no-win situations, taking in so much demand and negativity and feeling demoralized, exhausted and seeing no way through, and the only option being “out.”  I read it out loud to myself, once, and then again, and again. In fact, it so deeply resonated that I got choked up as I read it. And since I have coached many physicians grappling with burnout, I felt that it might be helpful simply to do a dramatic reading as part of a podcast introducing the topic of burnout. Clearly, it’s one of the major reasons why physicians' careers get “interrupted.”  Roughly 50% of physicians today are grappling with some element of burnout. There’s a pervasive sense of dissatisfaction across all age ranges and specialties. Worse, because of the malignant ways medical boards invade physicians’ privacy and compel referral to a non-overseen “physician health program” enterprise from which there is abundant evidence of psychological abuse, physicians are inclined  to avoid seeking help and , should they pursue help, to attempt to conceal it from their peers, their employer and certainly from their medical board and PHP.  As a result, demoralized and burned out physicians are leaving the field, and encouraging others not to enter it. If they don’t get help with their burnout, it may deteriorate into an emotional illness like depression or, if depression or anxiety was already present, greatly intensify it. And untreated, whether for fear of stigma or  opportunistic and traumatic handling by one’s medical board, peer review / performance appraisal entity or the PHP,  the risks of disabling outcomes are greatly increased. And that is such an unfortunate loss.  I know this will be one of many visits to the topic of burnout. I welcome hearing your thoughts. (see: https://www.kevinmd.com/blog/2019/07/im-sorry-why-i-lost-my-love-for-medicine.html) 

In Part 2 of Questionable Drug Testing, host Dr. Kernan Manion continues an amazing conversation with Dr. Michael Langan, author of the blog DisruptedPhysician.com. Michael has intensively studied the PHP (physician health program) movement and its 47 state programs’ use of inappropriate alcohol biomarker drug testing in assessing physicians referred for the question of substance abuse-related occupational impairment. The EtG urine test as well as others routinely used by PHPs are known to produce false positive results. Use of these tests in such a forensic environment was strongly advised against by SAMHSA, the US Substance Abuse Mental Health Services Administration, specifically because such alcohol biomarker tests were KNOWN to have a very problematic incidence of false positivity. However, these test results are still routinely being used to mandate compliance with PHP’s incontestable diagnosis of definitive alcohol abuse and its  “recommendation” to the medical board (MLB) that the physician immediately cease practice and go to a PHP-network facility out-of-state at exorbitant cost under threat of loss of license and public humiliation.  These tests were never intended to answer the question of “occupational impairment” or even to establish a diagnosis of “substance dependence,” and yet PHPs portray as much to the MLB and to the rights-deprived physician and his/her counsel who naively accept this as established scientific proof.  The physician is deprived of any recourse to contest. As presented, there would be little doubt that such a knowingly wrongful process is equivalent to fraudulent diagnosis. The consequences for the wrongfully charged physician are dire.   (Due to the length of the original interview and its immense importance, the podcast was divided into two separate podcasts. This is Part 2.) If you’re a physician, physician’s counsel or simply interested in a deeper exploration of the specifics of the ill-advised use of such tests, the harms that may ensue and potential approaches to confronting this wrongdoing, be sure to visit [https://www.physicianrights.net/drugtestwebinar] to be notified of our upcoming free live webinar specifically devoted to more deeply understanding these harmful practices and what you can do to defend your rights. We’ll send you the Zoom webinar and Facebook Live logistics as soon as they're finalized.

Host Dr. Kernan Manion talks with Dr. Michael Langan, an internist / geriatrician formerly with Mass General Hospital and now a consultant, researcher and author of the blog DisruptedPhysician.com. Michael has intensively studied the PHP (physician health program) movement and its state programs’ use of highly questionable drug testing in assessing physicians referred for the presence of substance abuse related impairment. He reveals that one or more of the urine tests routinely used by PHPs are known to produce false positive results. Further, use of these tests in a forensic environment was strongly advised against by SAMHSA, the US Substance Abuse Mental Health Services Administration, specifically because such alcohol biomarker tests were known to have a very problematic incidence of false positivity (due to high sensitivity but low specificity). Worse, these test results were then being used to mandate compliance with PHP’s “recommendation” to the medical board (MLB) that the physician immediately cease practice and go to a PHP-network facility out-of-state at exorbitant cost under threat of loss of license and public humiliation.  And these tests were never designed as an assessment of “impairment” or “substance dependence,” and yet this is what the PHP is portraying to the MLB and to the rights-deprived physician and his/her counsel. Worse, once accused, due to a complete absence of due process, the physician is deprived of any recourse to contest. (Due to the length of the interview and its importance, the podcast was divided into two separate podcasts. This is Part 1.)  If you’re a physician, physician’s counsel or simply interested in a deeper exploration of the specifics of the ill-advised use of such tests, the harms that may ensue and potential approaches to confronting this wrongdoing, be sure to visit [https://www.physicianrights.net/drugtestwebinar] to be notified of our upcoming free live webinar specifically devoted to more deeply understanding these harmful practices and what you can do to defend your rights. We’ll send you the Zoom webinar and Facebook Live logistics as soon as they're finalized.

Excited to give you a heads up about an upcoming podcast on Physician Interrupted.  Confronting Questionable Drug Testing in PHPs.  Very pleased to have as my guest expert Dr. Michael Langan who’s extensively studied the use of highly suspect alcohol biomarkers in PHPs. What he reveals is that not only are there very serious questions about the appropriateness of these tests for PHP intake screening purposes, their false positive rate may be wrongfully sending physicians to costly in-network evaluation and treatment centers. Worse, it appears the PHPs and the medical boards know these tests are both known to produce false positives and their use has in fact repeatedly been strongly advised against by at least one federal health agency. Dr. Langan suggests that what we’re really looking at is a massive scheme of intentionally fraudulent diagnosis. This will be one you don’t want to miss.