Tuesday, April 24, 2007

The History of the American Society of Addiction Medicine or ASAM

http://www.newcriminologist.co.uk/article.asp?aid=1132946770

The New Criminologist Published on 25 November 2005
Author PARKER, Janet Louise, D.V.M.,B.S.

The History of the American Society of Addiction Medicine or ASAM

By Dr. Janet Louise Parker

Why would 20 doctors, nurses and other health officials kill themselves after being treated by the American Society of Addiction Medicine program? The reason can be found in the history and philosophy of the ASAM (The American Society of Addiction Medicine). In spite of grave concerns regarding violations of confidentiality and informed consent and the proven coercion and abuse of patients, these boot camp like programs are forced on licensed medical professionals. The health professionals are threatened with expulsion from their professional employment and with not being certified which often means the loss of one’s professional career. The United States Public may not realize that Doctors are forced into mandated programs. There no longer needs to be proof of impairment, unsubstantiated claims or suspicions may be all that is needed to place an accused Doctor in the “program. Written charges of the accusations may not be provided to the accused Doctor. All that is needed for the Doctor to be involuntarily detained is the signature of one Psychiatrist. Isn't it illegal, or at best unethical to forcibly refer patients to yourself? But ASAM forcibly refers patients to its own treatment centers through Professional Medical Licensing Boards.

Consider the case of Dr. Leonard Masters who suffered false imprisonment and was held against his will for 4 months for an alcohol problem that was proven to be fabricated. He sued the Atlanta area mental hospital and won $1.3 million dollar judgment for malpractice, fraud, and false imprisonment. Whistleblowing doctors face real challenges and clear dangers when they come forward to provide information regarding criminal behavior which involves addiction treatment or mental health services. The backlash can be career ending or even life ending in the case of suicide.

Dr. G. Douglas Talbott is a physician who suffered from alcoholism and was the Medical Director of the Talbott Recovery Campus (TMRC) in Atlanta, Georgia. Dr. Talbott believes in confronting doctors, coercing and compelling them into treatment into his AA 12 step program. He set out to create a medical specialty society for addiction medicine and to change existing laws in order to coerce medical staff into treatment programs run by ASAM. Dr. Talbott was the previous President of ASAM from 1997-1999. He was in the forefront of the consolidation of various alcohol and drug treatment organizations into to the present American Society of Addiction Medicine (ASAM). In 1999 Talbott stepped down as president of ASAM, but only after a $1.3 million dollar judgment against him for his treatment of a patient, Dr. Leonard Masters, of Jacksonville Florida. Treatment by G. Douglas Talbott, MD, had been described by patients in court testimony, as being demeaning, coercive, and medically inappropriate.

In May, 1999, a jury awarded Dr. Leonard Masters the substantial judgment for malpractice, fraud, and false imprisonment, based on Masters' 1994 stay with Talbott at an Atlanta area mental hospital. Masters says they misdiagnosed him as an alcoholic and held him against his will for four months. Masters accused hospital officials of ordering him to undergo a four-day evaluation at Anchor in 1992 or lose his professional license following complaints that he was writing too many prescriptions for pain medication. An associate made an unfounded allegation. That evaluation turned into a four-month stay in which he was diagnosed as an alcoholic and forced into a treatment program, even though he tested negative for alcohol or narcotics. The former president of the ASAM, Dr. Anne Geller had to testify in court that Dr. Masters had been incorrectly diagnosed alcohol dependent. The panel ultimately found that Masters' diagnosis amounted to malpractice. The fraud claim was considered by the jury to be "intentional.”

But ASAM still kept G. Douglas Talbott as a member of ASAM's Board, even after that judgment. But to prevent any further successful lawsuits, ASAM made it a priority to change existing laws in all states, so that they could never be sued again. These new laws give them immunity for civil and criminal damages even in the case of a patient’s suicide while under treatment in one of their facilities. Thus granting them the power to “deputize” their agents and avoid the legal responsibility for their own actions. These laws prevent Doctors from bringing any legal action at the state level against the ASAM facilities or staff.

It is surprising that in spite of high levels of suicides from patients in the ASAM programs, United States medical licensing boards continue to order health care professionals into treatment with the ASAM. In one 4 year period at a Atlanta based facility run by Talbott, 5 health care professionals committed suicide. One doctor, Dr. Paul G. Cohen, who criticized Talbott’s programs found that Talbott retaliated by continually accusing him of drug or alcohol addiction. Dr. Cohen as a result of these false accusations, underwent at least five psychiatric evaluations and more than 30 drug tests, none of which revealed substance abuse. Further investigation showed that the allegations of drug abuse were totally unsubstantiated.

In spite of these abuses the ASAM seems to have suffered no professional repercussions. They have even published a volume, Principles of Addiction Medicine. In this book they outline their principles but never address ethical issues — such as violations of confidentiality and informed consent, and coercion and abuse of often highly vulnerable individuals.

Other patients of the ASAM program in Atlanta (TMRC) were required to give "first steps" in front of the entire client population. This involved humiliating the client in front of a room of strangers in order to force him/her to admit their “problem.” These sessions were even shared with staff from a visiting local university staff without the consent of the patient. These exercises involved very detailed and intimate accounts of the client's drug addiction. No releases for sharing of medical information were signed, a clear violation of patient privacy rights. If clients don’t admit to guilt they are told that they are in “Malignant Denial”. Treatment at the ASAM Atlanta program involved yelling at patients, pages of rules to follow, and punishments.

One TMRC patient who had a previous manic-depressive illness was prevented from having proper medication for his primary disorder and instead labeled as “Addictive Disease”. This emphasis meant that the entire “Master Treatment Plan” focused on Addiction and never addressed the bi-polar issue at all.

When the medical charts of the Dr. Talbott’s ASAM program were examined, it was found that 96% of those sent to Talbott Recovery Program in Atlanta would stay for OVER four months — some stayed two years — unless their insurance ran out. The treatment would last as long as the money was there to pay for it and the patient was not legally allowed to “opt out”. There was a lack of medical supervision of these lay addiction treatment team members. Doctors, the patients never met, signed off the medical charts. The ASAM staff made the primary diagnosis “Addiction” as that is the only specialty in which they could claim credentials. Therefore in order to bill for services rendered, a non attending Doctor with the right credentials in Psychiatry or Psychology, then signed off on the charts for billing purposes. This was a very lucrative fraudulent billing scheme.

The ASAM’s A Guideline for Credentialing and Privileging of Clinical Professionals for Care of Substance-Related Disorders: A Joint Statement of the American Society of Addiction Medicine and the American Managed Behavioral Healthcare Association allows persons without an MD degree to ascribe a “diagnosis to a patient” and then institute “treatment”. It states “Whether a non-physician can ascribe a 'diagnosis' to a patient he/she has assessed is determined by the professional practice acts of a given state of the union. “

Even after leaving the facility the Doctor’s patient rights would be violated. One physician patient indicated in court testimony that staff members contacted the _______ State Bar Association, to inform them that he had left the facility "AMA." (against medical advice). As you should know, such breaches of confidentiality are criminal in nature, punishable by substantial fines and even jail time.

State Licensing agencies in the United States state that participation is “voluntary” but threats of losing licenses amounts to intimidation. There is a coercive pressure, which is exerted through the licensing agencies, which mandate treatment at an ASAM facility. This effectively removes the patient’s absolute constitutional right to make his or her own choices regarding treatment or to refuse treatment. The ASAM seeks to remove from the patient their own right of autonomy and right to refuse treatment. This civil and human right is critical for any mental health patient.

Coercion plays a highly controversial role in the administration of mental health services including services for drug addiction or alcoholism. Involuntary commitment to mental hospitals -- and "voluntary" hospitalization to avoid imminent commitment may cause patients to be so alienated that they refuse to comply with treatment as soon as the coercion is lifted. Patients are also reluctant to seek voluntary treatment in the future for fear of being coerced again. Treatment outcomes produced by coercion may be very transitory.

Members of ASAM have no respect for patients’ point of view or alternative approaches to addiction or drinking problems. They are willing to rely on coercion and threats to get and keep patients in their program. If the targeted person doesn't own up, the addiction treatment team feels justified in applying, indeed obligated, to apply a range of coercive techniques, from peer group pressure, deception, entrapment, workplace bullying, social isolation and threat of removal of licensure. There is an assumption of guilt; the treatment system requires innocent people to prove that they are not guilty. Patients are forced into the 12-step precepts of confession and contrition.

The ASAM has been proactive to have state legislatures enact laws that will completely remove any liability, criminal or civil, for the actions of members or deputized agents of ASAM. This means that no further damages will be awarded to the widows of those who commit suicide after treatment by the ASAM addiction treatment team. In addition ASAM has placed into practice laws that prevent patients from refusing treatment by the ASAM and allow coercive and forced treatment even when there is no proof of impairment (only suspicion). A statement of suspicion, without substantial proof is enough to cause a doctor to be threatened with removal of their license. In addition the ASAM has fostered laws in each state that allow their affiliated agencies to use state funds to gain proof of impairment of the patient through investigative techniques. In 2000 ASAM lobbied for mandated placement of all Medicaid clients into ASAM programs in Oregon thus replacing publicly funded and operated programs with the privately owned ASAM Contract organizations. ASAM has worked for legislation in every state to limit civil and criminal liability, increase options for the use of force and coercion, and increase publicly paid service provisions for addiction treatment. This maximizes the profit to the ASAM Doctors but limits their liability. These laws extend immunity for liability to contracted program staff in the private sector.

Due to recently passed laws, patients have no right of refusal, and no legal right to bring civil or criminal suit against the ASAM for abusive or harmful treatment. Any medical patient who attempts to whistleblow on abusive practices or excessive billing practices will suffer threats against their license. Patients who had witnessed abusive treatment of others, are fearful of coming forward because they might loose their own medical license, or be forced to stay longer in treatment as punishment for reporting.

Psychiatric care permits the doctor to act against the patient’s own wishes, even drugging them if the doctor dictates. Physical restraints, isolations and withholding contact with family members and friends, refusal to call a lawyer, involvement of employer and co-workers as spies, can force the patient into submission. As patients have no right to sign themselves out of treatment, they are kept often until the insurance runs out or until the time limit allowed for care has been exceeded. This marriage of privately owned profit making enterprises with state sanctioned immunity from civil and criminal prosecution makes this system perfect for medical fraud and illegal billing practices. Couple that with the power and authority of the medical licensing boards and the ability to use state funds for entrapping investigative practices. This coercive program can violate the most basic civil and human rights and removes freedom of choice from its patients especially in light of mandated treatment of Medicaid patients or licensed medical professionals.

In addition to the ASAM’s efforts to be the mandated provider of addiction treatment services for all Medicaid patients and all medical health professionals, ASAM had lobbied for increased monies from State and Federal sources for payment for extended treatment stays. The ability to obtain payment from governmental programs is often a matter of knowing how to fill out the paperwork to optimize the money available for payment for services. Ordinarily having increased money available would increase appropriate care but not when the patient is forced involuntarily into treatment and kept with coercive and intimidating psychiatric methods. Dr. Leonard Masters, of Jacksonville Florida was kept for 4 months against his will and treated for an addiction that he did not have. This is a highly effective program which can be used to silence a medical whistleblower.

Physicians already fear being targeted by fellow doctors through the process of Bad Faith Peer Review. The American Association of Physicians and Surgeons (4,000 members) says that the peer review panel consists mainly of physicians and the system is open to manipulation and needs reform. When allegations of poor care or other serious complaints against a doctor are decided in secret, fair due process is often denied to the accused Doctor.

False Allegations of drug abuse or alcohol abuse are easy to fabricate and the Mandated Impaired Provider Treatment by ASAM easily manipulated. Dr. G Douglas Talbott has devised a protocol for labeling a person as addicted, based on behavioral signs, even without any positive drug or alcohol testing. ASAM has pushed through legislation in many states to allow just a suspicion based on these behavioral signs to allow coercive measures to be used against medical professionals “suspected of impairment.”

The Semmelweis Society, whose members are mostly doctors who have been victims of "malicious peer review," say that the Peer Review process is used to damage competitors or punish whistle-blowers. The use of forced hostile psychiatric evaluations can silence medical whistleblowers. Atlanta, Georgia is where ASAM and Dr. G. Douglas Talbott had their addiction treatment center and is now the site of one of the largest medical corruption cases in years (Grady Hospital in Atlanta). Hostile psychiatric examinations were used to intimidate witnesses in that case.

Dr. Robert Lifton labeled this extraordinarily high degree of social control characteristic of organizations that operate reform programs as their totalistic quality (Lifton 1961). This concept refers to the mobilization of the entirety of the person's social, and often physical, environment in support of the manipulative effort. This can be called brainwashing and is often used in cults.

Considering this drug addiction treatment philosophy, it is concerning that licensed medical providers (Doctors, Nurses, Dentists, Chiropractors, Pharmacists, Veterinarians) in most states face ASAM mandated professional providers. Doctors are kept silent about the fraudulent billing practices because of concerns for their professional careers. To what extent Doctors who might know about medical fraud or criminal behavior, are intimidated by threats from a mandated professional provider system will never be fully known. Silence is the unspoken rule.

Many doctors who have been exposed to the ASAM 12-step program will recognize these techniques of coercion/persuasion. One has to question the use of these coercive methods in conjunction with state sanctioned immunity for civil and criminal liability for any harm done to the patient. Historically there have been many instances of outright mistreatment in drug treatment and mental health facilities. There is also a pattern of using Bad Faith Peer Review, Forced Involuntary Hostile Psychiatric Evaluations and of False Allegations on Whistleblowing doctors. If patients are denied their own rights and the ethical doctors are prevented from whistleblowing through threats and intimidation, the system is ripe for fraudulent billing practices. In light of this knowledge it is particularly concerning that American doctors in Washington State face a Washington Physicians Health Program that has state sanctioned civil and criminal immunity for harm done to patients in their programs. Under such a system how can a Doctor be a whistleblower on abusive practices, corruption or fraud.

Dr. Lifton always maintained that such coercion used by these drug treatment programs could only influence short-term behavior, not permanently change long term behavior, beliefs or personality. .Dr. Lifton identified eight themes or properties of reform environments that contribute to their totalistic quality:
Control of communication
Emotional and behavioral manipulation
Demands for absolute conformity to behavior prescriptions derived from the ideology
Obsessive demands for confession
Agreement that the ideology is faultless
Manipulation of language in which cliches substitute for analytic thought
Reinterpretation of human experience and emotion in terms of doctrine
Classification of those not sharing the ideology as inferior and not worthy of respect
Robert J. Lifton, Thought Reform and the Psychology of Totalism (1961), ISBN 0807842532 pp. 419-437, 1987

In the USA (Washington State), these two laws passed by the Washington State House and Washington State Senate that changed the legal aspects of the ASAM program (Washington Physicians Health Program)

Washington State HOUSE BILL REPORT HB 1618 As Reported By House Committee On: Health Care, Title: An act relating to treatment programs for impaired physicians. Brief Description: Modifying certain aspects of programs that treat impaired physicians.

The "impaired physician program" is changed in several respects. Regulated health professions may contract with the Medical Quality Assurance Commission for providing services to other impaired health practitioners.

The requirement that the physician be verified as impaired before the commission can intervene is expanded to provide the commission with the ability to intervene when a non-compliant or non-cooperative physician is suspected of impairment.

Immunity from civil and criminal liability is provided for commission members and staff under the "impaired physician program" and extended to program staff for information submitted to the disciplinary authorities.

Testimony For: The authority of the impaired physician program needs to be updated to reflect current usage and terminology. Immunity from legal liability needs to be clarified and extended to program staff.

Testimony Against: Immunity from liability should not be extended to contracted program staff in the private sector.

Testified: Representative Skinner, prime sponsor; Lynn Hankes and Andy Dolan, Washington State Medical Association (pro); and Ron Weaver, Department of Health (con).


Washington State SENATE BILL REPORT SB 6545, As Reported By Senate Committee On: Health & Long-Term Care, February 6, 1998 Title: An act relating to treatment programs for impaired physicians. Testified: Lynn Hankes, M.D., WA Physician Health Program (pro).

“The impaired physician's program includes extension of immunity to the entity that runs the impaired physician's program……… The scope of the impaired physician's program is broadened to include treatment and assessment of reports of suspected impairment…. The impaired physician program is given authority to select treatment programs for its patients.”


Note:
California Society of Addiction Medicine is the California branch of ASAM
Washington Physicians Health Program is actually a renamed version of WASAM (Washington Association of Addiction Medicine) and is a branch of ASAM http://wsam.org/


References:
Stanton Peele “A Prototypical Case of Alcoholism Treatment and Coercion: G. Douglas Talbott “http://www.morerevealed.com/books/resist/r_chap_6.htm
In the Belly of the American Society of Addiction Medicine Beast http://www.peele.net/debate/talbott.html Threats and Indoctrination at Talbott Recovery Campus Reactions to the ASAM/Talbott Trial http://www.peele.net/debate/talbott.reactions.html

ASAM Takes No Action as Founder, Past President, and Board Member Held Liable for Fraud and Malpractice http://www.peele.net/debate/asam.html

Dave Williams, “Doctor wins his lawsuit; Says hospital misdiagnosed him” The Florida Times-Union (Jacksonville, FL) May 25, 1999 Tuesday, City Edition METRO; Pg. B-3 http://www.schaler.net/talbott.html

Dr. Salvo, “The Harbinger consists of area faculty, staff and students, and members of the Mobile community.” The Harbinger, Mobile Alabama, The Harbinger is a non-profit education foundation http://www.theharbinger.org/salvo/950221.html
http://www.theharbinger.org/salvo/950307.html
http://www.morerevealed.com/books/resist/r_appx_a.htm
http://www.napil.com/PersonalInjuryCaseLawDetail23981.htm

Joe Sharkey, Bedlam: Greed, Profiteering, and Fraud in a Mental Health System Gone Crazy , St Martins Pr; 1st edition (April, 1994) ISBN: 0312104219 In 1993 a FBI investigation revealed $1.74 billion Medicare- and Medicaid fraud by 86 Psychiatric hospitals in Texas (National Medical Enterprises and others). Some hospitals used questionable or totally unethical marketing practices, going so far as to offer bounties of up to $1500 for referrals.

Dean Anason, “IN DEPTH: HEALTH-CARE QUARTERLY” November 8, 1996 print edition Biz Journals
Anchor and Talbott-Marsh treat addicted professionals
http://www.bizjournals.com/atlanta/stories/1996/11/11/focus5.html
https://www.talbottcampus.com/indexnew.htm

ASAM’s A Guideline for Credentialing and Privileging of Clinical Professionals for Care of Substance-Related Disorders: A Joint Statement of the American Society of Addiction Medicine and the American Managed Behavioral Healthcare Association http://www.asam.org/ppc/Credentialing.htm


On Coercion, Attitude Change and Mental Health Services
Richard J. Ofshe, Ph.D. “Coercive Persuasion and Attitude Change” Encyclopedia of Sociology Volume 1, Macmillan Publishing Company, New York http://www.rickross.com/reference/brainwashing/brainwashing8.html

THE MacARTHUR COERCION STUDY, May 2004 John Monahan, School of Law, University of Virginia, 580 Massie Road, Charlottesville, Virginia 22903-1789 (e-mail: jmonahan@virginia.edu).

Bennett, N., Lidz, C., Monahan, J., Mulvey, E., Hoge, K., Roth, L. and Gardner, W. (1993). Inclusion, motivation, and good faith: The morality of coercion in mental hospital admission. Behavioral Sciences and the Law, 11, 295-306.

Dennis, D., and Monahan, J. (Eds.). (1996). Coercion and Aggressive Community Treatment: A New Frontier in Mental Health Law. New York: Plenum Publishing Corporation.

Hoge, S., Lidz, C., Mulvey, E., Roth, L., Bennett, N., Siminoff, L., Arnold, R., Monahan, J. (1993). Patient, family, and staff perceptions of coercion in mental hospital admission: An exploratory study. Behavioral Sciences and the Law 20, 281-293.

Hoge, S., Lidz, C., Eisenberg, M., Gardner, W., Monahan, J., Mulvey, E., Roth, L., and Bennett, N. (1997). Perceptions of coercion in the admission of voluntary and involuntary psychiatric patients. International Journal of Law and Psychiatry, 20, 167-181.

Lidz, C. (1998). Coercion in psychiatric care: What have we learned from research? Journal of the American Academy of Psychiatry and the Law, 26, 631-637.

Lidz, C., Mulvey, E., Arnold, R., Bennett, N., and Kirsch, B. (1993). Coercive interactions in a psychiatric emergency room. Behavioral Sciences and the Law, 11, 269-280.

Lidz, C., Hoge, S., Gardner, W., Bennett, N., Monahan, J., Mulvey, E., and Roth, L. (1995). Perceived coercion in mental hospital admission: Pressures and process. Archives of General Psychiatry, 52, 1034-1039.

Lidz, C., Mulvey, E., Hoge, S., Kirsch, B., Monahan, J., Eisenberg, M., Gardner, W., and Roth. (1998). Factual sources of mental patients' perceptions of coercion in the hospital admission process. American Journal of Psychiatry, 155, 1254-60.

Lidz, C., Mulvey, E., Hoge, S., Kirsch, B., Monahan, J., Bennett, N., Eisenberg, M., Gardner, W., and Roth, L. (1997). The validity of mental patients' accounts of coercion-related behaviors in the hospital admission process. Law and Human Behavior, 21, 361-376.

Lidz, C., Mulvey, E., Hoge, S., Kirsch, B., Monahan, J., Bennett, N., Eisenberg, M., Gardner, W., and Roth, L. (2000). Sources of coercive behaviors in psychiatric admissions. Acta Psychiatrica Scandinavica, 101, 73-79.

Monahan, J., Hoge, S., Lidz, C., Roth, L., Bennett, N., Gardner, W., and Mulvey, E. (1995). Coercion and commitment: Understanding involuntary mental hospital admission. International Journal of Law and Psychiatry, 18, 249-263.

Monahan, J., Hoge, S., Lidz, C., Eisenberg, M., Bennett, N., Gardner, W., Mulvey, E. & Roth, L. (1996). Coercion to inpatient treatment: Initial results and implications for assertive treatment in the community. In D. Dennis and J. Monahan (Eds.), Coercion and Aggressive Community Treatment: A New Frontier in Mental Health Law. New York: Plenum Publishing Corporation (pp. 13-28).

Monahan, J., Lidz, C., Hoge, S., Mulvey, E., Eisenberg, M., Roth, L., Gardner, W., & Bennett, N. (1999). Coercion in the provision of mental health services: The MacArthur studies. In J.Morrissey, and J. Monahan (Eds), Research in Community and Mental Health, Vol. 10: Coercion in Mental Health Services -- International Perspectives. Stamford, Connecticut: JAI Press (pp. 13-30).

For criticism of Alcoholics Anonymous and its 12 step program see the following website:
http://www.orange-papers.org/

For additional information on Robert Jay Lifton

Robert J. Lifton, Thought Reform and the Psychology of Totalism (1961), Robert Jay Lifton is a Visiting Professor of Psychiatry at Harvard Medical School. And over his long career, he's studied the New Global Terrorism, the aftermath of the Hiroshima bomb, Nazi doctors, and the Aum Shinrikyo cult that released poison gas in the Tokyo subway. He is, one of the world's foremost experts on the disturbing violence of our times. ISBN 0807842532 pp. 419-437, 1987

Cult Formation Lifton outlines the eight psychological themes that distinguishes a cult from a mere political, religious, or social grouping. http://www.csj.org/studyindex/studycult/study_lifton2.htm

Evil, the Self, and Survival: A Conversation with Robert Jay Lifton, M.D.In this "Conversation with History" from the Institute of International Studies, UC Berkeley, Robert J. Lifton explains his intellectual journey from his childhood home of Brooklyn to his groundbreaking studies in the scientific field of psychohistory. Discussion themes vary from death and the continuity of life; psychic numbing; the survivor motif; the socialization to evil; doubling; and terrorism, as these concepts interact and explain the more devastating events of the 20th century. http://globetrotter.berkeley.edu/people/Lifton/lifton-con0.html

For additional information on The Grady Hospital Corruption Case, Atlanta, Georgia
http://www.newcriminologist.co.uk/grady.asp?aid=-1245300027

Summary of corruption unearthed by the New Criminologist and the Atlanta whistleblower team.Published on 15 September 2005 Author/Source: TNC Staff reporter Atlanta
#HCA, inc. Facing massive liability associated with Medicaid fraudJune 30, 2005 Author/Source: Grady Coalition

Atlanta Corruption: New Whistleblower Emerges with Damning EvidenceApril 24, 2005 Author/Source: Christopher Berry-Dee

8 comments:

Anonymous said...

A very detail article on the impairment problems of Health Care providers. You should review this web site for what you have described in your Blog. www.drpatherrera.com

It would be helpful if you had an
E Mail address for additional information on this subject

technocat said...

I survived a coercion into Talbott-Marsh by the Tennessee Board of Pharmacy from December 1997 to May 1998 (and that was just in-patient).

I finally broke away that summer after I was convinced I could do so cleanly. I never returned to pharmacy.

I would like to know if I have a law suit here.

Anonymous said...

Im having problems as a physician and need help for being falsely accused. Where do I go to defend myself? Www.rubanodmd.com

MedicalWhistleblower said...

It is very difficult to counteract false accusations against a doctor's medical license or professional character. Because of the ability of anyone - and I mean anyone - to report anonymously under the Health Care Quality Improvement Act, unscrupulous lawyers have found a perfect way to intimidate doctors who might be inclined to report medical fraud, medical abuse and neglect or even criminal money laundering. Most doctors, dentists, pharmacists, nurses, and other professionals shut up if they find their medical license in serious jeopardy. Medical Whistleblower has presented this problem of proper due process for medical professionals to the United Nations in the UPR report

http://lib.ohchr.org/HRBodies/UPR/Documents/session9/US/JS14_JointSubmission14.pdf

and Medical Whistleblower also spoke to President Obama and the Supreme Court Justice - Chief Justice John Roberts about the HCQIA protections for anonymous accusations. Unfortunately the US government does not see the need to protect the innocent doctor from criminal intimidation or false accusations to be as important as protection what they view as consumer rights to report problem doctors. But the reality is that real consumers do not know how to even make a complaint through that legal process. So the only people who know how to effectively use the complaint process are lawyers. Lawyers representing large hospital corporations, large medical associations, or pharmaceutical companies always know how to intimidate doctors with accusations against a doctor's license. Fighting false accusations can be professionally damaging, time consuming, emotionally stressful and often futile as the damage is already done when a cloud of doubt covers your professional reputation. Thus many doctors just don't try to fight such a unfair battle and instead give in to the pressure and intimidation. getting an employment law or health law attorney to do the battle for you is expensive and often they will try to settle out of court. This means negotiating a mediated settlement with the accuser - something very distasteful if the accusations are patently untrue. It might be possible, depending on who the accuser is, to get help from your professional association - such as the AMA or American Dental Association etc. But often these organizations are very much influenced by the big money corporations and malpractice insurance companies and thus not independent or unbiased. You can look for a civil attorney who specializes in constitutional law and mount a legal challenge under some constitutional protection - this of course requires money for legal fees and possibly court costs.

Anonymous said...

Thank you for your help Medical Whistleblower. I really appreciate the time you took in posting. It is very helpful. I hired a health care lawyer and am going to trial. It is costing me a lot of money that I am struggling to come up with... but my attorney is allowing me to make payments thankfully. I am still very worried about the outcome. There is no guarantees because I was told that the judge holds high regard for the department of health and prn no matter what they say. I have to prove I am innocent here even though there is no proof that I am "impaired". My income source has been cut by suspending my license based on false allegations. I have a tough road to fight and am now preparing for trial by trying to get as many experts as possible. I have lupus and am prescribed pain medication accordingly. I am falsely being accused of being an addict. It is hard to fight this because the use of pain medication chronically is frowned upon by many --- including PRN. I need witnesses to testify against PRN and their coercive practices. I have multiple doctors, forensic psychiatrists and psychologists, etc. that will be my experts to testify that I an not impaired and take my medications accordingly. However, I need more than just that that. I need to discredit PRN and DOH and show that they are making an example out of me in the fight against pain medication. If anyone can help in my defense, that would be greatly appreciated. My email is curlyq679@aol.com. www.rubanodmd.com Thanks and God Bless -- Miriam Rubano

Doctor Joey, MD/PhD said...

Dr. Parker and Friends: I am a psychiatrist certified in five of our six subspecialty Boars. I always had severe headaches and anxiety as a kid. My doc was perhaps a little too sympathetic a tines but he knew his patient, I could charm extra scripts from of U's Med Director because I was once of the star reporters and they needed good PR. (Actually, for it's time— 1972-1980), it was a good place. Jnior year while pulling either a two or three al-nightersand modulating the Dexedrine with Valium PRN, I was in that netherworld that happens to such patients. Dr. Mary Ryan Miles, probably the First Disciple outside of GA of Dr. Tallbott, decide I needed to be admitted to a Rehab Unit. What I needed was (ca. 1975) a 20-mg IM injection of Valium, full work up because that's what WE do, and probably some more Valium the next morning. Dr. Ryan-Miles, a ""recovering drug addict" who allegedly took 30 x 100mg Nembutal caps during the peak of her addiction (and that's doubtful given that barbiturates have a ceiling beyond which the user cannot go or probably will die.') She had to pack for hder early plane to the Islands and, undoubtedly because of a consent form signed somewhere along the line, caked the Sheriff to transport me to the county hospital's Pysch ER. I was very unhappy when my sister (a veteran trial attorney) had her Pa look into it and we learned the Statute of Limitations had come and gone, "Too bad,: said sited. "Unlawful Imprisonment is Kidnapping and that's been a Federal Crime forever. Like to see how tough that bitch against the Fibbies and Dept. of Justice". Not too much was known about affluent kids scamming scripts for docs in suburbia.I recovered WITHOUT AA, NA or even the talents of the late Drs. Talbott and Ryan-Miles.How many college kids did they sell this steaming cock of sugar (?) to. I went to meetings and I was well read enough to notice too many similarities to the Third Reich to suit me (and I'm a Catholic ). There was no questioning of doctrine. If you screw u, you brought it upon yourself by not following guidelines in various "for sale" publications that make the ABA Canons of Ethics for Attorney seem light reading. We DO have some laws in place. Sister Anne, who know works for a white-shoe, deep-pockets law firm (the kind that can outspend any local DA's office and sometimes the US Attorney General's office in preparing a case. (She deserves it. She spent 10 years as an Asst. DA and out away a lot of rapists, pedophiles, child pornographers, etc. She rewrote her contract permitting NOT to have any part of the defense of accused child molesters, pedophiles.
I just had a thought. While visiting said sister I noticed a few times that she had about a dozen directories listing attorneys by area of specialization AND expert witnesses for all occasions. They remind me of all the free junk we get as docs. I'll look into this and hit you back ASAP. One of my med school classmates got in this same "scenario of trouble" about 10 years ago. Fortunately, a high-priced, experience Defense Attorney with all the resources of a super-powered law firm to assist her, he beat the bogus charge. Even subtracting fees the firm would have charged for their attorneys' prof services, the fees and expenses were something like $5K - Dr J -02/15/13

Doctor Joey, MD/PhD said...

Dear Dr. P - I'm impressed with your scholarship. I have an MD and a PhD and everyone assumes the PhD is an Psychopharmacology or any of ten other wrong choices.My PhD is in English and American Literature, believe it or not. You write extremely well.

I recoverED without AA/NA, thank God (and I can believe in Him without anyone's help or reminders.) Today, as a practicing psychiatrist (Boarded in all sub-specialities except Geriatric Psych), I realize my college-age comparison to the propaganda arm of the Nazi Party was spot on. I had just graduated from medical school; in NYS, we can get our own licenses and DEA Reg Nos. after the completion of the first year of a residency; I stayed fir what seemed to be 10 years per Residency.) I had taken and passed our licensing boards and simply was waiting for my license to arrive.

At that meeting, I heard a local FP excoriate a young woman whom today would probably be diagnosed with a Bipolar I Disorder. Why did she go to a psychiatrist when the answers are all in the Big Book and the 12 and 12. (I knew that shrink's rep and it was impressive; even was his pt. briefly).

The young woman stated, through tears, that her experienced shrink had written for Triavil and she was beginning to sleep again. (Triavil is a comb of Trilfon - pherphenazine, a phenothiazine antipsychotic drug (not used much now) and Elavil - amitriptyline, one of the first tricyclic antidepressants that is used to treat Depressive Episodes, chronic headache syndromes. etc. Also marketed as Endep, amitriptyline a good, safe drug is now widely prescribed generically.)

He directed her IMMEDATELY to stop taking the Triavil, talking to her sponsor and go to more meetings, perform service for others, etc. At that point I interrupted and disrupted the anonymity of the meeting. I told Dr. Gerry that he was flagrantly guilty of a number of administrative regs and even possibly the Penal Code. I then told him I now was a fully-licensed MD who certainly has standing to make a complaint.

"But it's an anonymous program; you can't tell." Find me the statute that makes this privileged. Don't look to hard because it's not there, And there are 20 witnesses sitting right here. "But were Alcoholics ANONYMOUS; we don't have to testify." I told him to remember to mention that to the judge who will hold him in Contempt if he refuses to respond to subpoenas or refuses to answer questions."

I didn't have the psychotherapeutic skills that I do today. Thirty years is a long time to be learning, but that's what we physicians - medical or veterinary - do. Instead, I drove her right to her shrink's office. He asked his next patient to chill - this was an emergency. I turned to leave and she said she wanted me there to prove she was telling the truth. I only had to stay about 10 minutes and she was convinced Dr. C. believed us.

I couldn't make this stuff up if I had a PhD, a D.Litt and a string of best-sellers behind we….and that's why ASAM HAS TO BE STOPPED.

I'm gay, btw. WE have (hope I got the name correctly), the Lambda Legal Defense Fund to provide legal services to gay men and woman caught in much the same situations. I never needed its services, but I've sent them a check every years since Jesus was born. That's what we need to do — stop assuming that we're all helpless victims of this almost incomprehensible legal maze and put together a "Dream Team" specifically to make NEW CASE LAW (law that actually is made at trial.) We can find competent attorneys who hopefully will volunteer their services as there LLDF did, but this would be like prescribing 200mg of Thorazine IM q6h for nausea secondary to Migraine. It would leave an impression!

Anonymous said...

ASAM was an attempt by a group of physicians to legitimize the approach used by people such as Douglas Talbott. It was a very clever ploy to use "denial" as a tool to convince physicians and medical boards that the more any given individual denied a problem, the more that suggested he had one.

I was involved with said physician over 30 years ago. Treatment consisted of group therapy and 12 step meetings. Obviously there were physicians who truly were addicted. For them, the real therapy was time. It probably didn't matter if the "therapy" was group therapy or basket weaving, for it was obvious that forced time away from drugs and having to cope with life during that time was the real benefit.

All the addicted physicians saw Dr. Talbot as a God. He was a fantastic lecturer, creating within the audience a profound emotional and mesmerizing atmosphere. My parents came up to visit with me and they had a private conversation with the good doctor. Neither of my parents went to college. My father owned a small hardware store in Brooklyn. Both of them, after coming back from meeting with him, told me, “this guy is a crook.” But I had no choice. I still laugh when I wonder, “Did he believe his own bull or did he know hee was a con artist?”

The treatment center was dysfunctional but nobody seemed to care. I remember one of the female patients sleeping around, and then marrying Talbott's son. She immediately got on staff.

My opinion is that addiction is a neurochemical disease and the vast majority of addicts are self-medicating and running from emotional pain. That aspect is never fully emphasized. You are going to have to live with it! Instead, one goes to AA meetings and hears how life is so great now that they follow the 12 steps. It really becomes a cult. The fact is that the true addict will never feel okay. True life will be better off drugs but there will always be emotional pain. The false sense of hope that treatment centers such as the one in question, coupled with 12 step programs is merely a ploy for people to have their wallets biopsied.