The Looming Fraud Case Against PHPs and Medical Boards

lab fraud $$

I wrote this essay in response to Michael Langan’s piece (reblogged on this site) on the crucial importance of diagnostic accuracy (6/5/2015)

Very pleased to see Michael’s explanation of diagnostic accuracy, especially in his coverage of the dangers of false positives.

While he covered it elsewhere in his blog, it bears highlighting that while a “false positive” in clinical medicine can lead to more refined testing before one begins on a costly treatment regimen, a “false positive” in forensic medicine can lead not only to loss of one’s right to practice but in fact to one’s very freedom. And, since the very test that is yielding the false positive is explicitly known to produce such, the likelihood that more people are going to be falsely deprived of their civil rights and their fundamental liberty is concomitantly higher. PHPs and Medical Boards know this and have been complicit with this scam.

This would be bad enough even if considered alone. But in the white collar licensed professions like medicine, the use of such a test occurs in a setting where the deprivation of the protections afforded by due process is routine. In other words, if the test comes back positive – even though it’s a false positive – you’re guilty until proven innocent. And you’ve got to spend a fortune to prove your innocence while you’re removed from your practice, deprived of making a living, and coerced into a “preferred program” for extended treatment and 5 years of “monitoring” – ironically using the very same test that falsely established your diagnosis! And it will take years to extract yourself from such a bureaucratic entanglement. One thing is certain – you will not come out of this mauling intact. You will be like the increasing numbers of unfortunates who have been set up by a deeply broken judicial system, framed on false evidence, and sent to prison.

Astoundingly, some Physician Health Programs (PHPs and PHSs and congeners) are using an alcohol usage screening test (the EtG amongst others) that they got approved as a LDT – a laboratory developed test (see elsewhere on his blog). That LDT bypassed the FDA process which requires rigorous testing to establish its sensitivity and specificity, in other words to prevent a test from being introduced into the market which yields too many false positives.

But here’s the more amazing thing – SAMHSA, the Substance Abuse and Mental Health Services Administration (a division, I believe, of DHHS), actually issued two explicit alerts in both 2006 and 2012 specifically advising against these tests’ usage in the forensic environment. The PHP enterprise is explicitly a forensic enterprise as, by definition of their role, they are conducting “fitness-for-duty” forensic diagnostic psychiatric evaluations on behalf of a professional (here, the medical) licensing board.

Stop Fraudulent Lab Testing!

Stop Fraudulent Lab Testing!

The conclusions are obvious. PHPs are knowingly using tests which produce false positives to incriminate physicians and compel them to enter into their “preferred network” of costly evaluation and lengthy 3 month treatment programs. Ad they are under state protection in doing so. And the medical licensing boards with which they are affiliated are fully complicit in this crime.

I am convinced this will turn out to be a scandal equivalent in magnitude to the Annie Dookhan falsified evidence case and the forensic fraud committed by the FBI’s hair and fiber analysis forensic lab (uncovered by FBI whistleblower Fred Whitehurst) and the compounding pharmacy contamination scandal.

Do you realize how many physicians (and many other medical professionals’) careers have been sabotaged by this fraud? Do you realize how many other professionals are soon going to be subjected to similar “professionals health / employee assistance” programs testing abuses? And then marched into their licensing boards for a kangaroo court? If physicians and other professionals don’t wake up and demand accountability, especially given the worsening prognosis for being provided due process in responding to such contrived findings, it’s going to be too late. Their careers, as unbelievable as it may seem, will be wiped out.

In a separate essay, I’ll write about the perverse incentives that keep such a system embedded. For now: it feeds the legal “professional license defense” industry; it makes it look like the medical licensing board and their legal department and investigators are “protecting the public;” it let’s PHPs keep their lucrative referral pipeline of falsely diagnosed docs flowing to their “preferred programs,” all of which are FSPHP members; and it creates an exceedingly fine profit potential for the drug testing labs, a select number of which the member PHPs also have “preferred relationships” with. (Some treatment programs actually own their own labs!).

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8 thoughts on “The Looming Fraud Case Against PHPs and Medical Boards

  1. Christian Wolff

    I would prefer to be thought of a skeptical. Skepticism is a foundation of science and reason. Doubting that science and reason are alive and well, I went to check. Sure enough they do seem do be alive and well. Then again, so seem the chickens and goats I keep in my backyard. So are seem the goldfish and mice my son uses to feed his snakes. Not all such animal are kept well. Perhaps it is humane that the controlling figures (my son and I) keep these critters ignorant of their fate. We’ve erected walls between them and the place where we have slaughtered their fellows so that they may be more relaxed and passive.
    Many things can be taken from Orwell’s Animal Farm, but one is that when the smarter of the animals caught on to what the farmer was doing, they took action and headed up a revolt. Yes, there are in fact things which are not always visible. Some cannot see the good. Some cannot see dangers which lie ahead or the bad which is occurring over the wall in their neighbors’ fields. In deciding whether it would be worth our while to do an over-the wall check, if one is familiar with it, one might consider Pascal’s Wager.
    My son and I have opted out of being forthright with our food-creatures. Were we to have opted otherwise, we would have “said” to them, “We love you. We find you interesting and you give us something to do. We are hungry though, and we will eat you or sell you. We are farmers, and this is what farmers do. We feed you and give you a place to live because you serve a purpose. Our purpose.” Yes, the “farmers” may “care.” They may be seen as good people by the town folk. But they are farmers. They exist. They do what they do and they sleep well at night.
    I apologize if this seems aggressive. I do not mean to knock your positive attitude, AddictionMyth. I love positive attitudes. My own attitude is more hopeful knowing we have senates on the wall such as Drs. Manion and Langdon.

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  2. Pingback: Do you have faith in forensic diagnostic psychiatric evaluations? | Chaos Theory and Pharmacology

  3. Christian Wolff

    Dear Dr. Manion,
    You have written a wonderful “take-away” from Dr. Langdon’s article on Diagnostics 101. I wish that your articles were written simply as pieces of matter-of-course general education for the public. Both articles were written on levels which an averagely intelligent person could understand. For specialized scientists in all fields, the systematic reasoning (and empiricism) you each address should be recognized as nearly going-without-saying. You and Dr. Langdon describe the very foundation of science & reason without which the entire structure which rests upon it (as in healthcare and in law) would crumble. Sadly, reluctantly, and with great resistance, I have come to admit to myself that I believe science and reason to be dead in America. I brings me to tears to think that the bringing of truths to the table via science, the articulation of reason, and the possession and presentation of evidence is for naught. It is sound and fury. It is a shouting into the abyss. It is falling on deaf ears. Reason has yielded to power and force. That which Americans (and increasingly, world citizens) accept as that which is true is that which is said not by the smartest and morally most conscientious kids in class, but the biggest and most threateningly brutal bully on the playground. I am afraid we are going to have to “power back.” That is, to let go of the belief that science, reason, and social responsibility will win the day. Big Business (such as Big Pharma and Big Insurance) and as well, Big Government, twisting science and mocking justice, are fighting dirty. This presents a dilemma for those among us who value honesty, fairness, and merit of argument. It is not in our nature to “fight dirty.” We don’t want to “stoop to their level.” “Nobody wins in a war,” we are given to tell ourselves. At the same time, we feel the pressure to do something about the current state of affairs. We know all this is not a static state of affairs. We have seen the future. We are not simply in a handbasket. We are going to hell in a handbasket. As evidenced by the admirable speaking up (and out) by bright citizens such as yourself and Dr. Langdon, there are at least small groups of good people who are not standing idly by. However, it seems clear to me that this speaking up must, hopefully only in the short term, give way to a more forceful approach. Figuratively, those who would sully science & provide disfigurement to justice are using guns while those of us who hold out for the higher ethic are countering with flowers. Until we level the playing field via executable force, these wonderful articles will carry but the weight of fanciful poetry (I am endlessly sad to say).
    With respect and gratitude to you and Dr. Langdon for your good and tireless work,
    Christian Wolff, MA, Psychologist Associate, Portland, OR, deftears@gmail.com

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    1. AddictionMyth

      Science and reason are alive and well. I am not so cynical. People care, and change is happening all around us even if it is not always visible. We just have to keep up the pressure.

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