
The Federation of State
Physicians Health Programs (FSPHP) [i]
arose from state chapters of the American Society of Addiction Medicine (ASAM).[ii]
For example, Washington Physicians Health Program is the former Washington state
chapter of the American Society of Addiction Medicine. The FSPHP was originally established in order
to monitor physicians with addictive problems in diversion programs. But over the years the FSPHP expanded its
outreach to include any “impairment” or “suspected impairment.” In 2008 ASAM President Dr. Louis E. Baxter,
Sr. MD (addiction psychiatrist FSPHP
president 2009-2011) proclaimed that Physicians Health Programs (PHP) now includes,
“To provide a means to identify, evaluate, and treat physicians who have diseases of impairment.” [iii]
The use of the wording diseases of
impairment is not coincidental as it is the language used in the
legislation that provides governmental authority for the PHP’s existence and
also it’s funding through the state departments of health. This expanded mission now includes not only
drug addiction and alcoholism, but also smoking, eating disorders, mental
health issues such as disruptive behavior, psychiatric disorders, psychosexual
disorders and even physical diseases and metabolic disorders. In this mission creep volunteers and paid
“agents” of the PHP now feel they are authorized by the state medical board to
address as diverse problems as grief, sexual assault, domestic violence, child
abuse, divorce, child custody, bulimia, asthma, diabetes and hypertension. But these volunteers and “agents” may not
have any professional qualifications to handle these issues and they are
supervised by the PHP director who is only qualified in “addiction
medicine”. The PHPs are run by
supervisory committees made up of addiction specialists and people “in
recovery” who are not physicians at all.
Staffs of the PHPs are often recovered addicts who have Chemical
Dependency Counselor (CDC) credentials or some other similar training which was
gained while they were “recovering” from their own addiction. True to the vision of Bill Wilson,
co-founder of the A.A. or 12-step program, the ASAM and the FSPHP is run by
addiction peers who supervise the “peer mentoring”.
Under the Health Care
Quality Improvement Act (HCQIA) there has emerged a covert ability to impact or
revoke a medical professional’s license without requirement of standard, valid
legal evidence or court procedures. Thus, doctors, nurses, pharmacists,
chiropractors, dentists, and even veterinarians are now subject to control by
this organization FSPHP, the grandchild of ASAM. Persons placing
complaints against a doctors license are allowed to do it anonymously under the
federal Health Care Quality Improvement Act (HCQIA) and do not even have to
legally state what they allege is even true. There is no standard for admission
of evidence. Fabricated and false
statements can be placed in the doctor’s professional record without any
transparency, no legal standard for evidence and no due process. This HCQIA legislation, originally intended
to provide an avenue for patients to provide complaint information about
doctors to state medical boards and federal agencies, has now had unintended
consequences and instead protects hospital administrations from malpractice
liability. This immunity granted to
“Good Samaritans” who come forward with complaints under HCQIA regarding
medical care has been subverted by those wishing to hide malpractice and
medical fraud.
Doctors who lost their
medical licenses for participation in drug diversion, medical fraud, insurance
fraud, and patient abuse sought a way to be reinstated and gainfully employed
as ASAM substance abuse treatment professionals. Working as an addiction peer mentors to “impaired”
physicians was lucrative work. These captive
patients had good insurance coverage and could be forced to pay extensive
long-term monitoring and care. There was
little ethical concern for human rights, patient rights or proper informed
consent. Pharmaceutical and behavioral
researchers along with ASAM fellows found that there was less governmental
oversight and scrutiny of the treatment of addicts in private residential treatment
centers, outpatient clinics, hospitals, and prisons. These target populations of “human subjects”
were controllable and could be given drugs in clinical trials while in lock
down in facilities such as prisons, mental hospitals or drug treatment centers.
In return for facilitating
the pharmaceutical industry’s corporate goals, there would be political
influence exerted to soften certain legislative language to permit ASAM doctors
to regain their medical license and to erase the records of their own addictive
behaviors and/or criminal activity. The ASAM leaders strategically
analyzed how to circumvent the medical quality control system that prevented
them from expunging the history of their addictive behavior from their records.
The ASAM addicted doctors established a system for “monitoring” professionals
accused or suspected of substance abuse or other addictive behaviors (i.e.,
sex, gambling). Through the Federation
of State Physicians Health Programs they attempted to gain a controlling access
to professionals in every state. Through contracts made with the state
departments of health, they established themselves as the only capable
competitor for state funds related to medical licensing fees that were
designated to ensure quality professional performance.
ASAM doctors through the
state PHP’s were able to effectively obtain non-competitive bids for state
governmental contracts to do investigations and monitoring functions.
Thus, doctors who had been so impaired that their medical privileges were revoked
or curtailed were now permitted to monitor every licensed medical professional
within the state. An aggressive and expensive advertising campaign
through medical and nursing association journals presented the newly
established Physicians Health Programs (PHP) as advocates for “impaired professionals.” Everyone in the medical field was encouraged to
report other doctors, nurses, dentists, chiropractors, pharmacists and other
related professionals who might need to be “monitored” by the PHP. Strategic
marketing to allied professionals such as non-medically trained assistants,
office managers, and paraprofessional staff to report “suspects” allowed the
ASAM to target selected doctors and other healthcare professionals and force their
participation in an unregulated monitoring system.
There were no protections
against gossip, rumor or fabrications against licensed medical professionals. Private investigators could be hired to probe
the personal lives and background of professionals. Anyone with criminal interests
could make a complaint against a doctor or other professional and expect to
have the PHP take action. This could
neutralize or eliminate a competitor or whistleblower and halt investigation
into criminal behavior.
The ASAM embraced staff and
volunteers who not only had substance abuse problems (i.e., alcoholics and drug
addicts) but also “sex addicts” and compulsive gamblers as members of their
growing non-profit organization. Expunged histories provide no warning to
patients about a past sexual-compulsive history. The ASAM and the Federation of State
Physicians Health Programs politically worked to change legislative law in each
state to facilitate their control over the investigation into any quality
control issues related to doctors or other licensed medical
professionals. These legislative changes were achieved with no media
attention, and few professionals knew these changes occurred. Thus, legislation was passed to strengthen
the authority of ASAM doctors while limiting legal liability by grant of
quasi-governmental status and resultant governmental immunity.
Presenting themselves as
experts on the treatment of addictions, the ASAM doctors offered educational
programs to train others to view “problem” doctors through the lens of ASAM
principles, based on the Dr. Ruth Fox tradition of abusive and coercive
control. They could protect their own addicted or criminally
involved members and remove the medical license from anyone who could report
their criminal behavior.
The ASAM started another
organization which prevents licensed medical professionals from ability to
access their own medical credentialing verification documents. The PHP
requires that individual state licensing boards refuse to accept records that
document professional credentials without applicants sending requests for
credential verification to an independent incorporated centralized agency that
the ASAM corruptly controls. This prevents whistleblowers from seeking a professional
license in any state in the U.S.A. and eliminates a doctor’s ability to go abroad
with a clean record and obtain a license to practice. It ends a
professional career.
ASAM and FSPHP control over
professional licensing is not vulnerable to law enforcement scrutiny and is not
under the control of any government body. This is unrecognized covert power
is exerted with no government supervision or accountability. The state PHP is
incorporated as an NGO to limit liability but operate as a non-profit to reap
advantage of US tax laws. The state
boards of medicine do not control what transpires behind the closed doors of
this ingenious monopoly.
The U.S. Congress cannot
pierce the covert halls of this power. Even
the FBI is stymied by the provisions of HIPPA regulations that were enacted to
protect patients’ confidentiality, and which require a high burden of proof to
obtain a legal subpoena. ASAM doctors have created a system
they control and in which they can hide whatever criminal activity is necessary
to further financial goals. Money laundering is possible with much
less risk within the medical community collaborating with corrupted interests
within the FSPHP and associated interests.
It is possible to threaten or professionally destroy any whistleblower
naïve enough to report their criminal activity.
The FSPHP has the power and ability to force residential or outpatient
“treatment” on whistleblower opponents under the auspices of the substance
abuse treatment legislation and the mental health legislation at the state and
local level. Fewer medical
professionals, psychologists and therapists are courageous enough to risk loss
of their professional licenses if they report as “mandated reporters.” Yet, they are required to do so by law.
Unfortunately, many do not learn about this treachery until they report and are
then brutally attacked from unanticipated directions.
If law enforcement wants to
prevent medical fraud, the ASAM and FSPHP corrupted system of power and control
must be dismantled. It is necessary to ensure quality in our healthcare
delivery systems. That responsibility
must be returned to properly elected and/or appointed officials collaborating
with medical professionals in systems that are sufficiently transparent to
assure that professionals with integrity and consumers are protected.
We need to provide an
ethical professional alternative to the ASAM/PHP. It would be beneficial to take control of the
official systems so that they can be developed to protect patient safety and
medical integrity. Medical professionals with addiction problems must be
treated as human beings and patients not as commodities to extort insurance
money and means to obtain federal and state funding.
Because reports of abusive practices by the State physician
health programs have leaked out, media
attention, state legislative actions, court decisions and voiced concerns of
Congress have lead to the removal of PHP programs from many states including:
CA, MN, NV, TX, WI, and OR.
[i] Federation of State Physicians Health Programs Inc.,
515 North State Street – Room 8584, Chicago, IL
60610, Phone: 1.312.464.4574 Fax:
1.312.464.5841.
[ii] American Society of Addiction Medicine. 4601 N. Park
Ave., Suite 101, Chevy Chase, MD 20815. www.asam.org/.
[iii] Baxter Sr. MD, Louis E., “Physician Health Programs:
How They Work,” 2008 presentation on Physician Health Programs (PHP's) before
the FSMB (Federation of State Medical Boards) at their 2008 annual meeting, given
by 2009-2011 ASAM president FSPHP Dr. Louis E. Baxter, Sr., MD (an addiction
psychiatrist), PHP missions now include, "To provide a means to identify,
evaluate, and treat physicians who have diseases, at the Conference 2008.