Beloved doctor dies in physician health program. Her husband wants to know why.

Shawn C. Kelley, M.D., died by suicide under the care of Washington State Physicians Health Program. She was referred to the WPHP based on one unsubstantiated allegation unrelated to patient care. Her husband shares his thoughts and experiences about the program tasked with protecting his wife—and he appeals for a more objective and transparent process for helping vulnerable physicians.

I’m Vince Nethery, professor of clinical physiology, and my wife Shawn passed away six years and 55 days ago. I received a phone call at midnight on a Saturday night, and that’s never a good time to receive a phone call. It was from a law enforcement group in Seattle informing me that she had passed away. I got in the car and drove to Seattle. The circumstances that led to this are complicated, multifactorial, and questions come up all the time. We will probably never get answers to many of the questions, even today, six years later.

Shawn was a loving wife, tremendous mother of two children, 1,000 patients or more lost their physician, the medical community of North Central Washington lost one of their longtime members, and how this all came about, as I mentioned, we’ll never know. What we do know is that there are circumstances that led to some level of discontent in the workplace with one particular individual. That individual filed a complaint to the medical director of the hospital. Later we learned the complaint had something to do with an out-of-work experience. It was a private function that had nothing to do with the workplace. The complaint expanded to the workplace with the individual saying they would never work with Shawn again. We asked for an investigation to say, “Well, what’s the basis of this? Give us a root cause analysis of the situation. See how many others were affected by some allegations of . . . I don’t really know what they were, but whatever those allegations were.

Ultimately, Shawn was directed to go to the Washington Physicians Health Program. She wasn’t exactly sure why, but she was directed to go there and based on that directive she had no choice but to go. She met with two individuals in a conference room and those individuals discussed or asked or interrogated her, I don’t know, I wasn’t there, for about 45 or 50 minutes. At the end of that time period, the medical director of WPHP came into the room and within five minutes indicated that she was to go to an inpatient facility within a few days [Note: she was to pack her bags, leave her family, and travel to Georgia to enter their “preferred” inpatient facility at her own expense for four days. She was not given a diagnosis or a clear reason for their decision].

She walked out of there. She called me. I remember it as clear today as it was then. She was incredibly upset, as anybody would have been I would think.

We communicated about how it went and I asked her what was the basis for the directive that came from the psychiatrist at WPHP. She indicated that he was in the room for maybe five or 10 minutes and when he made the directive to her that she needed to go, she asked why, and he indicated to her that her speech was pressured or pursed and that was the basis for his evaluation. I wasn’t exactly sure what that meant so I asked Shawn and she indicated that, “Well, that’s usually a sign of stress, that you have pursed or pressured speech, and it’s a sign of stress.” And she said, “Well, how do you think I would be? I just spent 50 minutes in this meeting having these fairly one-sided conversations with two individuals and I was stressed out. It would be unusual for somebody not to be stressed.”

I asked her who the two individuals were who were in the majority of the conference meeting with her and she wasn’t sure. She knew the names because they introduced themselves, but she didn’t know what their role was, what their qualifications were.

A subsequent meeting with the medical director of WPHP many months later where I accompanied Shawn to that meeting, I asked the medical director who the two individuals were.

His first response was, “They are professionals in WPHP.”

I said, “Okay, are they trained psychiatrists?”

He said, “No.”

I said, “Well, perhaps they’re psychologists, right, they’re certified through psychology?”

He said, “No.”

I said, “Well, do they have a bachelor’s degree?”

He said, “They have a substance abuse certification.”

I said, “Okay, how do they get that? What level of education do they need to get that?”

He said, “They received that through a program at a local community college.”

I said, “So we’re making a decision that’s going to have a significant impact on somebody’s life here on the basis of 45 minutes of questioning discussion with two individuals who have a community college certification. That doesn’t seem right, does it?”

He said, “They’re professionals in our organization.”

I then followed up with the medical director and I asked him, that given the heavy emphasis in medicine today and for the last decade or more, on evidence-based being the base for making critical decisions, I asked him to explain what the evidence base was for the medical decision that he made. He got up and left. Came back five minutes later and said, “Our meeting is finished.”

We had spent about 90 minutes in this meeting with him to try to get to the bottom of a basis for his decision. He would not provide a rationale for it, none whatsoever. He provided no evidence to support it beyond the hearsay or the allegations made by a single person that were unsubstantiated in a following followup investigation of the setting in which this individual worked.

I was flabbergasted, actually, that an individual who had so much quote unquote “power over” the functioning of a physician could make those types of decisions and make them without being able to provide a justification, especially to the person to who that decision was being rendered. I’ll take a break.

Of course with 20/20 hindsight there are probably some things that might have been done in a different way that may have averted the outcome that did exist. One area I personally think would have benefited this particular situation would have been the development of a clear pathway to the resolution. That is, what are the specific areas that need to be addressed and completed in order to have a return to normalcy of the workplace? It seemed like we were forever chasing a moving target. One thing was asked to be done, it was complied with. At the end of that, there was another thing, and that was done. Then there was something else. And at the end of the day there was no clear pathway to resolving the matter and allowing individuals to return back to a professional environment that they were trained to be in.

In addition, the establishment of an ombudsman type of person within the setting to provide an objective evaluation of it without the workplace evaluations being conducted by essentially some of the individuals who were inherently at the root cause of some of it. And that didn’t exist. There wasn’t an objective individual who was doing a root cause analysis to find out at a very basic level the underlying factors and the veracity or lack thereof of the allegations that were made.

There was really no support provided from a physician perspective. Shawn felt like she was out there like a shag on a rock. Just at the whim of whatever direction the wind was blowing. To put a more defined mechanism in place and to have a clear set of directives that need to be addressed, to find out whether they need to be addressed, and then determine the pathway to follow for addressing them, if there is validity to them, would have been extraordinarily helpful in this case.

Questions that remain unanswered:

1) Why is it that one disgruntled individual in a social setting can leverage a complaint (unrelated to patient care) against a competent physician and undermine a doctor’s entire profession?

2) Why are two individuals with 10-month community college certificates in charge of determining the fate of a doctor’s career in 45 minutes?

3) Why are physician health programs not using evidence-based medicine?

4) Why is there a lack of transparency in physician health programs so that the physician and family and not given a diagnosis and treatment plan with a clear pathway to resolving the unsubstantiated allegations against the doctor?

5) Why are physician health programs unwilling to answer questions about physicians who have died by suicide under their care?

If you have answers to these five questions, please share your insight below as Dr. Shawn Kelley’s family deserves to know what happened to her.

Questions raised about physician health program safety:

Doctors fear PHPs—why physicians won’t ask for help (TV report)

Physician Health Programs: More Harm Than Good

Physician health programs: ‘Diagnosing for dollars’?

After investigating more than 1,300 doctor suicides during the last seven years, I’ve noticed a disturbing trend in which physicians have been dying by suicide under the care of physician health programs. Victims are sent to PHPs for unclear reasons, mandated to one-size-fits-all “preferred” substance abuse treatment centers for up to five years at great personal expense—even though many had no substance use issues. If you have been harmed (or helped) by a PHP, please share your story below.

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80 comments on “Beloved doctor dies in physician health program. Her husband wants to know why.
  1. SC says:

    I just read your post on the Wa. php followed physician who committed suicide. My husband had also been directed to go there to the wa php. I was in that same conference room with two staff and the director… he wouldn’t follow through with the process of an intake interview. Unfortunately, he lost his license this year and pretty much lost all after that. We are no longer Together…. so sad after a decade together. He’s basically homeless. I tried for years to steer him in your direction but his ego kept him from reaching out. He voluntarily gave up his license and is no longer a family practice physician.

  2. Melissa Freeman says:

    Iam another person who was mandated to go to the WPHP, for patient satisisfaction scores that were not in the 90th percentile – which is the necessary number to get medicare advantage money.
    I quit their “voluntary” (hint: it’s not) program when the witnessed urine screens provoked severe PTSD.
    I almost killed myself; in fact, I am unsure how I am not dead.
    I’m grateful for you speaking to me, Dr Wible, when I was so very lost and broken and alone.

  3. If it walks like an organized crime syndicate and quacks like an organized crime syndicate, it may be an organized crime syndicate. If any healthcare professional would rate, on a scale of 1 to 100, the extent to which they WANT to believe that THEIR healthcare profession could NOT be under Racketeering Influence, what numbers do you think we’d see. If you are reading this and are a healthcare professional, how would you rate yourself on this scale? How do you think your peers would rate themselves. What do you think the basic descriptive stats on this would be? In the story here, bravely shared by Dr. Kelly, and in all the other stories so creepy in their similarities, we must ask, “Did these strange authority-figures walk like competent, trained, ethical, healthcare professionals? Did they quack like the same?” Each story of this type of domestic-terrorism shake-down I have heard, and I have heard plenty, something seems very wrong from the get-go.

    My heart goes out to every victim of these medico-criminals. I become angry. It SHOULD NOT be that there are such elements among us but the plain fact is, there are. There is absolutely NOTHING that would exempt healthcare professions, entities, and institutions from being infiltrated by organized crime. WORK for a better system and a better world. If you try to WISH it into shape, your denial will simply exacerbate the problem and extend it for countless others to come. Sadly, tragically, denial = passive complicity. We HAVE been infiltrated by organized crime and we must call it what it is. May peace come to those who have suffered at the hands of criminals.

    • Kate says:

      Christian,
      Thanks for fighting for docs. What should we do to fight? I know we all want the courage to fight, but sometimes we don’t know where to start.

      • Pamela Wible MD says:

        Where to start in my opinion:

        1) Share your mental health story. Share your PHP story. Share your medical board story. When we are divided, we are conquered. The truth will set us free.

        2) Love each other as brothers & sisters in medicine. When we have unity and we have each others’ backs we don’t have to worry about so many third parties swooping in to “save us” from each other and patients.

        3) Get 100% nonpunitive and confidential health care. If we were all doing this we would not be drinking, doing drugs, or having mental health issues that escalate to the point of needing emergency treatment at a “preferred” center. Mental health care is not optional if you want to survive with your heart and soul intact within medicine.

        Short of all that, I stand by the conclusions at the keynote I delivered to the Pennsylvania Medical Society/ Pennsylvania PHP. Read (and listen to it) here for more strategic advice for changing medical culture at the system level: Keynote: Physician Suicide—Prevention & Intervention

        • Right on, Pamela! Very well said. As A member of Rotary International, I subscribe to our motto which is “Service above self.” By NO means is this “service to the excusion of self,” or even “service BEFORE self.” I think most of us have heard the generalizable sage advice about oxygen masks in an airplane incident. The BEST thing you can do for others is to put your OWN oxygen mask on FIRST. You will not do anyone else any good if you, tourself are not well sustained.

          To add to Pamela’s thoughts on where to start, I’d suggest JOINING others in a palpable and real-time alliance. Join HARBR-USA (you can google that and it should get you to our website at HARBR-USA.org. There, you will find the contact information for some of our brother and sister groups like Michael Langan’s Disrupted Physician, Kernan Manion’s (Center for Physician Rights), Linda Cheek’s Doctors of Courage, THIS site (Pamela’s), and more. Collectively, we will hope to see you become a part of us in this work we are doing.

  4. kali says:

    So many doctors are being ordered into PHP’s that are unnecessary and hideously expensive. Even innocent physicians are strongarmed, told that they have to undergo evaluations in facilities that all too frequently are not even accredited, or lose their licenses. It seems incredible that while everyone else has the right to choose a provider if they do have an issue, physicians who are bright and well educated are not allowed this option, this right.

  5. EA says:

    The key is knowing how the PHPs are funded and what their relationship is like with the state medical board. Dr. Peter Yellowlees’ book is a source of explaining how PHPs are funded differently in each state. http://bit.ly/DrYellowleesBook Refer specifically to page 194. The MBC has even written articles about complaints coming from relatives or friends of physicians in competition with each other. Sadly, psychiatry and the physician-patient relationship has become a sociopolitical weapon. An interesting perspective or insights could potentially come from mental health criminal defense attorneys and what their standards are for evaluation.

    • Pamela Wible MD says:

      Thanks EA! I didn’t know you were so full of wisdom on this topic.

    • The AMA at the behest of its HOD, over vigorous objection by representatives of FSPHP and ASAM, studied the sources of funding of PHPs back in 2010.

      Although the page has been taken down by FSPHP, you can use WayBack machine (Web Archive) to find the source of funding for your state’s PHP as linked in the AMA 2010 CSAPH report https://www.fsphp.org/State_Programs.html. Here, for example is WA (as of 2015) https://web.archive.org/web/20151130003643/http://www.fsphp.org:80/washington.html

      Here is a paper on Misuse and Abuse of Psychiatry by these entities:
      http://bit.ly/MisuseAbusePsychinMRTC, and one by a psychiatrist, on coercion in the Medical Regulatory-Therapeutic Complex http://bit.ly/MRTCCoercion that explains how this scheme operates.

      Basically, entities originally designed to deal with substance abuse (and staffed by substance use or other types of low level counselors, sometimes “supervised” by physicians) have, with the blessing of the FSPHP and FSMB, expanded their potential cache of physician clients into all arenas of “potentially impairing” conditions affecting professionals. The AMA HOD has recently endorsed the concept, without any evidence that the AMA itself either knows the particulars or is studying the legality of methods by which PHPs do this.

      Many of the policies promulgated by the FSPHP to its member PHPs (including WA—see http://bit.ly/WAPHPviolatesADA) routinely violate the federal protections due to all citizens under the ADA. All WA physicians already fund their program via licensure surcharges (which are to be increased dramatically in 2020), and in addition pay for all mandated evaluations, out-of-state inpatient evaluations, and up to 5 years of witnessed drug monitoring out of pocket if they become PHP “enrollees”.

      Those who most vociferously promote this “new paradigm” (RL DuPont, ASAM and FSPHP) do so by endlessly perverting a federal legal term, without any basis in law or precedent (see http://bit.ly/SafetySensitivegaslighting), that healthcare professionals occupy “safety-sensitive positions” and therefore require more intensive and prolonged surveillance, treatment and monitoring for potential substance use than normal citizens. These very same individuals have built fortunes from profits emanating from the requisite prolonged drug testing, and organizations too have profited in various ways by inducements from the inordinately restrictive and expensive drug treatment such “preferred” programs demand of physician patients, reportedly often without meeting criteria for bona fide substance use.

      Average cost to individuals caught up in these programs has been documented by one of the perpetrators (RLD) to be in the range of $250-$320K (Judges Journal 2018;57(1, winter):1:32-35).

      This is a VERY long term, well planned strategy for maximizing the extraction of profits (from ostensible “deep pocket” physician clients) using regulatory takeover and mission creep. (See http://bit.ly/WordIsOut)

      And it is killing some of us.

      • Pamela Wible MD says:

        Thank you Louise and so many others on here who have truly dedicated so much time and energy to research and protect our vulnerable physicians from harm. I now understand that PHPs are going after medical trainees & med students too. Heard some terrible cases of suicide attempts of med students (without substance use) entrapped in these programs that have injured them, ended their medical careers before they even got started.

  6. Eric Dover says:

    Money is certainly a big part of this situation. I assume boards get kick backs in some form. Otherwise, the PHPs are businesses. They want/need to make money to at least keep the lights on. They desire to grow. And like a private prison they have beds and programs to fill and most importantly a captive clientele without any constitutional or due process rights.

    But there is something more beyond the above. You are dealing with psychopathic individuals at the hospital, board and PHP level. Folks that actually enjoy torturing you. They get off on the power to break you – but it’s for your own good according to them. From what I hear PHP programs operate like reeducation centers.You admit you are an addict even if you have never used drugs or alcohol

    Anyone playing the game with the medical establishment using their rules and playing on their field is a fool. Defense will not work. Offensively attacking using the North Carolina Dental Board of Examiners v FTC SCOTUS decision of 2015 as a backstop to argue antitrust and constitutional violations by what are literally trade associations called boards.

    drdovervsomb.weebly.com

    harbr-usa.org

  7. AU says:

    This is very scary. I am currently having ongoing issues with an NP who works under me. I cannot fire her as I work for a large hospital. They basically cannot fire her. I am afraid that I am going to soon lose My temper as she is already accusing me of acting unprofessional. What is my option? How can we prevent ourselves?

    • Pamela Wible MD says:

      Sending you a private email with help. I know the perfect person who can strategize a quick resolution in your favor here.

  8. Anonymous Doc says:

    Dear Dr. Wible,

    I am a medical professional. At my hospital job I experienced appalling conditions where verbal and physical abuse of staff was a daily event. I also saw a lot of lateral violence among nurses in particular (I will never understand why women cannot stick together). My career ended prematurely a few years ago after I sought counseling and word went around that I was “cracking up” and couldn’t do the job anymore. Although I don’t regret seeking help (much), I can’t help but wonder if things would have ended differently if I had just developed an alcohol or drug problem like men in the fire service often do instead of crying in a peer counselor’s office (or if I had been a man). It was not a happy time in my life, but I kept working in the ER for a little while longer. Your articles and book had a lot to do with my decision to leave hospital based healthcare and look for other ways to practice. I knew what I was doing was breaking my body and my heart and it was time to stop and do my own thing. I don’t want to be sour grapes, but it still hurts when I run into guys I used to work with. Somehow they managed to salvage their careers in spite of disciplinary matters, injuries, family problems, trouble with the law, getting fat, blah, blah, blah….;) Thank you again for all your work and for giving healthcare professionals hope!

    • Pamela Wible MD says:

      You are the third person I’ve been in touch with this week with the same complaint. Gender discrimination in physician health prgrams on top of everything else is the icing on the cake.

    • Anonymous Doc, please join us in vehemently eschewing the term “sour grapes.” My Oregon HARBR colleagues and I encountered this in an act that marked our founding. We issued complaints against several DoJ attorneys to the state bar association. We were very pleased with the fact that we must have leveraged enough power that all these attorneys “lawyered-up.” The first response from their attorney was a direct attack on the integrity of the 12 complainants. We were all painted as a bunch of “sour grapes.” We put a GRINDING halt to that notion. We don’t let people call us “sour grapes.”

      • Pamela Wible MD says:

        When attorneys “lawyer up” now that’s exciting.

      • Those who are on the defensive from attacks by those who are exposing and trying to reform the system respond with “sour grapes” because they don’t want to admit that it’s actually “the fruit of the poisonous tree” that healthcare professionals are being coerced into partaking. T’is no wonder some are dying.

  9. Jose Ramos says:

    My story:
    https://m.youtube.com/watch?v=wktwWRJCaqg

    and please watch the follow up video A Plea to Anesthesiologists 2. I detail my struggles with addiction and recovery in a raw, nothing held back, brutally open and honest manner. If you know or suspect anyone struggling with a Substance Use Disorder please send them these links. It may save their life, their career and the life of a patient.
    Jose Ramos MD

    • Pamela Wible MD says:

      I LOVE YOUR VIDEO!! And your authenticity is LIFESAVING. Still have plans to help you help others. More to come. YOU are on my desktop and my next project and adventure. Keep the faith. YOU are AWESOME!

  10. Terri Lewis PhD, NCC says:

    Physicians, follow Dr Wible’s advice. This is not the first story that I have heard. It’s unacceptable and denies you the right of access to caring clinicians.
    Please share your story.

  11. Elizabeth Bartlett says:

    I will never get my license reactivated. The secretary at the PHP said she didn’t like my attitude and she had decided I was unfit and would never practice again. I was a victim of domestic violence. My then husband admitted he was a drug addict and cooperated. He is a practicing psychiatrist. He nearly killed me and our children. He belongs in prison. He was abusive to multiple patients in our shared practice. I refused to say I was a drug addict. I was forced to sign a false confession. I was told I could not tell the board what he did to me because they would assume I was making it up and would suspend my license. I am an excellent psychiatrist and would like to open a trauma recovery center. That will never happen.

    • Pamela Wible MD says:

      OMG. Unreal. I’ll email you privately as I have some excellent resources for you! Never give up. ALSO I would love to know what you wish you would have done differently (hindsight is 2020) AND what do you recommend for others who are dealing with retaliatory/frivolous PHP referrals?

  12. Dr Stacie says:

    I had returned from a wonderful conference that I had designed and delivered for a regional public health department. I was so happy. I sat down in my office to answer my phone messages And had a message from the Dept head of substance abuse asking me to give him a call about my “impairment “. As someone who rarely drinks alcohol and never takes drugs I was shocked and initially thinking he dialed the wrong number. As I told him that I did not have a drug problem I realized that was what most addicted people say who are in denial about their problem and the Dept head clearly didn’t believe me. I contacted the Physician Wellness program who had referred me to rehab BUT they refused to give me any information about the referral initially. My approach when I have experienced an injustice is TO Make IT Public. So. In my anger and disbelief I talked to every possible person who had supervisory roles over me- the chiefs of both inpatient and outpatient medicine, my clinical station lead, the nursing supervisor and none of them said they had EVER had a complaint or concern for my “alleged”impairment. I talked to every colleague I’d ever worked with and asked then point blank if the had had concerns about my patient care AND told them what was happening. One of my fellow docs suggested I get a drug test which I did immediately. Finally the Physician Wellness chair who was also in my department shared with me that they had received an anonymous letter about me. They were not at liberty to share exactly what it said but it lead the committee to recommend treatment in our rehab department. When I spoke up about getting an attorney they dropped my getting help for impaired physicians. An anonymous letter lead me to the physician impairment program in my hospital. It took me 6 months to let go of the resentment and anger. I couldn’t look anyone that I worked in the eye as I would wonder , “Was it you?” Im convinced that this experience had the power to completely unravel me BUT I had personal and social mechanisms in place that protected me from going down the road of isolation and depression. In my heart I feel like Dr Kelly would be alive today if the process was not shrouded in mystery and she and her husband had been empowered to seek litigation

    • Pamela Wible MD says:

      So having an attorney protected you and they dropped their investigation/evaluation? What would you suggest for others who are entrapped with frivolous or retaliatory referrals?

    • DrStacie says:

      I believe making it PUBLIC was the key. Fighting back. Not accepting their plan. Being up for a negotiation. I also recognize I was in a special place in my career that made it easier for me to fight back I was mid career I had worked in this organization for 10+ years I had mini relationships with many people. I know it would’ve been harder if I were a medical student or resident or early in my career. I would recommend for anyone in a situation like mine or like Dr. Kelly’s to immediately bring allies into the conversation get different perspectives and most importantly don’t jump to comply with what is being asked of you take some time to think about the allegations and their long-term consequences. We have to support each other when situations like this occur at work

      • Pamela Wible MD says:

        Aha! #1) DO NOT ISOLATE #2) MAKE IT PUBLIC #3) LEGAL SUPPORT. Don’t accept any abuse or predatory “help.” Real mental health care is non-punitive and confidential based on trust mot coercion.

  13. Pamela Wible MD says:

    Hey everyone, check TWITTER as the thread on this conversation going bonkers over on social media. https://twitter.com/PamelaWibleMD

  14. Concerned Victim says:

    People take on the identity of their profession. This is their life. When you are accused and publicly defamed for something you did not do. It is devastating. The medical professionals who have not experienced this , have no idea what it really entails. You are looked at with shame. The boards/ agencies print a pile a lies just because someone who is retaliating said it. They know it is not true, and try to make you think you are crazy. Gaslighting is what they are doing , bullying as well. And who will people believe ? If its in print, and posted by an agency people (even the ones in the profession) believe it to be the truth , or they can sue them . (They have all the money and power to fight you, the judges are corrupt, the agency is corrupt. It is over whelming to lose it all what you have worked so hard for , just taken by nonsense, using mental health as a cover up ) Those doing this kind of “work ” will have a huge dark cloud over their heads . While the victim in all this is screaming why can’t people see it? What kind of country do I live in ? Is this America ? Why is this allowed to happen. While your colleagues are thinking all along , it won’t happen to them .

    • Pamela Wible MD says:

      Many organizations blindly refer to PHPs for a range of issues (not just 12-step substance abuse)—communication/boundary issues, postpartum depression, test anxiety. One Program Director recently found herself trapped inside a PHP and boy did she regret sending so many residents there over the years. Now that she has had first-hand experience she is so apologetic to those who she referred. I know some people feel PHPs have helped them salvage their careers and that is fabulous. Others have lost their lives under PHP care and they deserve justice. Certainly their family deserves answers.

      • Required disclosures made during the ongoing procurement battle regarding Colorado PHP funding show that overwhelmingly the most common source of referrals to Colorado PHP in the last two years were founded on third party complaints. Public stakeholder spoken and written testimony about CPHP utilization show that organizations that employ physicians, very frequently residency programs were the majority of these “third parties”. The forced fitness for duty medical evaluations of employed persons, INCLUDING physicians is strictly constrained by ADA Title I. The Colorado PHP published a partial list of the contracts that it has with residency programs in the body of its sole source procured contract with the State of Colorado. CPHP, as a private organization, is not required to divulge these contracts. However, some of the signatories are state-funded residency programs that must disclose these contracts. A CORA request for one of these contracts was made last week and it is possible that the contract bound one of the parties into violating ADA. We’ll know soon.

  15. It’s curious to me in reading these testimonials, that there is not a presumption of innocence, but of guilt, in these unjust cases. It makes me angry to hear of these injustices. I agree with Dr. Wible that the medical community needs to support one another, first and foremost. No one else is going to help to defend us. Unfortunately, we as medical professional are sometimes our worst enemies, envious and vindictive, rather than nurturing, empathetic, and supportive. Until our professional culture changes, these atrocities will simply continue.

    • Pamela Wible MD says:

      We started out with noble humanitarian intentions and the process of medical education has pitted us against one another in a race for survival. Then the rampant human rights violations has caused (or exacerbated) mental health issues which we can now be punished for having. Please see Human Rights Violations in Medicine for details. Kind-hearted human beings who are not traumatized don’t behave this way. We have been placed in harm’s way through medical education and beyond. When we need help, we are often punished. Tragic.

  16. Emily says:

    This is a shocking story. So sorry for her family and friends about this unnecessary loss of life.

  17. Anonymous NP says:

    Hello Dr. Wibble,
    Thank you for sharing the story of Dr. Shawn Kelley and others who have lost their lives in the health care profession. Having been a nurse for over 20 years and an NP for 5, I have seen the toll that it takes on health care providers. It is brutal! I also live in Washington State and suffer from severe burnout. I have had 4 jobs in the last 5 years. At my last job I was working 60-70 hours a week and getting paid for 32, and not well at that. I got the flu and was sick for 7 weeks and was only able to take 3 days off from work. I was so sick and exhausted and then the final blow, a needle stick injury. I realized at this point that the job was killing me, and I had to leave. I am now unemployed since May and pretty much unemployable in my area. I am trying to start my own business, but it is hard with no money. I feel like such a burden to my family. I wish I was dead, but don’t think I have it in me to end my life because I could never inflict that kind of pain on my family. I have worked all my life to relieve pain and suffering and love my family dearly. Instead, I suffer silently…under tens of thousands of dollars of student loan debt…with no way out. I am deathly afraid to get help, and you clearly understand why. And as far as I can tell, there is no real help out there for me anyway. I am even afraid to share here anonymously, because what is anonymous anymore anyway? I would love to participate in your programs, but, unfortunately, I can’t afford it. I do follow your blog and it does give me hope. Thank you for all that you do for doctors and other health care professionals in need. Blessings to you!

  18. Ontario Doctor says:

    In Ontario, Canada, the Ontario Medical Association’s Physician Health Program seems like a mechanism that mainly allows hospitals and the accused to avoid the courts. It may also have some drivers that are well-intentioned (in addition to citing the service as addressing its members concerns or the desires of those the organization negotiates with), but there is much room for improvement if a priority is truly improving physician wellbeing and patient care.

    The burden is largely on the physician once they enter into such a PHP contract in Ontario. Hospitals, licensing bodies (CPSO), and even mandatory CMPA dues-collecting agencies (and often OMA partners) provide little support towards the additional costs physicians can occur that limit their ability to care. This seems to force physicians down the rabbit hole of falling in line to act as an ill-equipped Band-Aider for a breaking healthcare system rather than work towards healing the wounds. The faster you can put them on without looking up or speaking out, the higher your quality of life according to your bank account.

    In my humble opinion, upfront support would be more effective from a non-conflicted PHP. This may be especially helpful for the minority of physicians who come from lower socioeconomic backgrounds and/or enter medicine with the primary goal to heal, especially if a greater goal is to help provide health equity for all.

    • Pamela Wible MD says:

      Prevent the hazardous working conditions and rampant human rights violations within medicine and very few people would ever be impaired or need help (especially if we had NON-punitive on-the-jog psychological support. Results of 7 years of research into 1,300 doctor suicides reveals some simple solutions: Human Rights Violations in Medicine: A-to-Z Action Guide. Prevention is key. Waiting to be the next victim is not a great strategy.

  19. Leann says:

    Why? This shit is so hard for me to read. I appreciate what you do greatly, but it’s scary how neglected physicians are currently. Thank you for taking your time to publicize and attempt to reduce stigma related to mental health. I admire you and your desire to confront that which others shy from regularly.

    • Pamela Wible MD says:

      Classic cycle of abuse. Physicians have become victims–and playing that role for years with multiple third parties.

  20. Thank you Professor Nethery for sharing your touching story about your wife Dr. Shawn Kelly’s suicide as a result of the abuses she endured by WPHP.

    The abuses of the exclusively contracted PHP system and the complicit state medical boards which refuse to investigate their insider referral extortion racket must be exposed and confronted. At CPR – The Center for Physician Rights (www.physicianrights.net), we are actively educating and guiding physicians as they become wrongfully ensnared with these state-protected opportunistic predators in a veritable Kafkaesque nightmare

    The pattern we’ve discerned in literally hundreds of cases is that the physician is wrongfully “referred” to the exclusively contracted PHP, usually by the MLB or by the physician’s hospital or group employer. Too often, an anonymous complaint initiates this gruesome cascade.

    Claiming they’re benevolent programs for physician wellbeing, they newly diagnose the physician with a psychiatric condition and “recommend” that the physician be sent out of state at exorbitant cost to one of their “preferred programs.” Sadly, your wife’s story fits this reprehensible pattern.

    If the physician declines the referral, he or she risks being reported to the MLB as being “non-complaint” and the MLB threatens to publicly revoke the physician’s license on the alleged right that it needs to protect public safety.

    If the physician goes, chances are extremely high that the specialized “preferred 4 day program” will confirm the PHP’s referral diagnosis and “recommend” that the physician whom they’ve labeled as being in denial of their substance abuse illness be “enrolled” in a three month inpatient program. At the completion of this, the physician will now be placed on a monitoring program for five years, labeled as an “impaired physician.”

    There is no escape from this nightmare apart from preemptively severing one’s medical identity prior to the MLB publicly and humiliatingly revoking one’s license declaring the physician “incapable of practicing with reasonable skill and safety by reason of mental illness.” There is no other word for this unconscionable behavior than torture.

    Physicians and all concerned others must now demand of their medical societies and their state legislators and state executives a comprehensive, truly independent and transparent investigation of this corrupt movement, operating as it does as an extortion racket with the government’s tacit permission, doing so behind the seemingly impenetrable wall of sovereign and other immunities.

    I would encourage all concerned – physicians, their families, their patients, their colleagues – to join with us in halting these abusive practices and holding wrongdoers accountable. You can sign up on CPR (www.physicianrights.net) to receive updates and be notified of emerging initiatives.

    I would also welcome speaking with Professor Nethery about potential pathways he might pursue, especially as he is uniquely positioned to have his voice heard.

    • Melissa Freeman says:

      It’s so telling, Kernan, that despite so many (hundreds) of stories you have had, Chris bundy (director of WPHP and president-elect of the FSPHP) published this (https://wmc.wa.gov/sites/default/files/public/Newsletter/4.WPHpReport.pdf): While these are impressive outcomes by any measure, there remains a small minority of physicians who are not willing or able to effectively engage with their state physician health program (PHP). Such cases are often complicated and heart-breaking, resulting in a cascade of distressing personal and professional consequences that can irrevocably impact the physician, colleagues, patients and families. Under these circumstances, it
      is not surprising that a few will become disgruntled, intent on unfairly disparaging PHPs and the PHP model. Their public protestations and allegations are shielded
      Update! Vol. 9 Fall 2019

      WPHP Report
      from scrutiny by strict confidentiality protections that preclude PHPs from responding with facts that might prove illuminating. These one-sided stories can generate sympathetic support from well-intentioned, but often misguided, champions of perceived injustice who draw upon these anecdotes as evidence that PHPs mistreat physicians and that the PHP model is broken. This phenomenon is not new or unexpected given the nature of our work and, because most know otherwise, it has not appreciably tarnished WPHP’s reputation or weakened our stakeholders’ support.“

      He is gaslighting harmed physicians at the same time he is celebrating the PHP reputation not being harmed (yet) or having stakeholders’ support weakened.

      Who are said stakeholders?

      • Pamela Wible MD says:

        We really do need to have this conversation. Seems that by investigating those who are injured by the PHP (or any program) data could be collected that would benefit and strengthen a program. The main issue here seems to be the secrecy (lack of transparency) that leads to such polarization. Why hide the truth? Why leave families wondering years later why their loved one died of hopelessness and despair under the care of a PHP?

        I’m ever hopeful that justice and truth will prevail. Every life matters. Physicians and medical students deserve care, love, and support. By sharing our voices, our stories, our proposed solutions we can create a true safety net for physicians.

        I also would love to know who the stakeholders are. Of course stakeholders used to be the ones to hold the stake driven through the heart of a suicide victim in the 1800s. May we now move out of the mental health dark ages. Punishing those who need psychological help is an antiquated and brutal way to treat a human being in 2019.

        • Melissa Freeman says:

          it is absolutely abhorrent that he minimizes the harm done to people under his eye – he states that the WPHP is not involved in medical care; doctors are ‘participants’ and not patients – trying to absolve himself and his program from harm done.
          it’s not OK.
          if you want to dictate care for people, order & interpret laboratory tests, dictate terms of medication use – you are a health care provider for them, end of story, and you should be responsible for outcomes. if this is not the case, then an MD license would not be necessary to oversee a PHP in any state.

          • Pamela Wible MD says:

            Curious how you ended up in WPHP if you care to share publicly. If not for SUD I wonder why you are there.

          • Melissa Freeman says:

            it was for patient satisfaction scores (see above) not being 90th percentile or higher.

          • Pamela Wible MD says:

            So effed up. Infuriating. Who’s idea was it to refer you? Are you in a large megaclinic?

          • Melissa Freeman says:

            no, i was but i left my job because of the unreasonable traumatic demands of the WPHP. i have an article forthcoming that describes the circumstances.

          • Pamela Wible MD says:

            Thank you for being so vocal. Your are speaking for so many who fear repercussions. Grateful for your courage.

          • Tom Horiagon MD MOccH says:

            There is ABSOLUTELY NO QUESTION that PHP’s engage in medical inquiries under ADA Title I. This business about whether they practice medicine or provide treatment is a script from FSPHP and a complete red herring.

            PHP’s are not in technical violation of the law. These programs completely ignore ADA. My opinions do not follow below. These are quotations from EEOC and USDOJ regulatory guidance.

            According to the EEOC’s own published regulatory guidance: “A “medical examination” is a procedure or test that seeks information about an individual’s physical or mental impairments or health.” PHP’s perform fitness for duty evaluations on persons currently employed in and/or licensed in medical practice.

            “Title I of the Americans with Disabilities Act of 1990 (the “ADA”)(1) limits an employer’s ability to make disability-related inquiries or require medical examinations at three stages: pre-offer, post-offer, and during employment.”

            “At the third stage (after employment begins), an employer may make disability-related inquiries and require medical examinations only if they are job-related and consistent with business necessity.”

            “Generally, a disability-related inquiry or medical examination of an employee may be “job-related and consistent with business necessity” when an employer “has a reasonable belief, based on objective evidence, that: (1) an employee’s ability to perform essential job functions will be impaired by a medical condition; or (2) an employee will pose a direct threat due to a medical condition.”

            “An employer’s reasonable belief that an employee’s ability to perform essential job functions will be impaired by a medical condition or that s/he will pose a direct threat due to a medical condition must be based on objective evidence obtained, or reasonably available to the employer, prior to making a disability-related inquiry or requiring a medical examination. Such a belief requires an assessment of the employee and his/her position and cannot be based on general assumptions.”

            “What action may an employer take if an employee fails to respond to a disability-related inquiry or fails to submit to a medical examination that is job-related and consistent with business necessity? The action the employer may take depends on its reason for making the disability-related inquiry or requiring a medical examination. Any discipline that the employer decides to impose should focus on the employee’s performance problems. Thus, the employer may discipline the employee for past and future performance problems in accordance with a uniformly applied policy.”

            “May an employer require that an employee, who it reasonably believes will pose a direct threat, be examined by an appropriate health care professional of the employer’s choice? Yes. The determination that an employee poses a direct threat must be based on an individualized assessment of the employee’s present ability to safely perform the essential functions of the job. This assessment must be based on a reasonable medical judgment that relies on the most current medical knowledge and/or best objective evidence.(61) To meet this burden, an employer may want to have the employee examined by a health care professional of its choice who has expertise in the employee’s specific condition and can provide medical information that allows the employer to determine the effects of the condition on the employee’s ability to perform his/her job. Any medical examination, however, must be limited to determining whether the employee can perform his/her job without posing a direct threat, with or without reasonable accommodation. An employer also must pay all costs associated with the employee’s visit(s) to its health care professional.”

            “An employer should be cautious about relying solely on the opinion of its own health care professional that an employee poses a direct threat where that opinion is contradicted by documentation from the employee’s own treating physician, who is knowledgeable about the employee’s medical condition and job functions, and/or other objective evidence.”

            “May an employer require an employee to receive or change treatment for a disability to comply with a conduct standard?
            No. Decisions about medication and treatment often involve many considerations beyond the employer’s expertise”

            “Under current Commission regulations, an employer may justify action taken against an individual with a disability, including reducing work hours, where the individual poses a direct threat to the health or safety of himself or others. The term “direct threat” is defined as “[a] significant risk of substantial harm to health or safety of self or others that cannot be eliminated or reduced by reasonable accommodation.” 29 C.F.R. § 1630.2(r). A determination that a direct threat exists must be based on an individualized assessment of the employee’s present ability to perform the essential functions of the job safely, considering reasonable medical judgment that relies on the most current medical knowledge and/or the best available objective evidence. Id. Factors that must be considered include: (1) duration of the risk; (2) nature and severity of the potential harm; (3) likelihood the potential harm will occur; (4) imminence of the potential harm. Id. The availability of any “reasonable accommodation” that would reduce or eliminate the risk of harm must also be considered. See also EEOC Enforcement Guidance: Disability-Related Inquiries and Medical Examinations of Employees Under the Americans With Disabilities Act (July 27, 2000) (available on our website, and also discussing the “direct threat” standard).”

          • Pamela Wible MD says:

            Medical boards do undermine physician mental health by breaching physician confidentiality and privacy. Discrimination against qualified, competent applicants who report mental health conditions is a violation of the Americans with Disabilities Act. In their search for criminal behavior among physicians, medical boards must not become criminal in their own behavior. By breaking federal law and the AMA Code of Ethics, boards have weaponized mental health diagnoses against physicians. Recommendations for all state boards:

            1) Remove mental health questions from medical licensing applications. Replace with current impairment questions such as: “Do you currently have a condition that impairs your ability to practice medicine safely?” Comply with federal law by following best practices of Grade A states. Move criminal/predatory behavior queries to the criminal section alongside felonies and DUIs.

            2) Address impairment from hazardous working conditions. Rather than focus on individual victims, engage in high-yield activities that resolve hazardous conditions impairing physicians en masse. To truly protect patients, align with all other industries invested in public safety that have legislated (and enforced) maximum 16-hour shifts, 60-hour work weeks, with minimum 30-minute breaks every 8 hours.

            3) Encourage nonpunitive 100% confidential mental health care. Physicians require safe, accessible mental health care to be well-adjusted human beings. Most physicians enter medicine as humanitarians with noble intentions. Help them be well. After all, how can physicians give patients the care they’ve never received?

            “Physicians are treated as criminals and tracked more closely than Level III sex offenders,” reports a general surgeon. “Answering all these questions on applications, the subtle, unspoken lesson is ‘you had better be squeaky clean, mentally, morally and physically! If you step off the shining path, bad things will occur.’ I have known 7 male physicians who died by suicide. Most with a ‘happy’ exterior. Why? They cannot confide in colleagues for fear that their colleagues will turn them in to hospitals and boards—and there goes their privileges and livelihood. They cannot confide in their spouses because during rough patches mentally, their marriages are already in trouble. If they share psychological problems, they probably fear that the wife may use this as ammunition in any future divorce. So they keep on smiling—right up to the hour they die.”

            Even until their last breath, physicians retain their work ethic. Some doctors are completing chart notes, returning lab results, and checking in on hospitalized patients in the hours before their suicides.

            By injuring physicians, we aren’t protecting the public.

            Let’s end the physician mental health witch hunt.

            Conclusion from Physician-Friendly States for Mental Health: A Review of Medical Boards

  21. Neena says:

    This hurts my heart to hear of this in a so called free and just society.

  22. Abused and Depressed Med Student says:

    I feel I’m being abused and extorted by my PHP. I tried to get non-punitive and confidential care for my problems with alcohol, but my PCP talked me into going to the PHP. The PCP deceptively allayed my concerns about PHPs 00 0I0 felt desperate so, without doing any research, I went to the PHP for help with alcoholism. I’ve never regretted anything so much. They’ve been making jump through expensive hoop after expensive hoop.

    Despite never testing positive on any of their multiple drug tests of multiple modalities and never having a single professionalism/behavioral/legal issue or complaint neither before nor after going to them, they’ve been escalating my “treatment” and taking more and more money from me. First they increased the cost and number of drug tests. Now, due to minor compliance issues (being under an hour late for their required twice-daily breathalyzer tests) a few times, the PHP is sending me out of state for a $5000-$7000 four-day evaluation which I will have to pay out-of-pocket with student loan money. Again, I’ve been required to use this breathalyzer twice a day for nearly a year and despite never testing positive for alcohol, the PHP is coercing me into spend all this money and go to Kansas under threat of getting kicked out of medical school. There is no meaningful consent for any of this. They have a tremendous amount of power over me and no oversight.

    It feels as though this is a power-play by the director (who has no training in addiction medicine) who sees my minor infractions as deliberate insubordination and wants to punish me for that. Using medical treatment as punishment is not right, especially if it’s not even evidence-based, which these four-day evaluations are not! I don’t feel I’m being listened to by the PHP. The director has demonstrated on multiple occasions that they know little about my case. I feel depressed and defeated. I have no choice but to do whatever they say. If they require me to do an inpatient stay I will have no way to pay for it which means I’ll get kicked out medical school due to lack of compliance. Everything I’ve been working towards for the past 8 years will be destroyed leaving me nearly $200,000 in debt with nothing to show for it. I don’t know what I’d do then.

  23. mountainsbeyondmedicine says:

    I shadowed Dr. Kelley as a pre-med student and she was such an inspiring doctor and mentor for me!!! Such a bright ray of sunshine whose light was dimmed too soon😩 I was heart broken to hear about her suicide years ago. I’m so glad her loved ones have spoken up- the only way for the system to change is to acknowledge and address the problem!! Thank you for your continued hard work and efforts to expose and prevent physician suicide – mountainsbeyondmedicine on IG

    • Pamela Wible MD says:

      Oh her family would I’m sure LOVE to hear from people who knew and loved Shawn and saw her in action with patients. Thank you!

  24. Anonymous says:

    Dear family of Dr. Kelly [cc to Dr. Wible]
    So tragic, all my thoughts and prayers.
    From the many posts, it sounds like WPHP has gone “rogue”
    Perhaps a civil action in a court of law could at least send a message– and get WPHL to think twice

  25. Name withheld MD says:

    Five years ago I tried to kill myself with a massive overdose of tricyclic antidepressants. I was in a very bad marriage and really thought there was no other option for me then to kill myself. My then husband said he would ruin my life if I ever tried to leave him. Ironically I was the medical director of my practice and had a thriving and wonderful practice of medicine.
    When I woke up after My failed suicide attempt and a week in the ICU I was sent to the psych ward for 72 hours and when that 72 hours was up I was sent to a 90 day rehab in Atlanta Georgia.
    I don’t take or do any drugs I’ve never had any problems with the law, I never drank during the day only in the evenings. My only crime was clinical depression. My now ex-husband told them that I drink too much therefore the solution to my mental health problem was to send me away for 90 days rehab.
    The first few days I was at rehab they made me call my state PHP to let them know I was in this 90 day program. the Rehab said it was mandatory I let the PHP know I was getting help. I have had to pay to be monitored these past five years. The cost, time, expense and shame over being a monitored physician is crushing. This has been embarrassing and frustrating.
    I am treated by the PHP exactly the same as some other people in the program who diverted drugs had arrests for DWIs, going to work drunk or on drugs. I never did anything illegal the only thing I was guilty of was attempting to commit suicide. of note The fallout from being torn away from my family and sent to rehab for three months because I was clinically depressed -devastated and alienated me from my children, my friends, my patients, and my coworkers. it was like insult to injury. I have never felt such despair and hopelessness and the only way out was to follow their rules and submit to a program of random drug tests and mandatory AA meetings for the past five years.
    I could go on and on. But having your medical license and the threat of being outed to the medical board hanging over your head was a new version of hell.
    So basically, the lesson I learned is if you are horribly depressed And are in an abusive marriage don’t mess up trying to kill yourself or else you will be condemned to the PHP?

  26. Ron Fox says:

    I remember a resident in a cardiothoracic surgery rotation who was sliced on the forearm with a scalpel by the lead physician every time the resident made a serious mistake or moved his surgical tools in the wrong manner. The CT surgery resident fellow had several scars on his forearms from the “discipline”. He pretended not to mind and often said it was the price he had to pay for his mistakes and to be a CT surgeon. It seemed like real life slavery and rape to me as a medical student. Needless to say I had seen enough of my future and became depressed and eventually changed careers. The senior CT surgeon was later fired from the hospital but apparently he had been using the same training process at other top Ivy League hospitals for years. Pam, your tweets bring back so many memories of the abuses I witnessed in my medical school years. I just had to share this story to let it out after holding it in for decades. Thank you for this space to share.

  27. CB says:

    Reading about this really scares me. Is the purpose to destroy medical care in America? To subjugate medical professionals under the corporate health care owners until they are no better than a person who works any service job? I am hearing from more young people that they are deciding against college, against being in insurmountable debt, and this is sad. But I understand. I am considering dropping out of my masters program due to being warned about the corruption in my chosen mental health field. I don’t want to be blind sided one day by a phone call. It feels like we are now the United Mafia of America, everything must generate a profit or else. And if you dare speak up, your life is over…

  28. Beth Williamson says:

    After reading and listening to this statement it has occurred to me that the doctors who are expected to comply with the rules of confidentiality are not granted the same rights that they extend to their patients. Where then does a wounded healer turn when help is needed? Hopefully an answer will be found soon.

    • Pamela Wible MD says:

      Doctors are supposed to be superhuman and they are held to superhuman standards in which they have their human right chronically violated. I have an entire chapter in the book Human Rights Violations in Medicine dedicated to confidentiality breaches.

      Confidentiality Breach ~ When a medical student’s or physician’s sensitive and private information is intentionally disclosed or acquired by a third party such as an employer or medical institution that has power over the victim’s medical career.

      Medical students and physicians develop high rates of occupationally induced anxiety, depression, PTSD, and suicidal ideation. Yet we’re offered no debriefing or on-the-job support after witnessing trauma and death. Instead we risk interrogation and punishment by medical boards, hospitals, and insurance companies when seeking mental health care. As physicians, we comply with laws protecting our patients’ medical information; however, our confidentiality is often breached by hospitals and medical boards when we receive care. As a result, doctors either don’t receive needed care or drive hundreds of miles out of town, use fake names, and pay cash for psychiatric treatment.

  29. rita says:

    There is no way in hell I would ever try to get any type of mental health care under my own name. The PHP that I have seen collegues be forced into have been abusive and uncaring. They do not care about helping the physicians but only flexing their “power” over the physicians. I know one physician who has committed suicide over this after years of abuse and not being able to get her licensure resolved. She was one of the most talented surgical students I ever had the pleasure of working with but as she came under the care of the PHP, she became more and more dysfunctional and depressed. She complied with everything they asked of her but it didn’t make a difference in the long run. I also believe the medical boards in the various states have unchecked power to ruin a physician’s life unless they are independently wealthy to fight the medical boards as the medical boards have no one to account to.

  30. Physician health program (PHP) related suicide typically occurs during a period of extreme crises that creates an overwhelming feeling of helplessness, hopelessness and defeat. The “Cry of Pain” model states that people are particularly prone to suicide when life events are interpreted as a “failed struggle.” Unable to identify an escape from a defeating situation, a sense of entrapment proliferates with the perception of no way out, and this is what triggers suicide.

    In the 24 or so cases I am aware of almost all of the suicides were triggered by events that would most certainly be interpreted as a “failed struggle” and th perception of no way out.

    More than half were triggered by the PHP reporting “non-compliance” to the medical board. If a PHP reports “non-compliance” to the medical board disciplinary (typically summary suspension) is an absolute certainty. There has never been a case of reported non-compliance that did not result in disciplinary action and this is common knowledge among those monitored by PHPs. The majority here killed themselves before any board action was taken and a few did so immediately after the board imposed disciplinary action

    The PHP requesting a re-evaluation was the 2nd most common trigger found in 7 or so cases.
    All of these suicides occurred during the final year of a 5-year contract and most requests for re-evaluation were due random urine screens positive for an alcohol biomarker. Re-evaluations must be done at one of the out-of-state “PHP-approved” assessment centers and it is common knowledge that the 4-day re-evauations (as with the initial evaluations) result in further “treatment” (typically 1-month inpatient treatment for “relapse prevention”) followed by a new 5-year monitoring contract. Nearing the end of their 5-year monitoring contracts these physicians would most certainly know what was in store for them and felt no way out of the situation and killed themselves.

    The current PHP model constructed under the Federation of State Physician Health Programs (FSPHP) is toxic and it is irredeemable. The problem is not PHPs The problem is the extortion racket constructed by these charlatans they are calling PHPs. The FSPHP is a corrupt organization. PHPs are good organizations that have been corrupted by the FSPHP. This corruption needs to be recognized and addressed. The PHP model as it is needs to be bulldozed and rebuilt anew.

    https://disruptedphysician.com/2016/10/06/physician-suicide-and-organizational-justice-the-role-of-hopelessness-helplessness-and-defeat/

  31. Tom Horiagon MD MOccH says:

    The association of “non-compliance” designations with physician suicides in PHP needs to examined in all PHP’s. It should alarm readers to know that the Colorado PHP, and the state agency that contracts with it, announced at a public meeting this past May that declarations of non-compliance were done with no reference to any standards or PHP process. The declarations were arbitrary.

    The association of fatalities with these declarations adds to the weight of concern about PHP’s in the FSPHP model. It is already clear that CPHP and WPHP are state monopoly contractors and the population of persons that they serve are at least regarded as disabled or have a record of disability. Many of these persons may also have acute impairments.

    The point is that persons with a disability under ADA are forced into a state contractor monopoly program that is completely free to treat them in an arbitrary manner without reference to any standards. This is a systematic civil rights violation that targets a group of persons with disabilities under the ADA.

    And now, we have reason to suspect that these civil rights violations may be death-dealing. Corporate employers of physicians who send their employees to an FSPHP model organization retain liability for bad outcomes and civil rights violations.

    The liability of individual medical board members for putting these abusive systems in place is a big enough topic to warrant its own discussion.

  32. Not my real name says:

    Reading this article reminds me – as though I need a reminder – that two of my colleagues committed suicide – one due to the virtual advertisement by the PHP of his mental health problems to the community, the other one out of fear of seeking help. I personally would have committed suicide had I not rejected the entire PHP paradigm. I knew it and I also was aware that I would be giving up a career for which I am well-suited and for which I spent years in training. Better not a doctor than dead.

  33. Anonymous Doc says:

    In all, I had a terrible experience with the NY physician’s health program. I was sent there after reporting being raped by a fellow house officer. Medicine was my life and the hospital backed by the PHP put me on leave for depression. They just took away the most important thing in my life, and they wouldn’t let me back until ….. It felt like they were saying “we are going to put you underwater, and as soon as you learn to breath on your own under the water we will not let you have air”. When I moved to NJ they put me in touch with that PHP. I don’t know how many tens of thousands of dollars I spent trying to jump through their hoops. While I am licensed now, I have never been able to go back to what I loved.

  34. Pamela Wible MD says:

    In memory of Greg Miday on his birthday.

    Greg Miday was to hospital medicine what Pablo Picasso was to painting, what Babe Ruth was to baseball, what Muhammad Ali was to boxing, what Lucille Ball was to comedy. Every once in a while a prodigy is born, someone so gifted they could practice their craft blindfolded. Greg breezed through med school. he spent much of his time helping his peers keep up. He was an amazing hospital doctor. He admitted the most number of patients in one night at Barnes Jewish Hospital in Saint Louis—ever. Years after his suicide so many patients are still overflowing with gratitude on his obituary page: “Dr Miday was not only a great doctor, but a great comfort to my husband and I when my husband was in Barnes hospital. Danny (my husband) coded twice and I thank God Dr Miday was there both times. The last time I will never forget as he gave me the sweetest look and said I am bringing him back. And he did, Danny was terminal, but because of Dr Miday we had 2 extra years with our husband, Dad and Papa. So sorry for your loss, to my family he was a genius and we loved him.”

    Yet Greg was mistreated by his own profession for being human, for having anxiety (I bet most prodigies have anxiety because they are so far ahead of the rest of us), for drinking in his personal life. Bankers and realtors drink on their personal time without being policed and punished. Dr. Miday was never impaired at work. If you are ever in the ICU, Dr. Miday is the doctor you would BEG to have at your side. Yet none of us will ever have Greg Miday as our doctor. Why? He was punished by the medical board and physician health program for having HUMAN vulnerabilities in a profession that does not permit doctors to be human and have their constitutional human rights to life, liberty, and happiness respected. So at 29, Greg ended his life in a bathtub a few blocks from the hospital where he worked his ass off to save everyone else. WE LOVE YOU. <3 WE MISS YOU <3 WE WILL NEVER FORGET YOU.<3 HAPPY BIRTHDAY GREG MIDAY (11-13-82 — 6/22/12).

  35. Tom Horiagon MD MOccH says:

    The Washington state medical board seems to have received federal funding:
    https://www.fsmb.org/fsmb-foundation/foundation-highlights/  (2010)
    and 
     http://www.fsmb.org/advocacy/news-releases/federal-grant-awarded-to-expand-interstate-medical-licensure-compact/ (2019)

    So, the applicability of the Rehabilitation Act, in addition to the ADA, seems apparent.

  36. Pamela Wible MD says:

    Some information shared with me from a medical board investigator:

    1) Medical boards do have a hard time finding programs for doctors to participate in to satisfy state licensing statutes. It seems some states have more leeway than others. What may help in the struggle to get medical professionals help is to approach it through state legislative measures.

    2) Some Board have a process allowing licensees to go to one of several approved programs (mainly outpatient) for monitoring and diversion based on settlement agreements. These programs are within the state so that the state can also monitor them and the professionals running those programs. Some licensees can go to out-of-state programs if warranted and upon request (Betty Ford Clinic etc.). Monthly reports are required from each program regarding every licensee in diversion so we can monitor the progress of the licensee as well as monitoring whether that particular program is helping that licensee. Goal is first to protect the public however, also always want to get the licensee the help they need whether it is diversion or prescribing or more training in their field.

    3) From a Board’s perspective, there are a small few (more than you would think) who are always going in and out of diversion programs. Everything from patient abandonment to surgery nightmares can happen in these cases. We have doctors who literally leave patient records in garbage bags on the curb, refuse to get help and run off into the sunset. Contrary to what some might think…it is sad when we lose a physician to a ‘breakdown’ or ‘breakout’ of medicine. Many difficult decisions are made when these situations arise.

    4) Boards do try and figure out new and, more importantly, meaningful ways to help licensees while still protecting the public. It is definitely a gentle balance.

    5) Bottom line is….most Boards are willing to work with their licensees if they are honest about their situation. (It may be necessary in the future for physicians to determine where they practice based on the state Board!)

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