How physicians celebrate Independence Day—they don’t →

It’s July 4th! Time to celebrate freedom, liberty, and the pursuit of happiness.

Independence Day is a national holiday, so most Americans get the day off work—often a three-day weekend!

Family and friends gather to enjoy potato salad, apple pie, picnics, and parades. While physicians deal with fireworks mishaps and car wrecks. Some drown in documentation.

I know too many docs who collapse in bed each night atop their electronic medical records. In their pajamas. On weekends. Even holidays!

The truth is American medicine has little to do with liberation or independence. The Fourth of July is just another day of captivity for most American physicians, nearly all medical trainees—plus patients who are stuck with one-size-fits-all medicine doled out by docs who no longer act or think independently.

Once upon a time all US doctors were independent. My parents were both solo docs like me. Now most physicians are salaried factory workers practicing assembly-line medicine. In fact, 9 out of 10 doctors would not recommend medicine as a profession.

Why?

Here are a few factoids:

Pages of Medicare regulations by which physicians must abide: > 132,000

Current number of procedural codes doctors must know: 10,969

Number of ICD-10 codes doctors are responsible: 152,135

Average minutes allotted per patient appointment: 15

Average minutes per appointment doctor is on computer: > 16

Seconds before doctor interrupts patient: 11

Hours per day doctors require to deliver recommended care to patients: 26.7

Physicians who fear seeking mental health care due to career repercussions: 42%

Number of US state medical boards that punish competent physicians with mental health struggles: > 25

Number of Americans who will lose their doctors to suicide this year: > 1,000,000.

In the land of live free or die, some choose death.

I considered it.

Until I decided to live free as a solo doc.

Join me this July 4th to declare your independence.

Pamela Wible, M.D., is a freedom-loving physician who liberates discouraged doctors at IdealMedicalCare.org

Tags: , , , , ,
No Comments

***

DOJ ADA Complaint Letter Template →

Would you be willing to write a quick letter to end mental health discrimination by med boards? The DOJ is investigating physician civil rights violations by boards’ illegal mental health questions. Even if you experienced invasive questions years ago, your letter is crucial to our success now. Just 4 paragraphs. Should take 30 min. Here’s a simple template:

DOJ ADA Complaint Letter Template

 

PARAGRAPH 1  (3 sentences)

My name is _________.  I’m a (specialist) in (state). I believe I’ve suffered Title II ADA violation(s) by (state board).

Example: My name is Emma Powers, M.D. I’m a cardiologist in Alabama. I believe I’ve suffered Title II ADA violations by the Alabama State Board of Medical Examiners.

 

PARAGRAPH 2  (1-5 sentences)

Detail specific med board question violation and, if possible, include actual wording of your board’s question(s). If you don’t have access to your states’ application, reference questions here.

Example: The Alabama medical licensing application asks, “Have you received any therapy or treatment for alcohol or drug use, sexual boundary issues or mental health issues?

 

PARAGRAPH 3  (2-5 sentences)

Whether you answered YES or NO to board questions, explain impact of harms you’ve experienced as a result.

YES Example:
Because I answered YES to this question, my license was delayed by six months, and I was forced to undergo an evaluation by an “approved” (and expensive!) psychiatrist. It had been twenty years since I sought treatment for anxiety, yet they still ordered me to endure an embarrassing assessment. I have never had sexual boundary issues, nor have I abused substances–why is anxiety categorized with these?

NO Example:
I answered NO to this question for fear of the potential repercussions of answering honestly. Ironically, the guilt of lying, coupled with my fear of being “caught” caused me so much suffering that I wish I had answered honestly. I feel like a criminal–and the crime was not divulging that I have fully recovered from the anxiety of my teen years.

NOTE: I answered NO. I didn’t think I was harmed, yet here’s my letter.

 

LAST PARAGRAPH  (2-4 sentences)

State CTA (call to action) you wish DOJ attorneys take after reading letter. Read DOJ demand letter with official CTA from 3 US senators.

Example: I implore the DOJ to investigate the widespread medical licensing board violations of Title II, so physicians can get the mental health care they deserve. Given our US physician shortage, we can’t allow boards to harm doctors. When physicians would rather die by suicide than get mental health care–it’s clear something is very broken.

NOTE:   Aim for < 500 words. Provide more info upon DOJ request by including one last sentence: “For more information, please contact me.”  At very end carbon copy (cc) the letter to Senators Ron Wyden, Jeffrey Merkley, Cory Booker.

CAUTION: If letter contains Protected Health Information (PHI) you do not wish to have disclosed, either exclude PHI from letter, or (if needed for complaint) demarcate PHI section with [brackets] and redaction instructions.

ATTN: My complaint contains [PHI demarcated in brackets]. Please treat with utmost confidentiality in case of internal disclosure. If subject to public FOIA release, please redact [bracketed PHI].

HOW TO SEND YOUR LETTER

Submit your < 500-word letter confidentially to Dr. Wible here. I can edit your letter & get you confidential help for violations to your rights on Sundays @ 6 pm ET in our confidential group here.

PLEASE MAIL by USPS priority to DOJ (and all 3 senators):

1) U.S. Department of Justice
Civil Rights Division
950 Pennsylvania Avenue NW
Washington, D.C.
20530-0001

2) Senator Ron Wyden
United States Senate
221 Dirksen Senate Office Bldg.
Washington, D.C. 20510

3) Senator Jeffrey Merkley
United States Senate
531 Hart Senate Office Bldg.
Washington, D.C. 20510

4) Senator Cory Booker
United States Senate
717 Hart Senate Office Bldg.
Washington, D.C. 20510

I recommend you also submit online to: DOJ, and Senators Ron Wyden, Jeffrey Merkley, Cory Booker.

Thank you for helping end violations to physicians’ rights by medical boards and punitive physician health programs.


8 Comments

***

My medical board violated my civil rights. I filed a DOJ Title II ADA complaint. Why all doctors should do the same. →

Attention: Department of Justice, Civil Rights Division

My name is Pamela Wible, M.D. I’m a family physician in Oregon. I believe I’ve suffered Title II ADA violations by multiple medical boards.

In my 2019 study (1), I revealed how competent physician applicants who disclosed mental health conditions suffered discrimination and career jeopardy by medical boards nationwide. Senator Wyden cited my study in his 2023 letter to DOJ (2), demanding federal investigation of medical boards’ unlawful practices.

During my 30-year career, I’ve cared for patients in Texas, Arizona, Washington, and Oregon. Each state’s licensure application included ADA-impermissible mental health questions (1) unrelated to current competence—an unethical and illegal breach of privacy, confidentiality, and non-discrimination principles.

Falsifying answers to these impermissible questions risks license denial, and in some states, is a crime. Applications have threatened hefty fines—and even jail time.

Answering YES to these questions requires defending oneself in writing (in person at board request), risking costly unwarranted examinations by board-appointed non-impartial evaluators, and license delay or denial in each state, leading to similar actions in other states.

As a competent, qualified physician, I’ve always answered NO to these questions—at great personal expense.

I’ve been forced to hide my pain. I’ve never sought care from a psychiatrist (or any doctor) for work-related anxiety and depression.

Like my peers, I’ve always put on a happy face at work. I’ve consistently denied my own needs. I’ve repeatedly delayed my own care. I’ve sought off-the-grid therapists who use paper charts—to safeguard records from board subpoena. I’ve acquired psych meds on my own—so as not to be tracked by pharmacies or boards.

As long as medical boards continue to harm doctors by violating our rights under the guise of “public safety,” I can’t trust my profession to keep me safe.

In 2012, after three doctors from my town died by suicide, I asked Oregon Medical Board to track doctor suicides. Their attorney declined. They seemed disinterested in doctor suicide data.

Alarmed, I launched a free doctor suicide helpline. I’ve spent ten years listening to suffering physicians. I can tell you definitively the most common complaint I hear is, “I’m afraid of career repercussions for seeking mental health care.”

I love caring for patients as a family doctor. Yet I retired early—to care for my physician peers.

How can we serve our patients when we are struggling in silence—even dying by suicide—amid state-sanctioned mental health discrimination and punishment by medical boards?

I implore the DOJ to protect all Americans—regardless of occupation—by removing ADA-impermissible mental health questions from state medical licensure applications. Physicians must be able to voluntarily seek confidential care when needed—not deny, delay, and self-medicate occupational wounds until they fall prey to regulatory agencies that force doctors into punitive so-called “physician health programs.”

Please contact me should you need additional data. I truly appreciate your commitment to upholding our nation’s laws for liberty and justice of all.

Respectfully,

Pamela Wible, M.D.

(1) Wible, Pamela, and Palermini, Arianna. Physician-Friendly States for Mental Health: A Comparison of Medical Licensing Boards. Qualitative Research in Medicine and Healthcare 3(3):p 107-119, December 22, 2019. | DOI: 10.4081/qrmh.2019.8649.

(2) Wyden, Ron, Booker, Cory, and Merkley, Jeffrey. Congressional Letter to DOJ re State Medical Boards Violating ADA with Intrusive Mental Health Questions. February 23, 2023.

* * *

Do you fear mental health questions on board applications? Unwarranted scrutiny by board-selected psychiatric evaluators? Do you feel you must hide your emotional struggles? Avoiding or delaying seeking help? Enduring career-threatening discrimination for disclosing a mental health condition to your board? Been falsely flagged as impaired? Sent to a physician health program?

If you answered yes to any question above, your civil rights have been violated by a medical board. Please submit your DOJ ADA complaint here (you may remain anonymous).


18 Comments

***

TONIGHT: Your license at risk—responding to med board complaints & PHP referrals →

TONIGHT: Your license at risk—responding to med board complaints & PHP referrals (free event). 

Unprofessional Doctors

Have you ever been told you’re “disruptive” for standing up for patient safety?

Ever been labeled as “unprofessional” for speaking out against injustice?

Have you been coerced into a physician health program?

Maybe by an anonymous complaint?

You’re not alone.

A physician health program (PHP) sounds like a haven for injured doctors, yet . . .

“PHPs remain largely non-compliant with ADA laws in assessing medical and psychiatric fitness of physicians. They receive revenue from contracts with physician employers and residency programs plus referred med students and docs who pay costly out-of-pocket fees or risk career destruction. Physician employers liberally refer to PHPs for virtually any reason. PHPs even encourage third-party referrals. Aggrieved spouses, jilted lovers, market competitors have all successfully required PHP evaluations of physicians.” ~ Occupational Medicine Physician

Yep, anyone can submit an anonymous complaint about you to your medical board. You could be coerced by your board or employer to enter a PHP (without knowing your accuser or even why you’ve been referred).

You may be 300K in debt with more than a decade of specialized education—and one anonymous complaint could undermine your career.

I know several docs who have died by suicide while in physician health programs.

Meet one doctor who died in a PHP here.

What would you do if you faced an anonymous accuser and had to defend yourself from a med board or PHP?

Join us tonight for a free town hall to answer these questions. (event is over though you are welcome to join our ongoing support groups),

Need more support to emotionally and professional recover from trauma related to med board complaint, PHP referral, or other retaliation from a hospital, med school, or employer? join our Sunday physician peer support group.

Tags: , , , , , , , , , ,
2 Comments

***

3 US Senators Demand DOJ Investigate Medical Boards →

An attorney just notified me of this letter submitted to the Department of Justice citing my 2019 journal article documenting widespread mental health discrimination by medical boards. Read letter below or download original document with citations here. If you’ve ever been harmed by a medical board (or PHP), please contact Dr. Wible. You could be instrumental in ending mental health discrimination against physicians.

* * *

Dear Attorney General Merrick Garland, Assistant Attorney General Kristen Clark, and Disability Rights Section Chief Rebecca Bond:

I write to encourage the Department of Justice (DOJ) to extend its investigations of offenses under the American Disabilities Act (ADA) to include the practices of state medical license boards. Many of these boards ask physicians about their mental health and substance use or addiction history, beyond what is necessary to fulfill the purpose of screening physicians for current, debilitating cases of mental illness and substance use or abuse. These questions both discourage many applicants and licensed physicians from receiving care that they need, and they violate Title II of the ADA, which forbids public entities from discriminating against qualified individuals on the basis of disabilities, including mental health conditions. I know that you share my goals of protecting health privacy, encouraging a robust medical workforce, promoting mental health care, and enforcing the ADA, and so I write to ask you to prioritize this concern by issuing DOJ guidance and holding state medical boards accountable.

States oversee the qualifications of their physicians as part of the power to protect the health, safety, and welfare of its citizenry, but some of the questions that many state medical boards ask of physicians on their initial licensure exams and renewals are, according to the American Psychiatric Association, the American Medical Association, and the Federation of State Medical Boards, irrelevant to assessing current ability to practice. In fact, several peer-reviewed journal articles estimate that two-thirds of state medical boards violate Title II of the ADA with personal, taxing, and unnecessarily broad questions about doctors’ psychiatric history. The repercussions are not just a matter of law, but they also inform the practices of hospitals, health plans, and malpractice insurance companies, and impact the medical well-being of physicians.

A 2019 study looked at initial medical licensing processes in all states to determine if qualified applicants who report mental illness experience discrimination and to identify the most physician-friendly states for mental health.

The authors ranked Alaska as the worst of all states when it came to invasiveness of mental health questions on initial licensing applications with 25 yes-or-no questions including:

“Have you ever been diagnosed with, treated for, or do you currently have: followed by a list of 14 mental health conditions including depression, seasonal affective disorder, and “any condition requiring chronic medical or behavioral treatment.”

The District of Columbia asks two questions, both unrestricted in time and the second “broad and subjective given that one anonymous and unsubstantiated complaint can lead to a physician [Physician Health Program] referral and undermine a doctor’s career”:

“Have you ever entered into a monitoring program for purposes of monitoring your abuse of alcohol, drugs, or other controlled substances?”

“Have you ever entered into a monitoring program for purposes of monitoring your professional behavior including recordkeeping, billing, boundaries, quality of care or any other matter related to the practice of your profession?”

Georgia’s application does not directly ask impairment or mental health questions, but requires three separate peer references to answer whether the physician has or had in the past any mental or physical illnesses or personal problems that interfere with their medical practice. “Personal” problems are open to interpretation and there’s no indication that any assertions contained in these references must be substantiated by evidence.

These kinds of questions go far beyond conditions that could impair qualified individuals and may require comprehensive disclosure of one’s medical and professional history.

Even though physicians face an inordinate amount of stress—their burnout rate is 50%, twice the general working population’s level—many avoid seeking mental health support due in part to these questions. In one survey of women physicians experiencing mental health difficulties, 44% of respondents who did not seek treatment cited licensure questions as a reason why. In another survey of surgeons who experienced suicidal thoughts over the previous year, 60% said the questions would make them more reluctant to seek help. Physicians have had one of the highest suicide rates of any profession, and the pandemic has exacerbated suicide risk factors. Troublingly, there have also been reports of unwanted mental health support or assessments as physicians have reported retaliatory inquiries into physical, mental, or emotional health and referrals to impaired practitioner programs.

The DOJ oversees professional licensing bodies and has previously intervened when those bodies violated Title II of the ADA. For example, in 2014, the DOJ advised the Vermont Human Rights Commission about the unlawful nature of questions by state law boards about mental health history. Later that year, the DOJ investigated the Louisiana state law board for questions that violated Title II of the ADA. The DOJ also staked out a similar position in the case of state medical boards, writing in a 1993 amicus curiae brief before the U.S. District Court for the District of New Jersey that the New Jersey Boards of Medical Examiners’ “focus on past diagnoses and treatment of disabilities rather than conduct that cannot be deemed justified.” Nevertheless, to our knowledge, the DOJ has yet to open an investigation into a state medical board for violating Title II.

I urge the DOJ to investigate state medical boards’ compliance with the ADA. The DOJ should also issue guidance on 28 C.F.R. § 35.130 to clearly state that state medical boards cannot ask inappropriate medical licensing and application questions, especially questions related to mental health history. In the interim, I ask that you provide me with complete answers to the following questions by March 16th, 2023:

    • Does the DOJ have additional information, beyond the scholarship mentioned above, about the extent and different ways state medical boards may be violating Title II of the ADA? If so, please explain what it has learned.

    • Has the DOJ’s Civil Rights Division been engaged on this issue during the last several years? If so, please explain what work they are doing.

    • Does the DOJ stand behind its 1993 amicus curiae brief in Medical Society of New Jersey v. Jacobs? If so, can it commit to publishing a version of it in the form of subregulatory guidance?

    • How will the DOJ ensure that all state medical boards comply with the law and affected applicants or physicians have recourse?

    • Has the DOJ examined similar issues when it comes to residency programs and hospital privileges?

I also ask that you brief my personal office staff members Jenni Katzman and Kevin Wu on these questions.

Thank you for your attention to this important matter.

Sincerely,

US Senator Ron Wyden

US Senator Jeffrey A. Merkley

US Senator Cory A. Booker

* * *

Read Dr. Wible’s letter to the DOJ

Submit your own letter using simple DOJ complaint template

Video & commentary on DOJ letter here:

If you’ve been harmed by a medical board (or physician health program), please contact Dr. Wible.

Need help healing after abuse? Join our physician trauma recovery group.
Tags: ,
59 Comments

***

ARCHIVES

WIBLE’S NPR AWARD

The doctor who saves doctors

Copyright © 2011-2025 Pamela Wible MD   ❦   All rights reserved worldwide   ❦   site design by Pamela Wible MD and afinerweb.com