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.

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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.

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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

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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.
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To the anonymous suicidal doctor who lost his job for standing up to abuse →

I just got this email from an anonymous physician named “Still Hurting”

Dear Dr. Wible,

I’ve written before, hoping you would answer in some anonymous fashion on your blog.

I lost my career for standing up to abuse. I have no income, failing resources, limited health insurance that is exceedingly expensive, and several illnesses that will bankrupt me even with “insurance” (that’s what America is all about). I lost all the doctors I had for decades. I call other doctors, but their practices are full. Soon I’ll run out of money or die from lack of medical care, whichever comes first.

I am a broke doctor without a doctor, and no doctor seems to care.

And some say this is still a noble and just and good profession? Absolutely not.

The profession buries people like me just like they bury and forget the suicided. We just die in a slightly different way, euthanized through neglect, bankruptcy, despair, soul-killing days that endlessly stream into weeks and years of lost time until that once bright soul that loved people and life is so starved of love and acceptance it simply disappears, lost in time, forgotten, withered to ash, starved of purpose, love, human and social belonging—everything we worked for all our life. We die with all the accumulated pain of having had to experience the abuse and tragedy of being a physician in the United States of America. A soul death much worse than any physical death. And probably the reason why so many doctors choose physical death by suicide.

I loved medicine and science. I believe science only advances when opposing views are respected. Science is not consensus; it’s endless debate, disagreement and differences of opinion.

I lost my career over this belief.

The abuse I stood up against was unfathomable. Our hospital forced physicians to give up our right to bodily autonomy—to make decisions about our own health. They used coercion, threatened livelihoods, and forced all physicians to submit to an experimental medication without reviewing the data and deciding for themselves whether it was a good drug for them or not. With no evidence of safety or effectiveness, I refused to take it.

How can a so-called “caring, compassionate, and noble profession” advocate such a breach of medical ethics? What kind of profession, what kind of country, what kind of people would take away all that a person worked for all of their life, all of their resources, just over an experimental medication?

Without data, there can be no scientific evidence that this experimental “vaccine” would stop transmission, no scientific basis for segregation, discrimination, human rights violations, killing physicians by taking away their livelihoods.

I was always willing to be tested, to wear a mask or PAPR (how could you argue with that if concerned about respiratory spread?) But no, I was eliminated from the “profession,” like the lost, forgotten, silenced voices of all physicians you track who died of suicide.

The vaccine mandate ended my career and my life.

My letter is anonymous for good reason. I’ve spoken out before, and when I did the abuse and retaliation only increased. I cannot imagine what more would happen if I identified myself further. But, actually, I do know.

Still Hurting

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Dear Still Hurting,

1) I am a doctor who cares about you. I feel your pain. I’ve been reporting on human rights violations in medicine for more than a decade. Assaults on physician humanity are longstanding, premeditated, and well-orchestrated to disempower the most ethical and integrous among us—for profit and control.

2) Please read my free ebook, Physician Betrayal: How Our Heroes Become Villains (quick 20-min read) that details the methodical dehumanization of idealistic humanitarians beginning in med school—and how to retain your soul amid institutional betrayal of physicians (and patients).

3) Your career is not over. I’m so busy helping suicidal physicians I retired my license to devote myself full-time to healing our misguided profession. I’m more effective than ever (even earning more without a license!). Open your mind and heart to all of your career options. I can help you. Imagine having your own coaching practice (like me) where you’ll never be mandated to experiment on human beings again.

4) Join our peer support group full of physicians who feel exactly as you do. Isolation is deadly. You can heal.

💕Pamela Wible, M.D.

P.S.  I just called the phone number in your anonymous letter. Please call me back.

 

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Two doctors (unknowingly) stop each other’s suicides →

Few things shock me.

I run a suicide helpline—for doctors.

I’ve talked physicians off the ledge, out of their noose, away from their guns.

I thought I’d heard it all.

Yet today took my breath away. Two doctors (unknowingly) stopped each other’s suicides.

Nobody was prepared for what we heard in our physician peer support group.

Our group began amid the pandemic when docs contacted me from as far away as Poland, India, and New Zealand. As one person, I could no longer manage the volume, so I led group calls for suicidal doctors. Those eventually morphed into our Sunday physician trauma recovery group.

As far as I know, I maintain the only international doctor suicide registry. I’d like to stop adding names to my list. Our trauma group offers a safe space for doctors from around the world to heal together. Several claim our group has prevented their suicides.

For those who don’t realize the tremendous power of peer support, here’s an excerpt of what you missed today. Published with permission.

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Lynette: I’ve been in this trauma group a year though I’ve not been coming lately. I’ll explain why: After my family doc I truly love retired last year, I planned to continue with the “new doc” who’d be taking over her practice. Then I got a call that the new doc was dropping me before meeting me, but refilled my meds for three months to give me time to find another doc. I’d been stable and high functioning for 20 years on meds for major depressive disorder and ADHD. I was unsuccessful finding another doc, so last month I began to self-titrate, knowing an abrupt discontinuation was gonna be “not good.”

Not good, turned out worse than I imagined. I sank deeper into a dysfunctional depressive hopelessness with ADHD-exacerbated helplessness. Trajectories filled my brain all moving different speeds and paths, pinging, orbiting, colliding, overwhelming and eventually I walked into my backyard, found a good spot in the bushes that would be easy to hose down and got on the ground with my “38 special” loaded and held against my head.

Seconds from ending it all, pings were racing in my head, then one grabbed ahold of me and filled my brain—“Angela!”

When the thought of Angela overtook me, I couldn’t pull the trigger.

Angela’s my savior. She’s here today and she’s greater than the greatest great. I’d been avoiding her and everybody else’s calls for months, but one night a few weeks ago I answered. After we spoke she took it upon herself to find me a doctor. She called so many, screening them until her standards were met. She scheduled my appointment on March 27. I didn’t kill myself on March 24 in my backyard ‘cause I needed to make my appointment—for Angela!

Pamela: Wow, Angela. Amazing. Lynette, we’re so glad you are still here. Do you have a question for us? How can we all help you now?

Lynette: My question is what’s the closest you all came to suicide? And what turned you around?

Erika: Close! Two years ago, I found myself standing over a drawer of kitchen knives, thinking none of them would do the job properly. The fact that my own mother would find my body didn’t even matter to me. I was in a dark place in quarantine. Drank day and night to numb my pain. Reaching out to a helpline turned out to be a disaster. I felt foolish. Time and sick leave helped. I wish I knew about this group then!

Hannah: Lynette, this past Friday I cleaned out all my things and made a to-do list for my husband. Made sure my finances were taken care of. When I googled easiest and most foolproof method, I found Pamela and she convinced me to at least try this group first. I was close, but I don’t own a gun. Do you have someone who can hang on to your gun?

Jeff: Thanks for being vulnerable and trusting us with your story. Closest I came was after a tough shift when I felt the weight of my mistakes and considered what it would look like to just keep driving into a railing. What stopped me was prayer—I’m Christian. I was filled with an unexpected feeling of comfort that allowed me to make it safely home. I ended up taking the next day off work and it was restorative.

Priya: The time I got closest was after the second suicide in my residency in a year. I figured I’d be the third. After a 24-hour call, I went up to the hospital roof and just stared at the ground through my tears. What stopped me was the decision to leave training.

Lynette: Thanks so much y’all. I thought I’d cry today, but not sob like I am now. Priya, I totally understand ‘cause the thing about suicide for me is it offers comfort, a sense of relief, knowing if things get too painful or I just don’t wanna deal with it anymore I can make it be over in seconds.

John: That’s exactly what suicide is for me—having an “escape hatch” is a comfort. Only people like us can possibly understand. That was God—Spirit, Master of Light, Adonai—working through you Lynette. God isn’t up there inaccessible. He’s here on earth working through people like us.

Kendra: I see you Lynette. I hear you. You’re so brave. Like you, I feel suicide provides an option for comfort. I too find myself isolating and avoiding calls and texts. When I come as close as you, thinking of my family helps. Two months ago, I was so close. I tried to reach my mom by phone and was unsuccessful. I tried to reach out to church and got a voicemail. I felt abandoned by family, friends, God, and I didn’t think I’d make it through the night. Sarah—who I met in this group a year ago—stayed on the phone with me from 2:00 am until daybreak. I knew if I saw morning I’d survive the next day’s challenges. I’m so glad I’m still here.

Brittany: I can’t find the words to explain how close I’ve been, but I’ll write and share next week. I’m overwhelmed—this is like a spiritual experience hearing from you all, knowing I’m not alone and you beautiful people exist. I thought Zoom was for corporate meetings. I’ve never felt anything like this.

Pamela: Brittany, we’d love to hear your story next week. Angela, would you like to share now? What’s it feel like for you knowing you saved Lynette’s life?

Angela: A year ago last month, just after Ash Wednesday, I proclaimed my suicide plan. Plotted, planned, calculated. I had mom’s leftover hospice meds plus enough beta blockers and narcotics thanks to patients who tossed old pill bottles at me. As an overachiever, I needed to set everything up, get legal counsel, make a trust for kids, ensure everyone gets an education, leave no debts.

And that Friday night, getting dumped by a guy I didn’t find physically attractive, I said the heck with it. I’d cleanly finish the job. Seemed logical and do-able to me like most things I attempt. Why bother living? Trapped hostage in a marriage. Trapped for now by minor kids. My mom and aunt had just died. I put so much effort into everything with such little return. I’m not stupid: my patients will be taken care of by someone else. VOILA! Make sense?

Then, 36 hours later, out of the blue, Lynette’s sleepy voice was on my noon voicemail groggily croaking out something about a 500-word essay she had two hours to finish for a trauma meeting. I had to listen to it three times ’cause I found it ironic she’d be calling me after my rough week with no preconceived notion of my recent romancing. I’d just been dumped for a trauma surgeon. Let that digest for a bit while I’m hearing of a physician trauma group suggested for me. Was this to review trauma cases? Was this only for physicians who were physically assaulted? What’s a physician trauma group? Why was Lynette calling to tell me about it right then? My mind spun.

Lynette read her essay she’d written for Dr. Pamela’s group and by next Sunday I was hooked. Lynette coached me through the ridiculousness of my statements, her own suicidal thoughts, purging of toxic folks around us—I got rid of two, coming up on three soon. She listed my many accolades in her irreverent way and nick-named the doc who dumped me in words that still make me grin.

Lynette got me off the ledge without discounting what I was feeling or saying.

As did the rest of you.

I’m now happily divorced, thriving in my social life, enjoying my kids, exercising when I want to not because I’m “running away from something,” drawing a boundary with my narcissistic dad, feeling happy for the first time in a long time—and hopefully helping spare other docs from making similar mistakes!

I love you Lynette!

I pray for everyone here and send good vibes. No matter who you deify or not—who can say a higher power wasn’t at play when Lynette saved me that Sunday morning cluing me into the power of our trauma group?

Kendra: To all the new people, try the buddy system. Find someone here you can call 24/7. CALL THEM when you need to. The physician from our group who helped me through the night was not just a buddy. She’s my lifesaver and is now a lifelong friend.

[After our session I called Lynette and Angela. I wasn’t the only one in shock. They were both shocked to learn they’d prevented the other doctor’s death. Neither had revealed their near-suicides until today.]

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Note: First names have been changed since all doctors may face career suicide for admitting their pain.

Join a peer support group here.

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Is suicide a good option for me? →

A physician just wrote me:

“I know people try to prevent suicide at all costs, but on the flip side if someone is just suffering so much everyday, couldn’t it be considered the lesser of two evils? Everyone says it’s such a selfish act, but maybe the person needs to be selfish to get out of pain. How long is a person supposed to suffer? What type of life is it to sit around and suffer?”

I’ve been running a doctor suicide helpline for more than a decade and have spent thousands of hours speaking to suicidal doctors. Here’s my advice to you:

1) Ask yourself if you are terminally ill. Suicide is a legal option for terminal illness. I live in Oregon, the first state to legalize physician-assisted suicide. I’ve helped my terminally ill patients with physical illness and less than 6 months to live die by suicide. Is your illness truly terminal? Mental illness is rampant and poorly treated in our society. Most are suffering due to lack of treatment.

2) Explore ALL your options. Even most doctors who seek help receive only conventional drugs. Have you been offered curated peer support, spiritual therapies, or psychedelic ceremonies? Have you tried ALL of them with consistency? Don’t dabble haphazardly on your own. Find an expert guide and/or facilitated program for physicians that offers a safe, structured environment for your healing.

3) Avoid the term “treatment-resistant depression.” When allopathic interventions fail  that does not mean your illness is resistant to complementary therapies. Integrative psychiatrists know that rewiring our neural networks is possible. Are you working with the right psychiatrist? Some offer a holistic and “sacred” approach to ECT and EMDR. Most physician-patients are unaware of all their options—and have no idea how to find reputable and safe non-standard therapies. One doctor shares:

“The Sacramental use of psilocybin or other entheogens was the most effective approach for me. Ceremonial use of these medicines brings in the wisdom of age-old traditions that use these Medicines to help us reconnect to ourselves, not as a solution for any particular malady but as a way to return to balance and in turn, finding deeper understanding, improvement or resolution of our depression.”

4) Use curated peer support as your first-line treatment. I suggest highly targeted peer support as the foundation of any suicide prevention plan. Isolation and loneliness is immediately ameliorated in a properly facilitated group with members who have similar emotional wounds. I’ve been leading physician peer support groups for years. Share your story. Don’t suppress your tears. Most of the time, what is needed is human interaction. One surgeon reported: “Spending two hours with you all was more helpful than any therapist I’ve seen, anything they did on inpatient psych, any help I’ve gotten yet.”

5) Consider suicide a failure of community. When suffering is individually pathologized, the person is blamed for their condition. When we recognize that the “illness” is a normal reaction to an abnormal or traumatic situation, the wisdom of the individual’s psychological response finally makes sense. Recognizing societal influences and community/family dysfunction that lead to suicidal thinking is crucial. Evaluate your ACES (Adverse Childhood Events) to help you discover your family-of origin-core wound. Reference: Did your wounded child choose your career?

6) Identify your core wound. Most suicides are a culmination of many factors poorly managed over years. Discovering the origin story or genesis of your core wound will allow you to successfully address your primary issue (versus just dealing with the sequelae of your untreated core wound). If you feel detached from your inner core, find a hobby that brings you pleasure as a way to find yourself again. Sometimes our core wound is grief for the a loss of self or self image.

7) Know that suicide is an occupational hazard of your profession. Physicians are dying by suicide triple the rate of their patients. Why? We’re groomed in an atmosphere of self-betrayal and self-abuse. Hazardous working conditions lead to destruction of our own health and personal relationships with family. Physicians are placed on a pedestal until we can no longer perform—then we are vilified. We are not allowed to be human and are disconnected from our feelings, emotions, and spiritual core. Reference: Physician Betrayal: How Our Heroes Become Villains.

8) Realize that you are a spiritual being living a finite human experience. As physicians we are cut off from our humanity and untethered from our souls. Shells of our former selves just going through the motions with no passion or zest for life—a direct result of the methodical dehumanization of medical education and practice. I’ve interviewed many physician survivors of suicide attempts. All are grateful they are alive and regret their desperate decision. Many now feel a renewed sense of spiritual connection and purpose.

9) Believe your condition is curable. When offered holistic interventions and removed from hazardous working conditions, most all physicians heal quickly. Doctors have curable mental health conditions that often began in childhood and were exacerbated by medical training and practice. One wise physician (who lost her own physician husband to suicide) shares:

“I consider no disease terminal until you think so—and self motivation is the key what you want to do with your life. If you think you will get better—you will. Spirituality says the same. You become what you believe you want to be.”

10) Your suicide is a terrible option for a curable condition.

Need to talk? Contact Dr. Wible.

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