Guilty regardless of the evidence to the contrary

They Fell like Dominos: My License, My Certification, My Profession

They fell like dominos, one after another: first, my medical privileges, then my Ohio Medical License, then my state license, then my board certification, finally my DEA license. While, like most physicians, I had concerns about malpractice suit, a medical board investigation never crossed my mind.

I suppose that’s why the certified letter from an investigator with my state medical board took me by surprise. I was alleged to be “an unregistered terminal distributor of dangerous drugs.” I told the investigator everything. I hadn’t distributed anything. Seven months previously, my husband of 37 years announced that he was getting a divorce. I had no home, no marriage, no job, no doctor, not even a car. I couldn’t stop crying. I couldn’t eat. Worst of all, I couldn’t sleep. I tried alcohol; it didn’t help. In desperation, I had ordered a bottle of Xanax from a wholesaler.

That was it. I signed a release of medical records to confirm my statements and document the help I was getting and the progress I was making. I hadn’t seen any patients during that time, violated any laws, or driven under the influence. Since I wasn’t in any legal jeopardy, I didn’t need a lawyer.

Then the second certified letter arrived. The Board had reason to believe that I was “unable to practice according to acceptable and prevailing standards of care by reason of mental illness or physical illness…” I was ordered to submit to a forensic psychiatric exam. Failure to do so would constitute “an admission of the allegations…and a default and final order may thereupon be entered without the taking of testimony or presentation of evidence.” If I didn’t submit to their demands, I could lose my license.

The interview went smoothly. I had no personal or family history of alcoholism or addiction. I could spell W-O-R-L-D backwards. I did my serial 7s down to 57 and my presidents down to Kennedy, at which point the psychiatrist had said, “Enough!” I was still in therapy and taking an antidepressant, but I was back to work and feeling good. I thought that was it.

But again, I was wrong. Four months later, I got a third certified letter. This time the Board ordered me to submit to a 72-hour inpatient addiction evaluation. Knowing what was at stake, I submitted.

When I arrived at the rehab hospital, my phone, wallet and keys were confiscated, and my car, suitcase and body were searched. During my stay, I was assailed with questions I couldn’t answer, questions like “What’s your drug of choice?” and “Does your family know about your addiction?” I submitted to observed urine drug tests, sleep deprivation and hours of interrogation, group therapy and lectures on alcoholism. The cognitive dissonance was unbearable.

On the morning of the third day in rehab, I was told that, since I was still in denial about my addiction, I would have to stay in rehab at least 28 more days. I had packed for three.

I refused. I was reminded of the consequences to my career. I still refused. I had given the rehab hospital permission to contact my husband, my daughter, my brother and a longtime colleague. They would confirm that, except for that brief period, I was the epitome of sobriety. The nightmare would be over.

It wasn’t. Six weeks later, the fourth certified letter arrived. It stated: “We have reason to believe that you pose an imminent threat to your patients and we thereby are suspending your medical license.” I had to stop practicing immediately. I could have a hearing. It would be adversarial, but it was my last chance to salvage my career.

I prepared assiduously in the 15 days leading up to the hearing. I was an articulate, consistent and contrite defendant, but a terrible lawyer. After eight hours of testimony, the Board’s lawyer concluded that my children were enablers, my spouse was lying, my colleagues were clueless and I was a hopeless drunk full of excuses. Nonetheless, I was hopeful.

Shortly thereafter, the fifth certified letter arrived. I was offered a chance to face my accusers, the eight members of the state medical board, for five minutes at a public hearing. I took the offer. Three and a half minutes into my statement, the Board’s spokesman interrupted me and read a perfunctory statement echoing their lawyer’s sentiments. I was numb.

Two weeks later, the sixth certified letter arrived. It said, “There is clear and convincing evidence that you are impaired in your ability to practice medicine and your Ohio license had been permanently revoked.” The seventh certified letter said my state license was suspended, the eighth, that my Board certification was revoked, and the ninth, that my DEA license was invalidated.

It’s taken me months to be able to write about this. Months to get past the shame of a personal crisis made public, to recover from the pain of the ordeal, and to accept that never again could I practice the profession to which I had dedicated my entire adult life.

I have learned over these months that countless other unwary practitioners have been victims of the same disciplinary fervor. I know now that, to keep their licenses, most of these physicians will submit to what’s demanded of them and they will stay silent to protect their reputations. I, however, was physically, emotionally and financially unable to submit to my Board’s final demand. As a result, I lost everything professionally. I have nothing to lose by speaking out.

My colleagues need to know that if a Board investigator contacts you, you must immediately contact your lawyer. Unlike in a civil case, Boards can presume you’re guilty and ignore exculpatory evidence. Unlike in a criminal case, Boards don’t have to advise of your civil rights because you don’t have any. They can coerce you into medically unnecessary treatment, rob you of your personal freedom, publicly defame you and deprive you of your livelihood, all with complete impunity.

State legislatures cannot abridge the civil rights of its citizens. However, they allow state medical boards to do so based on the rationale that medical professionals must adhere to higher standards than average citizens. I accept that. However, boards should not be allowed to violate our civil rights when evaluating whether or not we are adhering to those standards. Perhaps in the long run, we can repeal the laws that allow this travesty. For now, any of you who can speak up, please do. Talk to your colleagues, your medical society, your state representative. For those who can’t speak up, please know this: you aren’t a pariah, you aren’t worthless, and you definitely aren’t alone.


7 Responses

  1. Obviously this narrative is for physicians. My management specialist is following the 2016 CDC “guideline” to the letter. I am…was a state licensed building contractor for 29 years, 37 years, self employed and like physicians had everything to lose if I made mistakes so I understand the dilemma. Even though I did not have to be schooled except at the school of hard knocks, the “guideline” cost me everything too. My business, my home, my religious commitments, any social activity, our home, and our life savings now in just over two years after the “guideline” requirements were forced on my current spine pain management specialist of 9 years. The prior specialist treated me with the same medication for 14 years and the current physician has treated with the same medication as the first without an increase in dosage for 9 years prior to an 80 percent reduction in medication as per the “guideline” requirements of 90 mme daily….maximum. So sorry to see lives being destroyed, and lost in the effort to “save” lives as proposed would happen with the DEA enforced, state medical boards and regulators “adopted” (as state regulators say)the CDC “guideline” We all know the definition of “insanity”, doing or attempting thee same task or item over and over with failure ….expecting a different outcome.

  2. I had a similar experience.
    Not even “guilty until proven innocent”
    Just guilty.
    Once they set their sights on you,

    This system is feudal.
    Unchecked, as in no checks or balances.
    Run by appointed people who are completely unaccountable.
    No recourse.
    In the name of “safety”,
    With no evidence of harm.
    Like a trip to the Gulag.

    The key is for patients to realize that doctors have become so vulnerable that we cannot risk ANY exposure to ANY accusations.
    This risk-averse environment is due to the hostile regulatory environment we now have.

    So, as more and more patients despair over being abandoned by this system, the sacred physician patient relationship is further tarnished.

    I, for one, will continue to stand by the patients I can, and pray for those I cannot, and attend some of their funerals.

    • I respect you DR. Isben for continuing to be an advocate for the patients that you are able..and speaking publicly about it.
      I for one am greatful to you.

  3. The author of this story needs to join me on to change the current situation we work under. The BOM is an extension of the DOJ, all of which has gone rogue. Put your experience to work. You have a mission.

  4. The situation in this country is so far beyond insanity that an entire new vocabulary needs to be created. I know one doctor who is drunk, 24/7/365, and who has been practicing in that state for many years. But since the person very rarely prescribes pain medicines, the person will no doubt continue treating people & performing operations while drunk as a skunk.

    My heart goes out to the physician in the story. I gotta admit, tho, that the description of the Board’s behavior is exactly what every pain paitent goes thru with nearly every single med professional, pharmacist, and layperson in the country now: “…presume you’re guilty and ignore exculpatory evidence. …don’t have to advise of your civil rights because you don’t have any. They can coerce you into medically unnecessary treatment, rob you of your personal freedom, publicly defame you and deprive you of your livelihood, all with complete impunity.”

    Moreover, every time a CPP is deprived of the medications that permit them to function, to work, & to have a life, society celebrates another victory over an addict so worthless that they don’t even admit to being addicts. The only people who think it’s wrong are those inside the situation….& therefore largely powerless.

    • All true. Which is why all stakeholders in this issue need to pull together.
      If doctors had protection, patients would get what they need. So, if doctors aren’t the problem, and patients aren’t the problem, and pharmacists aren’t the problem, who is pulling the strings?

      • Mark;
        I’d put my money (if I had any) behind Killer Kolodny & his ilk*, who put so much work into guiding the national narrative so that they could then rake in the millions from their addiction clinics after they convinced the guv morons & lay people with their really effective PR…Himmler must be smiling up at them from Hell (& probably thinking that he should’ve owned crematoria when he was in Germany).

        Bless you, Sir, for continuing to try & treat patients, and for fighting against the tide. I’m not convinced anything is going to force a diversion of the insanity (certainly facts aren’t getting anywhere against the Oregon Idiots & their insane, draconian proposal)…I'[m not sure I hope I live long enough to see things turn around or not. That seems like an amazingly dreary & agonizing prospect, without the meds that I was stable on for decades that enabled me to function.

        *may they all get permanent, unspeakable pain & no treatment

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