Sham Peer Review

by admin on 07/20/2018 12:55 AM

PSYCHIATRIC EVALUATIONS ARE HAZARDOUS TO THE DOCTOR’S CAREER.

By Richard B. Willner, Executive Director of The Center for Peer Review Justice

http://www.PeerReviewJustice.org

In this day of excessive regulation and hindsight aided evaluation a new danger is even more pressing.  Various administrative boards that are established by states, the federal government or associated agencies maybe have their origin from well-meaning agencies.   The history of unbridled power almost invariably asserts itself with some sort of self-appointed expertise.

This expertise becomes one of defining a problem, in this case some type of professional practitioner, and then looking, searching for the reasons to label the professional. The complainant and the reported complaint, assuming there is a complaint and is not made up by whole cloth by the agency, is always asserted as “secret” – “confidential” so the professional has no capacity to discover from where the allegation arose. 

Certainly there are circumstances where protecting the identification of the person making him a complaint is important.

However the rights to defend oneself, to inform the investigating organization of the experience the practitioner did or did not have with the complaint and is an imperative. . .

Without careful oversight agencies are boards such as this especially become real “star chamber proceedings” It all comes to the practitioner to defend himself or herself against the allegations that can come without foundation or merit. The practitioner of course enjoys a licensed practice as long as such practice ethical, competent and within the standard of care…

However, allegations without merit taken up as an investigation, said investigation is without day-to-day ongoing oversight, the investigations by “investigators” who only know to look with their needing to find. These investigators are not trained, and enjoy the self-righteousness of being separated apart from most of our grounding and trust of our judicial system. . .

The courts and the associated investigation powers that would be afforded an average citizen do not apply.  The license to practice is a privilege and obtained by proper training, and controlled certified institution from which the practitioner must graduate in good standing. Then the practitioner needs to pass an additional state board exam in the and the relative relevant field. There is also the requirement of ongoing continued education credits. It seems   relevant that the practitioner being in compliance with the particular agencies requirements to be licensed and to continue the license should be a prima facie, prior established, the starting point…

The new rubric, the catchall, the moneymaker, the real “food for the trough” is the very plastic and flexible label of being a disruptive practitioner. A disruptive practitioner, to say the least, could be angry and upset and appear disruptive for very laudable reasons. The complaint and making a report about any particular station time.

It perchance over expression of the concern that truly was dramatic to the practitioner but observed and reported to the control agency know set fact pattern of the specifics associated with the observed practitioners “disruptive episode” as it appeared to the reporting complaining person when contacting the agents.

Patterns of referral from the agencies to particularly designed clinics a.k.a. peer-reviewed procedure mills becomes a for loop of income far above that was the average practitioner would make in practice. The self-appointed, unregulated, “expert collection of evaluators” expert only in the sense there is no way for the practitioner to challenge their procedures, the message or the conclusions…

A practitioner required to defend themselves from the fact pattern they have not been part of presenting impossibility. The agency sees this as “defensive practitioner” reinforcing the opinion concerning the original report notwithstanding the validity of the report has not been challenged, scrutinized authorized by an statute or court of law…

These boards and agencies of self-appointed expertise are and have been known in many circumstances to be new “Little Caesars” of current time. The reports are confidential and are forwarded to the referring agency before the practitioner have a chance to review or augment or challenge the substance of the report…

This label – DISRUPTIVE PRACTITIONER – is like indiscriminate glue applied to find tissue paper. Removing without tearing up the document unless the substance is written – the tissue paper – is impossible. Envisioning the  tissue paper as a professional reputation, the self-esteem of the practitioner, the practitioners immediate families struggles with the unproven allegations and additionally the massive emotional costs to say nothing of the burden some financial costs and demands on professional time as well…

Certainly there are conditions that one can suffer from that would be causal for the loss of capacity to control one behavior, to become disruptive. This could be secondary to an injury, secondary to the disease, secondary some abuse of the subject, or secondary to a very slow-moving process of  which the practitioner is unaware. One example would be the onset of the dementing illness.  The sadness of seeing a fine mind loses its capacity is tragic. Clearly someone, a practitioner, should not remain in practice if they lost his skills. However, Justice is not served when a reported behavior is assigned the same significance as would a formal diagnosis of the dementing illness…

Disruptive is a description not a condition. Those asserting the disruption should be required provide documentation that can be objectively reviewed and if possible corroborated and its origin understood. The money mill peer-reviewed factories often are communicated with by the referring agency before the practitioner is ever seen for evaluation…

This is a crisis within our society. The finger-pointing by incompetent to understand and to know making up the reporting thrust to the agency investigator starts in motion is self-feeding frenzy, the nourishment for this feeding frenzy is the reputation of the practitioner the practice the practitioner had labored years to build his further fodder. It is prudent to ask the question who is controlling those in control?.  To who or to what are they required to answer? From the view of the victimized practitioner labeled “disruptive” it is a runaway train building steam to find a certain end. This train was perfected without any braking mechanism. Arguendo is assumed a self-fulfilling label is assigned a predetermined diagnostic significance…

It is a simple fact that the effort and the struggle to defend oneself is seen as denial and therefore declaratory of the lack of insight for the practitioners to understand his or her own “disruptive condition”. Perchance a well-meaning report to an agency by complaint and whose complaint is accepted as fact before such as proven…

A desperate feeling of danger to livelihood, professional respect, professional reputation will descend on the practitioner. An average citizen when accused of a crime carries a presumption of innocence until proven guilty “beyond a reasonable doubt”. In the case of our practitioner there has been no proof of a “crime”, the proof is assumed in the assessment moves forward with pell-mell speed to a disastrous conclusion a disturbing percentage of time regardless of the real merits of the relegation…

Justice, equal protection, fairness, proper procedure, proper investigation by competent regulated investigators, an assignment of the defense assistance, if needed without charge, a fair hearing by an impartial factfinder would seem base line…

However the invaluable elements above are not afforded to the practitioner at any time. Even a calculated and spiteful report by a complaint and can start an investigation that leads to the destruction of so much…

The only thing that is insured in the employment of those that staffing agency, their secretive methods remain protected, the referral pattern to favored, favored because of the express expectation of the outcome is as well insured. The EXPERTS AT DIVINING SELF-SERVING TRUTHS is now a lucrative business. It is unbridled investigation of the not yet charged, those who know not what to defend, the publicity afforded a hungry public as injury to previous injurious insult…

It is said the truth shall make you free. If that is in fact the case in a consequence where there is no truth the death of freedom as known before an allegation is a certainty.

Follow this HealthPlanUSA column for some answers to our health care conundrum.

America, it is critical to wake up before it’s too late.

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Well-Meaning Regulations Worsen Quality of Care.

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