Are congratulations in order for Mr. Gary Ostrick? Did the Medical Board's whore, Gary Ostrick, get that promotion or bonus yet? Gary, you must be so proud of your big win (even though it was a fixed decision) against a pro per. It will be our little secret that you were really just a puppet- I know the "mystery people" in Sacramento at the California Medical Board and Attorney Generals office did all the work....you just signed your name. I won't tell. :-)
Gary, again, How do you sleep at night knowing you sold your soul to the devil? Does your Rabbi know of your sins? You obviously have no conscious. Do you enjoy hurting children and trying to destroy good people? I hope their 3 innocent faces haunt you forever...YOU hurt them- 3 little kids, YOU hurt their parents and YOU've hurt many others. They wanted to see the man (known to them as "one of the bad people" and "monster") who is hurting them and their family. We never knew evil until people like you, Gary Ostrick, who came into our lives. You are a sick man!!
Friday, October 15, 2010
Los Angeles Superior Court Judge Robert H. O'brien - Judicial Corruption at it's best!
Is "retired" Judge Robert O'brien a bribe taking Judge? How much money did the California Medical Board have to pay Robert to give them the verdict they wanted?
Saturday, July 3, 2010
A crooked lawyer in our society is almost beyond reach
“A crooked lawyer in our society is almost beyond reach.”
G.Robert Blakey, Organized Crime section of the Department of Justice
Add dark political influence to said crooked lawyer and we deal with a ridiculously unassailable fortress.
The passage of term limits in California completely changed the locus of power in Sacramento. Legislators now race through the system, attempting to master a thirty year job in fewer than ten years in order to create their legacy. With term limits, the permanent parties have the real influence. They are the Lobbyists, Legislative staff and State employees. They train the Legislators and try to keep them out of trouble. They are the crafters of the legacy. The professional Licensing Boards are identical. The Board Members are appointed, and rarely do they serve more than 5 years. They are informed and guided by the Boards Executive staff and influenced by Lobbyists. State employees remain on board while Members come and go.
The Fellmeths are both lawyers. Mrs.Fellmeth is a trained Prosecutor and Registered Lobbyist for CPIL, their family business. Ed Howard is a Lobbyist for CPIL and on their Board of Directors They also have a Media Lobbyist (KSR Strategy Group). With a media lobbyist, CPIL is able to feed a nasty story about a doctor to an Orange County free paper and then place it in a State document as independent investigative reporting.
In one of Mrs Fellmeth’s self-aggrandizing themes, she points out how she has attended every Medical Board meeting for over 20 years. Together with Robert, they require law students from the USD School of Law to attend the meetings of the other Licensing Boards. The purpose is to invent or develop reasons to complain that a particular Board is not protecting the public. Robert came up with this lucrative justification for CPIL.
The Licensing Boards are low hanging fruit for CPIL. Once the Boards came under the Department of Consumer Affairs, no one was allowed to question their attacks. Under their self-proclaimed banner of public protection, no challenges are permitted. Easy pickings.
Mrs.Fellmeth likes the Medical Board in particular. She has been enriched by selling an equation: advocating various ways to damage and ruin physicians equals patient protection. Her special target has been physicians in recovery and the former Physician Diversion Program. In spite of the obvious successes and contributions the Diversion Program has provided to better the quality of medical care, Mrs.Fellmeth was able to sell her false narrative of the “failed program”. Like any professional Lobbyist, she forged alliances with the Executive Directors and the Board Members, then determined their perceptions. Calling Audits from the early 80’s “evidence of failure” rather than a record of accomplishment in the face of difficulties , she relied on the fact that no one reads old audits. Her epic tome of bad faith, the Enforcement Monitor Report, is largely unread but frequently quoted by her. Even the BSA Audit of 2007 is generally unread. Who reads State audits? For those who are familiar with program audits, they don’t find it a failure by any means. If they actually read other BSA audits of California Programs or Departments, they are baffled by the CPIL negative spin . If they read other BSA audits, they will find much harsher Findings and conclusions. She falsely claims the lucrative Enforcement Monitor Report has never been challenged or refuted. Both Fellmeths repeat the false claims that patients were harmed by physicians in Diversion, and no one demands actual facts. Mrs Fellmeth/KSR fed media stories are never verified. Having a Media Lobbyist is solid gold for CPIL. In politics, perceptions rule and perceptions are easily manipulated by CPIL.
CPIL like to represent themselves as protectors of the underdog against the powerful special interests. In their war or “judicious jihad” against physicians in recovery, they are the well paid Lobbyists. Physicians in recovery are easy to demonize by fictional accounts of patient harm. The supposed powerful advocates, like CSAM and CMA, are politically weak and have other more important agendas.
The case of the Target Physician is a prime example. CPIL aligned with self-proclaimed victims and tabloid media to create a monster to destroy. They had their “evidence of patient harm by a physician in Diversion”. With this concoction, they dominated the Medical Board and its Chairman, Richard Fantozzi MD. Reading Fantozzi’s apologia for closing Diversion in the Medical Board‘s Official document, a discerning reader easily realizes Mrs.Fellmeth is the real author. The references to “botched surgeries” have never been verified, and in fact have utterly fallen apart after the damage to the Target Physician and the Diversion Program. Mrs.Fellmeth illicitly obtained the Target Physician’s confidential Diversion record and published the titillating and petty details in an official publication of the University of San Diego, a prestigious Catholic University. We can guess the University misplaced its traditional commitment to social justice.
Years earlier, CPIL inserted a Lobbyist (Ed Howard) as Chief Counsel to then Senator Liz Figueroa. CPIL was thus able to write the legislation weakening Diversion. The legislation also created the lucrative Enforcement Monitor position specifically for Mrs.Fellmeth. As payback, Ms Figueroa was appointed to the Board of Directors of Public Citizen. Robert Fellmeth is Chairman of the Board of Public Citizen.
Politically, Mrs.Fellmeth forged a close relationship with Bill Gage, a senior Legislative Consultant for the Senate Business, Professions and Economic Development Committee. This is the Committee that deals with Licensing Boards. The Chairmen come and go and Mr.Gage stays. In 2007, Senator Mark Ridley-Thomas Chaired the Committee. He absorbed the CPIL rhetoric against physicians in recovery. He authored and led the effort to successfully pass SB1441 to establish standards for Board sponsored Diversion Programs (e.g., Nurses, Dentists, Pharmacists, etc). Carrie Lopez, the former Executive Director of the Department of Consumer Affairs, along with Mrs.Fellmeth , were in position to be able to undermine the implementation for the benefit of the D’Angelo- Fellmeth family business, CPIL..
In the fall of 2007, Senator Ridley-Thomas generously agreed to meet with actual alumni of the Physician Diversion Program. Bill Gage was at his side, introducing himself as a “close friend of Julie Fellmeth”. The Senator led with the Fellmeth feed of “botched surgeries” “zero tolerance” and “enforceable standards”. Next, the doctors introduced themselves and told their stories of recovery. Among them was a distinguished Ophthalmologist who had recently received a community service award from the Senator. He provides many hours of unpaid care to an underserved community. Most of us in attendance left somewhat discouraged. The false narrative of CPIL won again. However, in January of 2008, there was a “what do we do now?” Stakeholders meeting in Sacramento. Senator Ridley-Thomas appeared and spoke about the physicians he’d met. He described them as “stellar individuals”. In March 2008, at a meeting of the Senate Committee on Business professions and Economic Development, he interrupted Mrs.Fellmeth to rebuke her for her “callous disregard” regarding physicians.
Lost in the false narratives and media manipulations are the typical examples of the benefit of physicians in recovery. While reams of valid research clearly supports the conclusion that physicians in recovery have far lower potential for harm than physicians in general, the accounts of their added benefit to society are lost. Physicians in recovery spot and intervene with addicted patients earlier and more effectively than others. This both reduces healthcare costs and prevents the progression of disease and injury. In contrast, the overall training of physicians regarding addiction is scant. The typical attitude of physicians in training toward addicted patients is quite negative. Addicted patients are demonized and regarded as clogging up the healthcare system. The resulting focus in their training emphasizes end organ damage caused by addiction, while ignoring the underlying cause. CPIL’s emphasis on punishing and eliminating physicians in recovery is against the public interest and against consumer protection.
CPIL continues to wage its war against physicians and to enlist the Board’s cooperation. Building on a previous victory, the public Enforcement Link, Mrs. Fellmeth seeks further damage under the cover of public protection. In the public Enforcement Link, Accusations by the Attorney General are presented in their entirety without challenge or rebuttal. It is a pure and unadulterated adversarial portrayal of the case. While this writer has objections to the manner of publishing Decisions (no rebuttal, no authentication of the actual facts), publishing Accusations is even worse. Physicians are traumatized when they read them. Those who read a number of Accusations recognize the hyperbolic boiler plate language of the Prosecutor. While the Prosecutor has a necessary function in a Court, the Court has a Judge and Defense Attorney along with the burden of proof. The public Enforcement Link in its present form is merely destructive. Many Deputy Attorney Generals agree.
The public Enforcement Link is simply a step for CPIL. CPIL desires to reduce or eliminate as many Constitutional protections for physicians as possible. Mrs.Fellmeth complains in the press about protections against illegal Search and Seizure. She claims these protections just slow down discipline. She now demands that Complaints be published and placed in doctor’s waiting rooms. She would eliminate due process entirely in the steps between a Complaint and Discipline. She wants to eliminate physician Members entirely from the Board, due to her false claim of excessive empathy. Witnessing the Board in action easily contradicts her assertion. The California Board is often both backward and punitive with respect to physicians in recovery. Physicians see the Board as their enemy now. She would substitute Public Members for doctors. The Public Members would be trained by CPIL under their lucrative California Endowment Grant. They would be “jurors” who only hear the Complaint, Accusation and the Prosecutor.
The need to support effective programs of early intervention, secondary prevention and monitoring continues. Additionally, those of us who care about patients and physicians must challenge the repeated false statements of CPIL, confront their destructive agenda and demand transparency from CPIL.
Mrs. Fellmeth continues to attend all Medical Board meetings. This is her life, she is tenacious, she is an expert in manipulating Regulatory Law for her own ends, and this gives her a great advantage over those for whom these issues are only a small part of what they do with their careers. She is now in the patronizing phase of her next attack. In a recent Board meeting, she complimented the Board for having “the sixth best” medical board web site, according to Public Citizen. Stop laughing. Sid Wolfe, MD, is also on the Public Citizen Board. He fronts an annual study that rates and ranks State medical boards based on the number of physicians disciplined. The more disciplined, the better the board, according to Wolfe. They sell the equation that harming doctors equals consumer protection. Their interlocking connections of cronies and media manipulation must be matched with intelligent, active involvement. No Medical Board meeting should lack CSAM, CMA, and CPA participation. The CPIL dominance of the Board functions best in darkness.
G.Robert Blakey, Organized Crime section of the Department of Justice
Add dark political influence to said crooked lawyer and we deal with a ridiculously unassailable fortress.
The passage of term limits in California completely changed the locus of power in Sacramento. Legislators now race through the system, attempting to master a thirty year job in fewer than ten years in order to create their legacy. With term limits, the permanent parties have the real influence. They are the Lobbyists, Legislative staff and State employees. They train the Legislators and try to keep them out of trouble. They are the crafters of the legacy. The professional Licensing Boards are identical. The Board Members are appointed, and rarely do they serve more than 5 years. They are informed and guided by the Boards Executive staff and influenced by Lobbyists. State employees remain on board while Members come and go.
The Fellmeths are both lawyers. Mrs.Fellmeth is a trained Prosecutor and Registered Lobbyist for CPIL, their family business. Ed Howard is a Lobbyist for CPIL and on their Board of Directors They also have a Media Lobbyist (KSR Strategy Group). With a media lobbyist, CPIL is able to feed a nasty story about a doctor to an Orange County free paper and then place it in a State document as independent investigative reporting.
In one of Mrs Fellmeth’s self-aggrandizing themes, she points out how she has attended every Medical Board meeting for over 20 years. Together with Robert, they require law students from the USD School of Law to attend the meetings of the other Licensing Boards. The purpose is to invent or develop reasons to complain that a particular Board is not protecting the public. Robert came up with this lucrative justification for CPIL.
The Licensing Boards are low hanging fruit for CPIL. Once the Boards came under the Department of Consumer Affairs, no one was allowed to question their attacks. Under their self-proclaimed banner of public protection, no challenges are permitted. Easy pickings.
Mrs.Fellmeth likes the Medical Board in particular. She has been enriched by selling an equation: advocating various ways to damage and ruin physicians equals patient protection. Her special target has been physicians in recovery and the former Physician Diversion Program. In spite of the obvious successes and contributions the Diversion Program has provided to better the quality of medical care, Mrs.Fellmeth was able to sell her false narrative of the “failed program”. Like any professional Lobbyist, she forged alliances with the Executive Directors and the Board Members, then determined their perceptions. Calling Audits from the early 80’s “evidence of failure” rather than a record of accomplishment in the face of difficulties , she relied on the fact that no one reads old audits. Her epic tome of bad faith, the Enforcement Monitor Report, is largely unread but frequently quoted by her. Even the BSA Audit of 2007 is generally unread. Who reads State audits? For those who are familiar with program audits, they don’t find it a failure by any means. If they actually read other BSA audits of California Programs or Departments, they are baffled by the CPIL negative spin . If they read other BSA audits, they will find much harsher Findings and conclusions. She falsely claims the lucrative Enforcement Monitor Report has never been challenged or refuted. Both Fellmeths repeat the false claims that patients were harmed by physicians in Diversion, and no one demands actual facts. Mrs Fellmeth/KSR fed media stories are never verified. Having a Media Lobbyist is solid gold for CPIL. In politics, perceptions rule and perceptions are easily manipulated by CPIL.
CPIL like to represent themselves as protectors of the underdog against the powerful special interests. In their war or “judicious jihad” against physicians in recovery, they are the well paid Lobbyists. Physicians in recovery are easy to demonize by fictional accounts of patient harm. The supposed powerful advocates, like CSAM and CMA, are politically weak and have other more important agendas.
The case of the Target Physician is a prime example. CPIL aligned with self-proclaimed victims and tabloid media to create a monster to destroy. They had their “evidence of patient harm by a physician in Diversion”. With this concoction, they dominated the Medical Board and its Chairman, Richard Fantozzi MD. Reading Fantozzi’s apologia for closing Diversion in the Medical Board‘s Official document, a discerning reader easily realizes Mrs.Fellmeth is the real author. The references to “botched surgeries” have never been verified, and in fact have utterly fallen apart after the damage to the Target Physician and the Diversion Program. Mrs.Fellmeth illicitly obtained the Target Physician’s confidential Diversion record and published the titillating and petty details in an official publication of the University of San Diego, a prestigious Catholic University. We can guess the University misplaced its traditional commitment to social justice.
Years earlier, CPIL inserted a Lobbyist (Ed Howard) as Chief Counsel to then Senator Liz Figueroa. CPIL was thus able to write the legislation weakening Diversion. The legislation also created the lucrative Enforcement Monitor position specifically for Mrs.Fellmeth. As payback, Ms Figueroa was appointed to the Board of Directors of Public Citizen. Robert Fellmeth is Chairman of the Board of Public Citizen.
Politically, Mrs.Fellmeth forged a close relationship with Bill Gage, a senior Legislative Consultant for the Senate Business, Professions and Economic Development Committee. This is the Committee that deals with Licensing Boards. The Chairmen come and go and Mr.Gage stays. In 2007, Senator Mark Ridley-Thomas Chaired the Committee. He absorbed the CPIL rhetoric against physicians in recovery. He authored and led the effort to successfully pass SB1441 to establish standards for Board sponsored Diversion Programs (e.g., Nurses, Dentists, Pharmacists, etc). Carrie Lopez, the former Executive Director of the Department of Consumer Affairs, along with Mrs.Fellmeth , were in position to be able to undermine the implementation for the benefit of the D’Angelo- Fellmeth family business, CPIL..
In the fall of 2007, Senator Ridley-Thomas generously agreed to meet with actual alumni of the Physician Diversion Program. Bill Gage was at his side, introducing himself as a “close friend of Julie Fellmeth”. The Senator led with the Fellmeth feed of “botched surgeries” “zero tolerance” and “enforceable standards”. Next, the doctors introduced themselves and told their stories of recovery. Among them was a distinguished Ophthalmologist who had recently received a community service award from the Senator. He provides many hours of unpaid care to an underserved community. Most of us in attendance left somewhat discouraged. The false narrative of CPIL won again. However, in January of 2008, there was a “what do we do now?” Stakeholders meeting in Sacramento. Senator Ridley-Thomas appeared and spoke about the physicians he’d met. He described them as “stellar individuals”. In March 2008, at a meeting of the Senate Committee on Business professions and Economic Development, he interrupted Mrs.Fellmeth to rebuke her for her “callous disregard” regarding physicians.
Lost in the false narratives and media manipulations are the typical examples of the benefit of physicians in recovery. While reams of valid research clearly supports the conclusion that physicians in recovery have far lower potential for harm than physicians in general, the accounts of their added benefit to society are lost. Physicians in recovery spot and intervene with addicted patients earlier and more effectively than others. This both reduces healthcare costs and prevents the progression of disease and injury. In contrast, the overall training of physicians regarding addiction is scant. The typical attitude of physicians in training toward addicted patients is quite negative. Addicted patients are demonized and regarded as clogging up the healthcare system. The resulting focus in their training emphasizes end organ damage caused by addiction, while ignoring the underlying cause. CPIL’s emphasis on punishing and eliminating physicians in recovery is against the public interest and against consumer protection.
CPIL continues to wage its war against physicians and to enlist the Board’s cooperation. Building on a previous victory, the public Enforcement Link, Mrs. Fellmeth seeks further damage under the cover of public protection. In the public Enforcement Link, Accusations by the Attorney General are presented in their entirety without challenge or rebuttal. It is a pure and unadulterated adversarial portrayal of the case. While this writer has objections to the manner of publishing Decisions (no rebuttal, no authentication of the actual facts), publishing Accusations is even worse. Physicians are traumatized when they read them. Those who read a number of Accusations recognize the hyperbolic boiler plate language of the Prosecutor. While the Prosecutor has a necessary function in a Court, the Court has a Judge and Defense Attorney along with the burden of proof. The public Enforcement Link in its present form is merely destructive. Many Deputy Attorney Generals agree.
The public Enforcement Link is simply a step for CPIL. CPIL desires to reduce or eliminate as many Constitutional protections for physicians as possible. Mrs.Fellmeth complains in the press about protections against illegal Search and Seizure. She claims these protections just slow down discipline. She now demands that Complaints be published and placed in doctor’s waiting rooms. She would eliminate due process entirely in the steps between a Complaint and Discipline. She wants to eliminate physician Members entirely from the Board, due to her false claim of excessive empathy. Witnessing the Board in action easily contradicts her assertion. The California Board is often both backward and punitive with respect to physicians in recovery. Physicians see the Board as their enemy now. She would substitute Public Members for doctors. The Public Members would be trained by CPIL under their lucrative California Endowment Grant. They would be “jurors” who only hear the Complaint, Accusation and the Prosecutor.
The need to support effective programs of early intervention, secondary prevention and monitoring continues. Additionally, those of us who care about patients and physicians must challenge the repeated false statements of CPIL, confront their destructive agenda and demand transparency from CPIL.
Mrs. Fellmeth continues to attend all Medical Board meetings. This is her life, she is tenacious, she is an expert in manipulating Regulatory Law for her own ends, and this gives her a great advantage over those for whom these issues are only a small part of what they do with their careers. She is now in the patronizing phase of her next attack. In a recent Board meeting, she complimented the Board for having “the sixth best” medical board web site, according to Public Citizen. Stop laughing. Sid Wolfe, MD, is also on the Public Citizen Board. He fronts an annual study that rates and ranks State medical boards based on the number of physicians disciplined. The more disciplined, the better the board, according to Wolfe. They sell the equation that harming doctors equals consumer protection. Their interlocking connections of cronies and media manipulation must be matched with intelligent, active involvement. No Medical Board meeting should lack CSAM, CMA, and CPA participation. The CPIL dominance of the Board functions best in darkness.
Liz Figueroa lies and cheats...
In 2003, then Senator Figueroa , with the assistance of Ed Howard, passed legislation that was the beginning of the end for the Physician Diversion Program and the creation of the Medical Board Enforcement Monitor position for Mrs.Fellmeth. The EF qualifications were designed so only Mrs.Fellmeth would be eligible. Today, she trumpets the EF position was awarded as a result of "open, competitive bidding". She never mentions that Ed Howard is a CPIL Lobbyist and member of the CPIL satff. Ms.Figueroa is a member of the Board of Public Citizen, chaired by Robert Fellmeth.
Apparently, Ms.Figueroa has a truth issue in other areas, too.
Recent tabloid articles by ProPublica, usually a respected Public Interest Journalism source, on these issues appears more like a CPIL conduit. It seems timed to support the budget request by the Department of Consumer Affairs (DCA) for $30,000,000+ to add enforcement positions and make the process of enforcement less encumbered by Due Process or Equal Protection for Healing Arts practitioners. The financial gain for Mrs.Fellmeth and CPIL should be out in the open (eg. What's her involvement in the DCA "Enforcement Academy" and what is she being paid?).
Apparently, Ms.Figueroa has a truth issue in other areas, too.
Recent tabloid articles by ProPublica, usually a respected Public Interest Journalism source, on these issues appears more like a CPIL conduit. It seems timed to support the budget request by the Department of Consumer Affairs (DCA) for $30,000,000+ to add enforcement positions and make the process of enforcement less encumbered by Due Process or Equal Protection for Healing Arts practitioners. The financial gain for Mrs.Fellmeth and CPIL should be out in the open (eg. What's her involvement in the DCA "Enforcement Academy" and what is she being paid?).
Saturday, April 17, 2010
Mission Hijacked by Lobbyist
Mission Hijacked by Lobbyist
“The mission of the Medical Board is to protect health care consumers through the proper licensing and regulation of physicians and surgeons and certain allied health care professions and through the vigorous, objective enforcement of the Medical Practice Act, and to promote access to quality medical care through the Board's licensing and regulatory functions.”
Most of the key elements in this mission statement of the Medical Board of California (MBC) have been unwittingly ceded to the lobbyist for The Center for Public Interest Law (CPIL). The hijacked components include, “…protect health care consumers,” “objective enforcement” and the promotion of “access to quality medical care.”
Public Protection
Demonizing doctors recovering from alcohol or drug problems is dated but very easy. Merely offering untruthful scenarios of patient harm grabs the attention of the salacious media. The story of any recovering doctor possibly doing something wrong is fascinating. The story of a thousand recovering doctors doing everything right isn’t worth a side bar on page eight. Untrue allegations of one doctor supposedly doing something bad warrants page one. Mobilizing professional victims and paranoid litigators and chauffeuring them into Medical Board meetings is colorful and scintillating. CPIL’s lobbyist has attended every Board meeting and repeated these themes. The result is that the Board is unduly influenced and like the repeating scene in Invasion of the Body Snatchers, has been taken over, implanted with falsehoods and aggrandized dramas.
The truth is that the very nature of the Physician Health and Diversion programs is prevention of physician impairment and possible patient harm. Early intervention prior to the risk of harm is the focus of these programs nationwide. The real risk of patient harm results from delayed intervention. Physicians with potentially impairing illness, at an early stage, typically function at a high level for a decade or more before impairment is evidenced. The existence of illness does not mean impairment is present. Taking away early intervention through the likelihood of adverse disciplinary action tends toward delayed diagnosis and increased risk. The Medical Board’s Mission to protect the public, therefore, is best served by a system that encourages early diagnosis and treatment. The Medical Boards idea of a ‘proactive’ approach – combining “just say no” with educating medical students about Licensing consequences – while well intended, is minimally helpful. Unfortunately for the consumer, the Board has expressed a belief these miniscule steps will eliminate the problem.
OBJECTIVE ENFORCEMENT OF THE MEDICAL PRACTICE ACT
When CPIL works with other parties to, 1) solicit false Complaints, 2) divert Board resources away from legitimate Investigation and Enforcement activities, and 3) effectively pressure the Board to discipline ill doctors simply to avoid bad press, this results in a very dangerous, destructive and unjust process. As a nation, we suffer collectively when we discover such things as abuse of prisoners, justification for torture and the stripping of Civil Rights. Likewise do we suffer when we learn of doctors being harmed in this way by the Board? The case of the CPIL targeted physician is not an example of a bad doctor being disciplined, but an innocent man and his family persecuted and harmed by those who claim to protect the Public. The Target is the most investigated doctor in the entire history of the Medical Board. CPIL’s lobbyist continuously hounds the Board to Revoke his License. Dozens upon dozens of contrived Complaints have been filed and costly investigations conducted. The Deputy Attorney General (the Board’s own Prosecutor) even told the Board there wasn’t a single valid Complaint of patient harm by the Target. In spite of that, the Board was pressured into demanding a lengthy show trial and informed the Administrative Law Judge they wanted a License Revocation. The Board got a very harsh and questionable Decision; but since it wasn’t harsh enough, they simply Non-Adopted the Decision. The patient harm issue? One patient, prior to the Target’s entry into the Diversion recovery process had a breast reconstruction and got matched “c” cups versus the “d” cups she expected (six years after her surgery she filed a Complaint, and in 2001 she sued and her suit was dismissed with prejudice for no evidence of malpractice). That is it; as far from Objective Enforcement as can be imagined. Ultimately, after the Non-Adoption all for show Hearing, the Medical Board did revoke the license of the Target. While an expensive Appeal is available, the Board has communicated its intention to file additional Accusations and reject any favorable legal outcome by the Court. In February 2009, for example, the Board refused to accept the Target’s monthly payments for required Probation monitoring fees. Why on earth would they do that? Simply put, the Board planned to file another Accusation for failure to pay the required fees, a violation of Probation.
There is an old saying, “the victors write the history books”. All the public Enforcement documents on the Target will remain for all to view. CPIL will quote the most salacious and libelous of those to support their position that doctors in Diversion harmed patients. Those who read them and believe them will conclude he was a bad guy. There will be no rebuttal, and no factual “other side “presented. This public use of hyperbolic prosecutorial writing represents both an early victory for CPIL, and a continuing effort to demonize doctors through the publication of solely adversarial documents. CPIL now demands ALL complaints be published on the Medical Board web site and posted in the doctor’s place of employment. As usual, no rebuttal or other side allowed. The real potential for malicious abuse is obvious.
When the Board had a Diversion Program, there were doctors who faced Discipline for things like DUI’s, diverting drugs for personal use, and unauthorized use of scheduled substances. These cases were thoroughly and professionally investigated by the Board. If there was no patient harm and the doctor was cooperative, the doctor was directed away from Discipline into the Diversion program so they could get the help they needed and the process monitored. The doctor’s participation in Diversion was confidential, even though the full situation was known to the Board. Some parties had concerns over this level of confidentiality. Most States have a confidential tract for those who enter voluntarily in the absence of patient harm, and most states have Boards that refer without formal disciplinary action. In California, referrals from disciplinary action have always been public. CPIL and its media Lobbyist, KSR Strategy Group, incite Populist outrage over this topic. Manipulating the press and exciting the lynch mob is easy. The modern day version of the “off with their heads” approach can resonate with an uninformed or misinformed public. However, prior to the creation of Physician Health and Diversion programs, that was the rule. It was a counter productive approach that placed patients at risk.
When the only option for a doctor with a potentially impairing illness such as substance use disorder, psychiatric illness, etc. is discipline, the doctor is driven underground and afraid to acknowledge a problem. Those close to the doctor – friends, family, medical partners, and others – are reluctant to report since they don’t want to cause the doctor more problems. When a program exists that allows the doctor to receive help without fear of professional sanction or loss of livelihood, doctors are intervened on well before their illness reaches a state of being a potential risk to patients. In this more enlightened and accepted scenario, an otherwise excellent physician is salvaged and the public is protected. There are examples in other states that saw their referrals increase over 400% when they made a transition from a punitive to a supportive system.
This writer’s personal experience is a case in point. Working in a Los Angeles County hospital Alcoholism unit in the early 70’s, the patient population represented “the cream of skid row”. They were advanced in their illness, yet had a real potential for rehabilitation. There were former doctors among them. The stunning similarity of their stories is quite illustrative:
1. They all had the skid row nickname of “doc”.
2. They all had been highly skilled and respected doctors for many years.
3. Because the Board would revoke their License if it was known they had a diagnosis of alcohol dependence, they were all professionally hidden.
4. Eventually, their illness progressed to the point that even those hesitant to report could no longer keep the secret.
5. They all lost everything – family, career, social and legal standing. They were all consumed with guilt and shame, and subsequently deteriorated to a skid row existence.
6.Most rehabilitated and once again became productive members of society. Others died.
If CPIL gets their way, this scenario will be the norm. Along the way, CPIL will keep their hands in California’s wallet, while trumpeting their virtuousness, and pointing their vicious rhetoric at doctors in recovery. CPIL seeks, without understanding, to destroy what has been carefully developed and proven successful around the country. Their vision would set California back 30 years.
Finally, the Board has a responsibility to PROMOTE ACCESS TO QUALITY MEDICAL CARE in California. By withdrawing support for any kind of Physician Health or Diversion program, they limit this important objective. Currently, there are no Addictionologists or Addiction Psychiatrists among the Board Members, with a resultant lack of knowledge about the illnesses of Alcohol or Drug Dependency. Outside these groups, few doctors were trained to recognize, intervene and treat addictive illness. The Board’s lack of understanding in this arena of health care is problematic.
We must not mismanage and marginalize physicians with addictive illness. Through their personal treatment and recovery, they become experts in identifying and managing addictive illness. They provide superior care to their patients with these disorders. Through their acquired knowledge, they recognize the illness earlier than their untrained peers, and are able to intervene. The Nation’s health care costs are adversely impacted by undiagnosed and untreated addictions. Patients are damaged when doctors are reluctant to diagnose and treat the core problem that causes illness accident and organ damage. Family members also are adversely impacted when their addict isn’t diagnosed and treated.
Addictive illness affects about 10% of the American population. Our nation spends about $375 Billion dollars per year on these illnesses but, unfortunately, 99% of those monies go to failed policies on interdiction, incarceration, and cleaning up the mess. Our nation spends less than 1% of the money on education, prevention and treatment combined, although a study by Kaiser Permanente demonstrated that for every dollar we spend on education, prevention and treatment, we save $7 in services down the road. Who will lead America out of this abyss if not those who have recovered from the illness themselves?
Again, the author draws on decades of professional experience to illustrate the point. Running chemical dependency units in large and respected Medical Centers required the training of the Attending Staff Physicians. One particular training technique was very
useful: many patients who were treated on the unit had been long term patients of the Attending Staff and had multiple previous hospitalizations. We would bring a medical chart, comprising a 3 volume or more pile of documents, and review the obvious. Repeated notes of alcohol related damage and nothing related to alcoholism itself. Yet all the major medical problems were consequences of untreated alcoholism. The doctors were reluctant to bring up the issue, either due to having the 1) moral defect notion of alcoholism, or 2) believing an alcoholic not living on skid row wasn’t an alcoholic.
The British Medical Journal published a report of the efficacy of state physician health programs in its 11/08 issue. Sixteen states PHPs studied demonstrated a 78% total abstinence at an average of 7.2 years of monitoring. With further treatment for their illness for those who did relapse, the success rate exceeded 90% at five years. Of the 904 recovering doctors studied, there was one (1) incident of patient harm – over prescribing. What other chronic illness management offers that level of success?
Any system that takes a reflexively prejudicial stance and punitive approach to doctors in need of help diminishes the value and access of these practitioners to patients who need them. It is of paramount importance that California has a vibrant, healthy Physician Health Program. Such programs are an invaluable resource for the ill physician, the medical community and, most important, the patients we all serve.
“The mission of the Medical Board is to protect health care consumers through the proper licensing and regulation of physicians and surgeons and certain allied health care professions and through the vigorous, objective enforcement of the Medical Practice Act, and to promote access to quality medical care through the Board's licensing and regulatory functions.”
Most of the key elements in this mission statement of the Medical Board of California (MBC) have been unwittingly ceded to the lobbyist for The Center for Public Interest Law (CPIL). The hijacked components include, “…protect health care consumers,” “objective enforcement” and the promotion of “access to quality medical care.”
Public Protection
Demonizing doctors recovering from alcohol or drug problems is dated but very easy. Merely offering untruthful scenarios of patient harm grabs the attention of the salacious media. The story of any recovering doctor possibly doing something wrong is fascinating. The story of a thousand recovering doctors doing everything right isn’t worth a side bar on page eight. Untrue allegations of one doctor supposedly doing something bad warrants page one. Mobilizing professional victims and paranoid litigators and chauffeuring them into Medical Board meetings is colorful and scintillating. CPIL’s lobbyist has attended every Board meeting and repeated these themes. The result is that the Board is unduly influenced and like the repeating scene in Invasion of the Body Snatchers, has been taken over, implanted with falsehoods and aggrandized dramas.
The truth is that the very nature of the Physician Health and Diversion programs is prevention of physician impairment and possible patient harm. Early intervention prior to the risk of harm is the focus of these programs nationwide. The real risk of patient harm results from delayed intervention. Physicians with potentially impairing illness, at an early stage, typically function at a high level for a decade or more before impairment is evidenced. The existence of illness does not mean impairment is present. Taking away early intervention through the likelihood of adverse disciplinary action tends toward delayed diagnosis and increased risk. The Medical Board’s Mission to protect the public, therefore, is best served by a system that encourages early diagnosis and treatment. The Medical Boards idea of a ‘proactive’ approach – combining “just say no” with educating medical students about Licensing consequences – while well intended, is minimally helpful. Unfortunately for the consumer, the Board has expressed a belief these miniscule steps will eliminate the problem.
OBJECTIVE ENFORCEMENT OF THE MEDICAL PRACTICE ACT
When CPIL works with other parties to, 1) solicit false Complaints, 2) divert Board resources away from legitimate Investigation and Enforcement activities, and 3) effectively pressure the Board to discipline ill doctors simply to avoid bad press, this results in a very dangerous, destructive and unjust process. As a nation, we suffer collectively when we discover such things as abuse of prisoners, justification for torture and the stripping of Civil Rights. Likewise do we suffer when we learn of doctors being harmed in this way by the Board? The case of the CPIL targeted physician is not an example of a bad doctor being disciplined, but an innocent man and his family persecuted and harmed by those who claim to protect the Public. The Target is the most investigated doctor in the entire history of the Medical Board. CPIL’s lobbyist continuously hounds the Board to Revoke his License. Dozens upon dozens of contrived Complaints have been filed and costly investigations conducted. The Deputy Attorney General (the Board’s own Prosecutor) even told the Board there wasn’t a single valid Complaint of patient harm by the Target. In spite of that, the Board was pressured into demanding a lengthy show trial and informed the Administrative Law Judge they wanted a License Revocation. The Board got a very harsh and questionable Decision; but since it wasn’t harsh enough, they simply Non-Adopted the Decision. The patient harm issue? One patient, prior to the Target’s entry into the Diversion recovery process had a breast reconstruction and got matched “c” cups versus the “d” cups she expected (six years after her surgery she filed a Complaint, and in 2001 she sued and her suit was dismissed with prejudice for no evidence of malpractice). That is it; as far from Objective Enforcement as can be imagined. Ultimately, after the Non-Adoption all for show Hearing, the Medical Board did revoke the license of the Target. While an expensive Appeal is available, the Board has communicated its intention to file additional Accusations and reject any favorable legal outcome by the Court. In February 2009, for example, the Board refused to accept the Target’s monthly payments for required Probation monitoring fees. Why on earth would they do that? Simply put, the Board planned to file another Accusation for failure to pay the required fees, a violation of Probation.
There is an old saying, “the victors write the history books”. All the public Enforcement documents on the Target will remain for all to view. CPIL will quote the most salacious and libelous of those to support their position that doctors in Diversion harmed patients. Those who read them and believe them will conclude he was a bad guy. There will be no rebuttal, and no factual “other side “presented. This public use of hyperbolic prosecutorial writing represents both an early victory for CPIL, and a continuing effort to demonize doctors through the publication of solely adversarial documents. CPIL now demands ALL complaints be published on the Medical Board web site and posted in the doctor’s place of employment. As usual, no rebuttal or other side allowed. The real potential for malicious abuse is obvious.
When the Board had a Diversion Program, there were doctors who faced Discipline for things like DUI’s, diverting drugs for personal use, and unauthorized use of scheduled substances. These cases were thoroughly and professionally investigated by the Board. If there was no patient harm and the doctor was cooperative, the doctor was directed away from Discipline into the Diversion program so they could get the help they needed and the process monitored. The doctor’s participation in Diversion was confidential, even though the full situation was known to the Board. Some parties had concerns over this level of confidentiality. Most States have a confidential tract for those who enter voluntarily in the absence of patient harm, and most states have Boards that refer without formal disciplinary action. In California, referrals from disciplinary action have always been public. CPIL and its media Lobbyist, KSR Strategy Group, incite Populist outrage over this topic. Manipulating the press and exciting the lynch mob is easy. The modern day version of the “off with their heads” approach can resonate with an uninformed or misinformed public. However, prior to the creation of Physician Health and Diversion programs, that was the rule. It was a counter productive approach that placed patients at risk.
When the only option for a doctor with a potentially impairing illness such as substance use disorder, psychiatric illness, etc. is discipline, the doctor is driven underground and afraid to acknowledge a problem. Those close to the doctor – friends, family, medical partners, and others – are reluctant to report since they don’t want to cause the doctor more problems. When a program exists that allows the doctor to receive help without fear of professional sanction or loss of livelihood, doctors are intervened on well before their illness reaches a state of being a potential risk to patients. In this more enlightened and accepted scenario, an otherwise excellent physician is salvaged and the public is protected. There are examples in other states that saw their referrals increase over 400% when they made a transition from a punitive to a supportive system.
This writer’s personal experience is a case in point. Working in a Los Angeles County hospital Alcoholism unit in the early 70’s, the patient population represented “the cream of skid row”. They were advanced in their illness, yet had a real potential for rehabilitation. There were former doctors among them. The stunning similarity of their stories is quite illustrative:
1. They all had the skid row nickname of “doc”.
2. They all had been highly skilled and respected doctors for many years.
3. Because the Board would revoke their License if it was known they had a diagnosis of alcohol dependence, they were all professionally hidden.
4. Eventually, their illness progressed to the point that even those hesitant to report could no longer keep the secret.
5. They all lost everything – family, career, social and legal standing. They were all consumed with guilt and shame, and subsequently deteriorated to a skid row existence.
6.Most rehabilitated and once again became productive members of society. Others died.
If CPIL gets their way, this scenario will be the norm. Along the way, CPIL will keep their hands in California’s wallet, while trumpeting their virtuousness, and pointing their vicious rhetoric at doctors in recovery. CPIL seeks, without understanding, to destroy what has been carefully developed and proven successful around the country. Their vision would set California back 30 years.
Finally, the Board has a responsibility to PROMOTE ACCESS TO QUALITY MEDICAL CARE in California. By withdrawing support for any kind of Physician Health or Diversion program, they limit this important objective. Currently, there are no Addictionologists or Addiction Psychiatrists among the Board Members, with a resultant lack of knowledge about the illnesses of Alcohol or Drug Dependency. Outside these groups, few doctors were trained to recognize, intervene and treat addictive illness. The Board’s lack of understanding in this arena of health care is problematic.
We must not mismanage and marginalize physicians with addictive illness. Through their personal treatment and recovery, they become experts in identifying and managing addictive illness. They provide superior care to their patients with these disorders. Through their acquired knowledge, they recognize the illness earlier than their untrained peers, and are able to intervene. The Nation’s health care costs are adversely impacted by undiagnosed and untreated addictions. Patients are damaged when doctors are reluctant to diagnose and treat the core problem that causes illness accident and organ damage. Family members also are adversely impacted when their addict isn’t diagnosed and treated.
Addictive illness affects about 10% of the American population. Our nation spends about $375 Billion dollars per year on these illnesses but, unfortunately, 99% of those monies go to failed policies on interdiction, incarceration, and cleaning up the mess. Our nation spends less than 1% of the money on education, prevention and treatment combined, although a study by Kaiser Permanente demonstrated that for every dollar we spend on education, prevention and treatment, we save $7 in services down the road. Who will lead America out of this abyss if not those who have recovered from the illness themselves?
Again, the author draws on decades of professional experience to illustrate the point. Running chemical dependency units in large and respected Medical Centers required the training of the Attending Staff Physicians. One particular training technique was very
useful: many patients who were treated on the unit had been long term patients of the Attending Staff and had multiple previous hospitalizations. We would bring a medical chart, comprising a 3 volume or more pile of documents, and review the obvious. Repeated notes of alcohol related damage and nothing related to alcoholism itself. Yet all the major medical problems were consequences of untreated alcoholism. The doctors were reluctant to bring up the issue, either due to having the 1) moral defect notion of alcoholism, or 2) believing an alcoholic not living on skid row wasn’t an alcoholic.
The British Medical Journal published a report of the efficacy of state physician health programs in its 11/08 issue. Sixteen states PHPs studied demonstrated a 78% total abstinence at an average of 7.2 years of monitoring. With further treatment for their illness for those who did relapse, the success rate exceeded 90% at five years. Of the 904 recovering doctors studied, there was one (1) incident of patient harm – over prescribing. What other chronic illness management offers that level of success?
Any system that takes a reflexively prejudicial stance and punitive approach to doctors in need of help diminishes the value and access of these practitioners to patients who need them. It is of paramount importance that California has a vibrant, healthy Physician Health Program. Such programs are an invaluable resource for the ill physician, the medical community and, most important, the patients we all serve.
Saturday, January 3, 2009
Public Interest Law - NOT! (Get Real Mrs. Fellmeth)
Dear Mrs. Fellmeth:
For the past fifteen-plus years you have expounded on and on about openness vs secrecy. You have urged passage of laws that would make physician’s private medical records open to public scrutiny if they were receiving treatment for addictions or mental health issues, or participating in the soon to end Diversion Program. So, in the spirit of openness, how about being open about the fact that you are a Registered Lobbyist? Or that Ed Howard, too, is a Registered Lobbyist and you are his client? Please tell us about the work that KSR Advocates (another Registered Lobbying Group) has done to assist you in manipulating the media.
Why don’t you open up about how CPIL receives substantial donations from Trial Lawyers who sue MD’s, Healthcare Organizations and HMO’s? Your work against Doctors surely will benefit them tremendously.
The work you do to deny or limit MD’s constitutional protections against illegal search and seizure gives these lawyers - these cronies of yours – major advantages in Plaintiff law suits.
Please tell us about your secret and underhanded appointment in 2003 as Enforcement Monitor for Diversion. Other, more qualified, interested candidates were told to apply, then told they couldn’t, then told they were too late and the position had been filled by you. Clue us in about how this was aided by David Thornton. Tell us how you could be considered an Independent Monitor when your conclusions were foregone. Mrs. Fellmeth, Mrs. Fellmeth, the deeper one digs, the more Kafkaesque this becomes.
Your self assumed identity as a patient advocate is preposterous. Your collaborator, Tina Minasian, is a prime example. While claiming she’d been injured by a Doctor in the Diversion Program, she never mentions how she gained excessive weight and resumed smoking after major lower body surgery, in direct disregard of written and verbal orders. Outside of your fantasy world, evidence trumps accusations and media manipulations. After Minasian’s complaint to the Medical Board was thoroughly and professionally investigated, why was it rejected? Why was her Medical Malpractice case rejected all the way up to the Supreme Court of California and Minaisan ordered to pay court costs? Minasian’s self-proclaimed “Victim Posse” is equally merit-less, as are the multitudinous false complaints to the Medical Board she has solicited through her lynch mob mentality, incendiary web sites. Please tell us who pays for all this? We know you know.
The repeated lynchings in the press and other media against the Target Physician has been going on so long and is so egregious that the Medical Board’s own attorney appeared before the Board. In this unprecedented appearance, the Board’s Attorney (the Prosecutor) informed the Board that there was not a single valid complaint of Patient Harm. The Board’s own Attorney recommended the Board not take the case to trial, as it would be lost.
Mrs. Fellmeth, you like to emphasize “Zero Tolerance.” Should that be applied to you? Since benefiting plaintiff Trial Lawyers does not always equate with Public Protection, shouldn’t you have to be accountable? Let’s apply the same standard to you and Tina Minasian and demand that you disclose how your efforts benefit lawyers who sue doctors.
For the past fifteen-plus years you have expounded on and on about openness vs secrecy. You have urged passage of laws that would make physician’s private medical records open to public scrutiny if they were receiving treatment for addictions or mental health issues, or participating in the soon to end Diversion Program. So, in the spirit of openness, how about being open about the fact that you are a Registered Lobbyist? Or that Ed Howard, too, is a Registered Lobbyist and you are his client? Please tell us about the work that KSR Advocates (another Registered Lobbying Group) has done to assist you in manipulating the media.
Why don’t you open up about how CPIL receives substantial donations from Trial Lawyers who sue MD’s, Healthcare Organizations and HMO’s? Your work against Doctors surely will benefit them tremendously.
The work you do to deny or limit MD’s constitutional protections against illegal search and seizure gives these lawyers - these cronies of yours – major advantages in Plaintiff law suits.
Please tell us about your secret and underhanded appointment in 2003 as Enforcement Monitor for Diversion. Other, more qualified, interested candidates were told to apply, then told they couldn’t, then told they were too late and the position had been filled by you. Clue us in about how this was aided by David Thornton. Tell us how you could be considered an Independent Monitor when your conclusions were foregone. Mrs. Fellmeth, Mrs. Fellmeth, the deeper one digs, the more Kafkaesque this becomes.
Your self assumed identity as a patient advocate is preposterous. Your collaborator, Tina Minasian, is a prime example. While claiming she’d been injured by a Doctor in the Diversion Program, she never mentions how she gained excessive weight and resumed smoking after major lower body surgery, in direct disregard of written and verbal orders. Outside of your fantasy world, evidence trumps accusations and media manipulations. After Minasian’s complaint to the Medical Board was thoroughly and professionally investigated, why was it rejected? Why was her Medical Malpractice case rejected all the way up to the Supreme Court of California and Minaisan ordered to pay court costs? Minasian’s self-proclaimed “Victim Posse” is equally merit-less, as are the multitudinous false complaints to the Medical Board she has solicited through her lynch mob mentality, incendiary web sites. Please tell us who pays for all this? We know you know.
The repeated lynchings in the press and other media against the Target Physician has been going on so long and is so egregious that the Medical Board’s own attorney appeared before the Board. In this unprecedented appearance, the Board’s Attorney (the Prosecutor) informed the Board that there was not a single valid complaint of Patient Harm. The Board’s own Attorney recommended the Board not take the case to trial, as it would be lost.
Mrs. Fellmeth, you like to emphasize “Zero Tolerance.” Should that be applied to you? Since benefiting plaintiff Trial Lawyers does not always equate with Public Protection, shouldn’t you have to be accountable? Let’s apply the same standard to you and Tina Minasian and demand that you disclose how your efforts benefit lawyers who sue doctors.
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