HARBR Declares Another PHP Unaccredited: Acumen

17NovNovember 17, 2017 By Christian Wolff

November 16, 2017 Investigative Report by Christian Wolff |

In March and May, 2017, I wrote letters to the Center for Personalized Education for Physicians (CPEP). I declared them “unaccredited” on May 25, 2017 in an article I wrote for the HARBR website. See “HARBR Declares CPEP “Unaccredited”” at HARBR’s website. HARBR stands for Healthcare Alliance for Regulatory Board Reform.

In May and June 2017, I wrote another Physician Health Program (PHP). It is the Acumen Institute located in Lawrence, Kansas. This time, I used my real name. The procedure was the same as with CPEP only my line of questioning was more extensive. After more than 3 weeks had passed without response, I wrote the Acumen Institute again. After 3 more weeks without response, I pronounced them “unaccredited” as well.

It is only now that I am publicly declaring them “unaccredited.” HARBR extends an open invitation for the Acumen Institute to publicly respond and to offer documentation of their accreditation.

Silence is capable of speaking volumes. It is reasonable to assume that the Acumen Institute did not respond because truthful responses to the questions asked would not shed them in a favorable light. We will assume the worst by default and expect the Acumen Institute to respond if they wish to redeem themselves as a legitimate Physician Health Program. HARBR also invites others to contact Acumen and to report the result of their contact or contact attempts here. Find the Acumen Institute website at http://www.acumeninstitute.org/.

Acumen did not offer an independent email address on their website. Only contact forms. The forms I filled out can be viewed here. The content of the emails I sent them is as follows:

May 13, 2017

To whom it may concern at Acumen Institute and Acumen Assessments:

I have a colleague who is being coerced into an assessment at your facility. He’s been order to be assessed in exchange for the possible retention of his healthcare license. I have a few questions for you if you would not mind answering them. I do want say, I am at first read, impressed by your website. As a web designer, I appreciate its good look. As a person with an interest in healthcare, I appreciate the fact that Acumen seems more transparent than other facilities who participate in coercive treatment.

1. Why do you have two separate facilities – Acumen Assessments and the Acumen Institute?

2. What are the tax classifications of each?

3. Do you accept medical insurance? Malpractice insurance? If not why not?

4. Do you have anything to demonstrate a history of the efficacy of your treatment set?

5. Do you use tests which have been tailored to healthcare professionals participating under regulatory board pressures? Do you have information on these tests suc as authors, author affiliation, and validity and reliability measures? Publication in major scientific journals along with independent peer review?

6. I see that your staff has a long and impressive list of “Presentations AND Publications.” By my count, there are 55 listed. Of those 55, I could only find one item which seemed to be an actual publication. Don’t you find that calling that list “Presentations AND Publications” a little misleading? Anyone not looking closely (especially with that section title) could easily assume half the items, more or less were publications. If you had divided this list into two sections for the sake of transparency, you would have had about 54 presentations under “Presentations,” and only 1 item under Publications. That publication seems to be a chapter in a handbook:

Stacy, S., Graham, P., Athey, G. (2008). The Use of the Rorschach in Professional Fitness to Practice Evaluations. In Gacono, C., Evans, B., & Kaser-Boyd, N. (Eds.), The Handbook of Forensic Rorschach Psychology. Mahwah, NJ: Lawrence Erlbaum Associates.
When I read a citation, I sometimes look for page numbers in order to see how long a chapter or article is. You citation has no page numbers.

Published independently peer reviewed written material is more reputable and reliable than presentations to a limited, time specific audience. How do you explain yo blending of your 1 publication with 54 presentations?

7. Would you say it is fair to say that the vast majority of your presentations have been to Physician Health Programs (PHP), the Federation of State Medical Boards (FSMB), and affiliates of these two?

8. As professional psychologists, psychiatrists, and other mental health professionals, would you say you understand the importance of independent peer review? Ho would you explain it’s importance – or if you prefer, why do believe this is important? Test results? What is the importance of independence in the establishment of the results’ reliability?

9. Why don’t you have a regular email address? I like to keep a paper trail of all my correspondence. Although I personally can work with your format, may people – li those being coerced into treatment – could not. I’ve noticed that this lack of a simple published email address is a regular feature on websites for facilities which participate in coerced assessments and treatment.

10. Finally, for now: Why don’t you just publish the answers to most of the questions I’ve asked. I’m sure you are aware that your clientele tends to be both scared an skeptical. They are surely going to want to know as much as possible. It seems you should be able to anticipate their questions and it seems the respectful thing to to provide answers – published and verifiable in advance.

Thank you in advance for answering my questions. I know they seem kind of tough and you may have some apprehension about answering them, but it is important. I will look forward to your response.

Sincerely,
Christian Wolff
Healthcare Alliance for Regulatory Board Reform (HARBR)

Then:

June 4, 2017

To whom it may concern at Acumen Institute and Acumen Assessments:

I wrote to you over 3 weeks ago, and so, far have not received a response from you of any kind what so ever. I am convinced you are agreeable to email communication since you have an email Contact Form. Perhaps you missed my email. That happens sometimes. I am still concerned that, for some reason, you don’t simply publish your email address so people may use their own email client. This would allow people to be sure that their email was received if, say, your Contact Form was not working. Did you receive my email of May 23? I have reproduced it below. Due to the delay in your response, my colleague is feeling pressure to make an uninformed decision about whether to comply with his board’s demands or not. He would like to be on solid ground in declining their demands if it turns out that yours is not a reputable facility. Without that information, he will likely comply by default. There is a lot that is on the line for him. I suppose, as experts in behavior generally, and experts in working with healthcare professionals being coerced into assessment and treatment, you know that licensees will comply by default if they are not on solid ground in declining to comply. Is that reasonable to believe – that you would know that?

I have a couple more questions:

1a. Do you require pre-payment for your assessments?

2a. Do you ever refund fees? If so under what conditions do you or do you not provide refunds?

3a. In cases in which it seems that an assessment was, in your opinion, unnecessary, unwarranted, or redundant, do you ever send the bill to the board who coerced licensee into assessment? If so are there any instances at all in which the board has ever paid?

Please get back with me a soon as possible. The matter is of great importance and time is getting VERY tight. Thank you.

Sincerely,
Christian Wolff
Healthcare Alliance for Regulatory Board Reform (HARBR)

Why would the Acumen Institute not answer these questions?

Medical School: Ethos Reform

12OctOctober 12, 2017 By Christian Wolff

by Kali Miller, PhD | Sept.12, 2017 | Posted to HARBR Oct.12, 2017

Mama don’t let your babies grow up to be doctors.

“75% of med students and new doctors are on antidepressants or stimulants (or both)”. The title of Pamela Wible MD‘s article caught my eye. I knew that CNN had reported that 25% of medical students report depression and about 1 in 10 have suicidal thoughts. As a former psychologist who had clients who were physicians and friends who went to medical school, that number sounded low to me. Dr. Wible’s numbers sound much more accurate, perhaps due to enhanced anonymity for her participants. After all, what professional is going to risk their career and livelihood by reporting having “psychiatric problems”. This could not only negatively impact medical students during training, but would then have to be reported to their boards when licensed. It’s interesting as professionals how we are trained to be HIPPA compliant, protecting our clients and patients confidentiality vigorously, while at the same time accepting that our own medical and mental health information is not protected from our boards and even some insurance panels.

The American Academy of Sleep Medicine reports that medical students are one of the most vulnerable groups when it comes to suffering from “poor sleep”. Those unfamiliar with medical school might think it is the rigorous studying and the stress of making life and death decisions that disrupts students sleep and I’m sure they’re not wrong. However, consider that in 2003 The Accreditation Council for Graduate Medical Education (ACGME) developed regulations which restricted “continuous maximum extended duty to 30 hours.” Does your mind boggle? Well thank goodness their recommendation was reduced in 2011 to 16 hours for some (not all!) medical students. In “The Danger Medical Students face when they don’t get enough Sleep” Sierra Kennedy writes that doctors who work more than 16 consecutive hours have “36% more serious medical errors than those whose scheduled work is limited to 16 consecutive hours” and “make 5X as many serious diagnostic errors.” This is certainly good information but really, isn’t the real question how many hours can an individual in a complex high stress occupation work before their cognitive ability significantly declines at all? These numbers don’t tell us what the decline in functioning was prior to the 16 hours. Are you curious what the decline was after 8 hours, or 12 or 15? If I recall correctly, in graduate school we were told that high stress professions such as physicians, police officers etc had a significant decline in the ability to make good decisions, defuse high stress situations and regulate their own emotions after 4-6 hours. And never mind learning.

The lack of sleep and the elusive search to feel sharper, faster, smarter explains the stimulants. And the use of stimulants doesn’t just include stimulant medications, which are controlled substances. Smoking and excessive caffeine intake is also rampant in the medical community. Didn’t you ever wonder why physicians, who of all people should know better, don’t. In my clinical psychology graduate program we were told that we could not even make an accurate diagnosis until our clients were sleeping 8 hour per night on a steady schedule for a month. Prior to that, our goal was primarily to assist our client in creating a healthy sleep routine for their mental as well as physical health. The research was in, sleep deprivation can cause depression, anxiety, aggression and even psychosis. Meanwhile, medical students and many physicians may have gone far beyond the hopes of best practice and are simply trying not to kill anyone in their impaired state.

Since being made privy to these facts over 25 years ago, I became convinced that forcing medical students and physicians to work with lack of, or interrupted sleep is not only unethical but should be illegal. I think of medical school as similar to joining a cult. You feel very honored to be asked to join. You quickly realize those in power control who and what you are exposed to but believe that the reward will be well worth it. You have little or no time for extraneous relationships, including family. To succeed you must strictly adhere to prescribed reading and activities. You are often limited in when and what you can eat and told when and sometimes where you can sleep. As exhaustion mounts you are particularly susceptible to suggestion. You are told your entire future rests on your actions, your absolute perfection, but are set up again and again for failure. Sometimes your failure has lethal heart wrenching results and but you can’t talk about it. In fact, there are a lot of dirty little secrets you aren’t supposed to talk about. When the inevitable error happens you are either shamed and chastised, even cast out, or a superior covers for you. This leaves you feeling pitifully grateful, yet knowing your mutual silence is another cost of being in the cult, or profession, as the case may be.

Medical school graduates hope that once they’re licensed the depression, the medications, the cigarettes and alcohol won’t be needed any more, the memory of mistakes will be blunted by time, and somehow everything is going to be Okay. You have only to look at the low career satisfaction ranking of physicians or the Mayo Clinic study that confirms physicians have the highest suicide rate of any profession to see that all to often, this simply isn’t the case.

It is refreshing to see professionals like Pamela Wible speaking out. If nothing else students can make an informed choice regarding whether they want to pursue a career in medicine. Facts in hand and caught in the spotlight, teaching facilities have an opportunity to make wiser choices about how young physicians are trained. Physicians themselves can begin to speak up about what they have endured and rather then argue that they made it through or “It’s always been done this way” they can speak up for their own, the future of medicine in this country.

Our current model of training physicians serves neither the provider nor the client and it doesn’t take a psychologist to figure that out.

Kali Miller, Ph.D.

Read the article which inspired this one:

75% of med students are on antidepressants or stimulants (or both) by Pamela Wible, MD

Friends Outside of Oregon: Dr. Michael Langan & PHP’s

25AugAugust 27, 2017 By Christian Wolff

August 24, 2017 – Injustice in the healthcare regulation is occurring across the nation and across the world. Although HARBR-proper is largely centered in Oregon, USA at present, we have friends and affiliates in other places. Thus, our web address, harbr-usa.org. In this report we’d like to introduce one of our dynamos from Boston. Michael Langan, MD is the owner and operator of a website called “Disrupted Physician.” Michael is extremely knowledgeable about the injustices physicians can face. Concerned about the effects of a medication he was using, Dr. Langan sought assistance from a Physician’s Health Program (PHP) believing he’d receive professional medical assistance. Once signed up however, Dr. Langan found himself moving down a path of, what we believe he may agree to call, dystopic enlightenment. Though Dr. Langan entered the treatment program voluntarily and in good faith, various other “authorities” soon took control of Dr. Langan’s fate and gained Dr. Langan’s “compliance” by threatening to take action against his license to practice medicine.

By all rights, Dr. Langan should be presently practicing his profession at Massachusetts General, be in good standing with his licensing board and teaching at the Harvard School of Medicine. Instead, he is fighting seemingly impossible protracted battles with the Massachusetts Medical Board, with the PHP, and with the legal system itself.

A Physician Health Program (PHP) is a generic term for many of the medical, mental health, and substance abuse programs across the country which are specifically geared toward the treatment of physicians. As evidenced by commentary on MedScape articles and elsewhere, many believe that PHP’s may have started out as legitimate treatment programs with faithful missions to help physicians in need of treatment. As these programs developed, they increasingly came to resemble diversion programs for physicians who had come to the attention of their licensing boards. By successfully completing treatment, physicians could avert action being taken against their licenses. Unfortunately, these programs have continued to “evolve.” To find out more, follow some of the links below.

Dr. Langan is a prolific researcher and writer on these topics. He has drawn attention to the problems surrounding PHP detention through his website, numerous articles published by him and about him in MedScape, and through his communications with other healthcare professionals experiencing similar abuses by healthcare authorities. According to a recent report by Dr. Langan, five physicians and other healthcare professionals are contacting him per week about similar abuses they are experiencing.

We consider Dr. Michael Langan’s work to be recommended reading.

You may find Dr. Langan’s website at https://disruptedphysician.com/

Medscape articles about Dr. Langan:

Physician Health Programs: More Harm Than Good?: State-Based Programs Under Fire by Pauline Anderson

Embattled Doc Suffers Another Setback in PHS Fight by Pauline Anderson

Note: For Medscape articles, one may need to go first to Medscape, and then search “Michael Langan” or otherwise go to these articles. It is also possible you may need to sign up. Sign-up is free and non-intrusive. You may also use a pseudonym to sign-up if you are concerned about board reprisal.

One of the advantages of signing up is that you may comment on Medscape articles, read comments and engage in discussion with others on these topics or others. Some have found the comment sections as valuable as the articles themselves.

Medscape Article by Dr. Langan:

Why Doctors Need to Be Gutsy by Michael Langan

We will be placing a permanent link to Dr. Langan’s “Disrupted Physician” on this website as well as links to these and other useful articles.

On the world scene: We have an Oregon physician we’ll be introducing who is doing some work on related matters with medical professionals in South Africa (in addition to her local work). She’s also making a feature film – a documentary – which will come out soon called “Do No Harm.” Why would injustices in South African medical settings matter to healthcare professionals in the United States? You’d be surprised. Such injustices are becoming a world-wide phenomenon and this provides us with an opportunity to create a world-wide united front for regulatory reform in healthcare.

We will also be introducing supportive material recently published in the BMJ (formerly, the British Medical Journal).

Counselors & Therapists

14AprAugust 27, 2017 By HARBR Writers

Are you a Counselor, Therapist or another type of healthcare professional licensed (or formerly licensed) by a State Mental or Behavioral Health Board? Aside from the general problems faced in dealing with healthcare regulatory boards, what are some of the special problems you face in this regard? Is it something about the nature of your profession, the way your profession is regulated in your state, both, or something else? Please contribute your comments below. Periodically, HARBR will produce a summary in the main section of this page.

Please feel free to dispute HARBR’s categorization of Counselors and Therapists. Among licensed Counselors and Therapists, we are focusing on professionals who usually have Masters Degrees and practice in fields of mental or behavioral health. Examples include various Licensed Professional Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers with abbreviations such as LPC, LCPC, LMHC, LMHP, LMFT, LCSW, and so forth.