Summary
The article vehemently argues that state medical, dental, pharmacy, and nursing boards are critically broken due to a severe lack of transparency and accountability, which ultimately harms both providers and patients. State medical, dental, pharmacy, and nursing boards, often lacking accountability, can unfairly target physicians for minor infractions, leading to career-threatening consequences. This regulatory imbalance is depleting the healthcare workforce, leading to physician burnout, reduced access to care, and a call for the “war on chronic pain patients, doctors, and pharmacists to end.“ Urgent reform is needed to restore balance and fairness, including increased transparency, independent oversight, and due process for physicians to restore fairness and public trust in the healthcare system.
from youarewithinthenorms.com
NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC., SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS, MD, PH.D., IN THE SPIRIT OF C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., M.B.A., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., EVELYN J. CLEMENT, IN THE SPIRIT OF WALTER F. WRENN III., MD., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., RICHARD KAUL, MD., IN THE SPIRIT OF LEROY BAYLOR, JAY K. JOSHI MD., MBA, AISHA GARDNER, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
DR. RICHARD LAWHERN: “It is time for the war on chronic pain patients, doctors, and pharmacists to end“
On July 23, 2024, Dr. Richard Lawhern joined six other members of the Speakers Bureau of the National Campaign to Protect People in Pain to offer a one-hour “listening session” to senior officials of the US FDA Center for Drug Evaluation and Research (CDER).
A 25-page summary of the proceedings has been posted to social media platforms and shared with the US FDA Office of Communications, Professional Affairs, and Stakeholder Engagement (PASE). Under the session rules, what follows below does not represent a commitment on the part of the FDA, either to validate our stated findings or to take action thereon.
The one-hour FDA presentation was titled “The Real Opioid Crisis in Three Charts”. Our key points included these:
- If the FDA audience carries away nothing else from this session, they should remember this: There is no such thing as opioid use disorder. The term originated in 2013 with the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – a document rejected by the National Institute for Mental Health as a framework for organizing research. Data published by the CDC itself completely discredits the notion that doctors prescribing to their patients are or ever were responsible for the US opioid crisis. And both CDC and DEA have known this reality for years.
- US CDC and US DEA are usurping missions delegated to the FDA by law, in the establishment of safety standards for prescription drugs. The consequence of this usurpation is the ongoing destruction of American pain medicine.
- CDC prescribing guidelines can be shown to incorporate outright fraud including failure to address genetically mediated opioid metabolism, misrepresentation of the effectiveness of non-opioid alternative therapies, one-size-fits all MMED dose criteria unsupported by science, and misrepresentation of opioid therapy, especially high-dose opioid therapy, as ineffective for long-term use.
- DEA prosecutions are grounded on non-representative “expert witnesses” who testify to anything DEA wants, no matter how false. Likewise, Administrative Law Judges deny defendants adequate representation by pre-trial asset confiscations and by rulings biased in favor of the DEA.
- It is now known beyond contradiction that incidence of addiction and overdose in pain patients treated by a doctor is too small to measure accurately within confounds of diagnosis and poor clinician training. Law enforcement is particularly ill-equipped to comment on this issue. It is also known to CDC and DEA that doctors overprescribing to patients was never a significant cause of the US opioid crisis — and is not now.
- Our speakers appealed to FDA to take public action to repudiate and demand the withdrawal of horrendously damaging injunctive relief provisions imposed by the National Opioid Settlement. We also encouraged the Agency to take immediate action to correct its own databases concerning shortages of prescription opioids created by the US National Opioid Settlement injunction.
- We asked FDA to publicly repudiate and demand withdrawal of CDC/VA/DoD opioid prescribing guidelines, without replacement. In a spirit of transparency, we also disclosed that stakeholder participants in the session are co-complainants in formal complaint actions filed May 21, 2024 with the US Department of Justice Office of Civil Rights and the Office of the Inspector General of DHHS. We allege criminal fraud and denial of US citizens’ civil rights on the part of CDC authors and approving officials for the 2016 and 2022 published opioid prescribing guidelines.
Findings briefed in the FDA Listening Session are being disseminated widely to US government Agencies, including the National Institutes of Health, National Institute on Drug Abuse, National Centers for Injury Prevention and Control, and the Offices of the Surgeon General and the Inspector General in the Department of Health and Human Services.
Online meetings are being requested with the Federation of State Medical Boards, as well as all State Medical Boards, Boards of Pharmacy, and Departments of Health.
“It is time for the war on chronic pain patients, doctors, and pharmacists to end”
Reforming medical boards is critical to saving patient care,” argues that state medical boards are failing both physicians and patients due to an overzealous pursuit of minor infractions against doctors while often neglecting serious malpractice. This “overreach” by boards, driven by factors like greed, a lack of accountability, and opaque processes, forces physicians into costly legal battles or punitive sanctions, leading to burnout, departures from the profession, and reduced access to care, especially in underserved areas. The article calls for urgent reform, emphasizing the need for transparency, independent oversight, and due process for physicians to restore balance, fairness, and trust in the healthcare system.
Why reforming medical boards is critical to saving patient care
Imagine a dedicated physician, after years of rigorous training and countless lives saved, facing a medical board complaint over a minor issue—perhaps a clerical error in documentation or a subjective interpretation of a clinical decision. What should be a straightforward matter escalates into a career-threatening ordeal.
State medical boards, endowed with significant authority, often wield it with little accountability. Armed with prosecutors who prioritize winning over truth, boards can distort facts, rely on questionable “expert” testimonies, and dismiss the input of respected colleagues.
Physicians, trained in medicine, not law, are ill-equipped to navigate this adversarial process. They face a brutal choice: drain their personal savings fighting a costly legal battle or accept punitive sanctions that may restrict or end their ability to practice.
In the U.S., a 2021 CBS News investigation revealed that state medical boards, often composed of physicians selected by state governors, frequently fail to discipline doctors for malpractice while aggressively pursuing minor or questionable infractions, leaving physicians vulnerable to unfair sanctions.
The financial and emotional toll on physicians is staggering. Legal defense costs can exceed tens of thousands of dollars, and the stress of prolonged investigations can lead to burnout, mental health challenges, or even departure from the profession. A 2013 study noted that medical boards reprimand less than 0.5 percent of physicians annually, yet these actions often target character-based issues rather than clinical competence, further illustrating a focus on punitive measures over patient safety. This misallocation of resources distracts from addressing genuine threats to public health.
The consequences of medical board overreach extend far beyond the individual physician. Every doctor sidelined by frivolous or overzealous disciplinary actions represents a loss of expertise, trust, and access to care for entire communities. In rural or underserved areas, where physician shortages are already acute, the removal of even one doctor can have devastating effects.
Patients face longer wait times, reduced access to specialists, and strained emergency services. The ripple effect is profound: a 2021 report from the Federation of State Medical Boards (FSMB) noted that boards’ actions, while intended to protect the public, can inadvertently exacerbate health care disparities when they disproportionately target competent physicians over minor issues.
For example, in California, critics have pointed to the influence of powerful lobbying groups like the California Medical Association, which may prioritize protecting the profession’s image over ensuring fair disciplinary processes.
A 2021 CBS News analysis found that the California Medical Board issued lenient punishments in nine out of ten cases, often allowing doctors with repeated negligence to continue practicing, while aggressively pursuing less severe cases. This inconsistency not only undermines public trust but also diverts resources from addressing serious misconduct, leaving patients vulnerable.
Every physician lost to overreach means fewer hands to treat chronic illnesses or respond to emergencies, weakening the health care system’s foundation.
The hidden motive: greed and power
Perhaps most troubling is the potential for greed to drive medical board overreach. Some boards exploit their authority to impose hefty fines or sanctions, turning oversight into a profit-driven enterprise. A 2016 analysis by Simas & Associates highlighted how slow, bureaucratic processes can prolong investigations, increasing financial and reputational damage to physicians, even when complaints are baseless.
Prosecutors, motivated by career advancement or pressure to maintain conviction rates, may push cases built on shaky evidence, as seen in the case of Dr. Bay, where the board’s actions were later deemed unlawful.
This profit motive is compounded by a lack of transparency. A 2023 audit of the North Carolina Medical Board found that restricted access to investigation records limited oversight, leaving the public unable to assess whether boards adequately protect patients.
Similarly, in Massachusetts, a 2019 report criticized the Board of Registration in Medicine for inadequate oversight of physician health programs, raising concerns about fairness and accountability. When boards operate in secrecy, they risk prioritizing self-interest over public welfare, eroding trust in the regulatory system.
A call to action: Restoring balance and fairness
The crisis of medical board overreach demands urgent reform. Transparency must be prioritized, with clear, consistent standards for investigations and disciplinary actions.
Boards should be required to publish detailed reports on their processes and outcomes, as suggested by a 2020 audit of Massachusetts’ medical board. Independent oversight, including non-physician members, can reduce bias and ensure fairness, as evidence suggests boards with diverse membership impose more equitable discipline.
Physicians must be afforded due process, including access to affordable legal representation and the ability to appeal decisions without excessive financial burden. The Texas Medical Board’s process, which allows for informal hearings and remedial plans for minor violations, offers a potential model, though it still requires greater transparency to prevent abuse. Patients, too, deserve a system that prioritizes their safety without sacrificing access to care.
Medical board overreach is a tragedy that harms everyone—physicians lose their livelihoods, patients lose access to care, and communities lose trust in the system.
By shining a light on this corruption, we can demand accountability and protect the healers who dedicate their lives to our well-being. It’s time to unite—patients, physicians, and advocates—to reform a broken system and ensure a health care future where no one loses. The stakes are too high to remain silent.
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