Thanksgiving Greetings!
Seems it was just the height of summer and now … it’s Thanksgiving and the Holiday Season!
I know I’m not the only one who feels like life is moving at warp speed while we’re each also dealing with a scatter of pressing issues in our professional and personal lives.
Certainly two things to be thankful for:
- we seem to be past the crisis period for Covid and reasonably normal communal life is returning; and
- we had the gift of many courageous physicians and nurses and the array of diverse primary care clinicians who navigated this pandemic with compassion and remarkable perseverance.
Please take just a moment of appreciative silence for all those who with the highest ideals of medicine served the profession of healing in these challenging times, with commemoration especially of those who gave their all.
Overwhelm
A term certainly not foreign to CPR’s subscribers!
Part of my overwhelm has been pursuing diverse collaborations within CPR; part the ongoing need for curbside consultations; part the ever-expansive legal and policy research re MRTCs; and then, part is managing multiple commitments in professional and personal life outside of CPR.
One in particular (ironically covering the nature of overwhelm) is my commitment to make definitive headway on a long-derailed project, sharing the practical emotional intelligence model MindSense that I’d developed over 20 years ago. With my then mid-career burnout, multiple subsequent transformations in professional life, and then my pivotal whistleblower experience which vaporized my medical career and threw me into the Twilight Zone, it got put away. But while the writing part of it lay dormant, its core ideas and practices didn’t. In fact, it got the down-to-earth applicability test. And I’m pleased to say it became the primary resource of maintaining psychic equilibrium in my ensuing upside-down Kafkaesque nightmare dealing with the NC Medical Board and its evasive sibling the NC Physicians Health Program.
More on MindSense later, for sure. I’ve begun posting MindSense-related pieces on my other, non-MRTC-focused Substack blog “ShrinkRap.”
Collaborations
As you may know, I’ve partnered with several MD colleagues over this past decade plus as we’ve grappled with making sense of the cauldron that is the state medical board and state physician health program collusion, an entity I and co-authors Bob Emmons and Louise Andrew came to term the Medical Regulatory Therapeutic Complex. You’ve likely seen many references to that unusual acronym – MRTC. The paper which named and explained it can be found on the articles page of our website.
One of our multi-year collaborations was among Louise Andrew, Tom Horiagon and myself. We began meeting bi-weekly about three years ago simply to make sense of this menacing behemoth in our career living room that each of us had only a limited grasp on. (You recall the image of the three sagacious Indians, each describing to the others the sight and feel of the elephant part they were closest to and trying to make sense of all of the perspectives.) Louise and I, earlier and concurrently meeting regularly with Attny Bill Goren in what was essentially a combined ADA tutelage for us and a medical world FFDE immersion for Bill, then began dialoging with Tom. Tom had been writing brilliant pieces on strategic approaches to boards, PHPs and contracting arrangements which he posted on LinkedIn. And so we came to meet regularly, sharing perspectives on this MRTC beast and exploring possible legal and extra-legal approaches to confront its renegade (and likely Sherman antitrust-violative) behavior in its often due process-denied approach to medicalized discipline.
Unfortunately, Tom, who with his four board certifications and whistleblower-related career derailment was just entering his second year of law school, was stricken by a rapidly progressive oropharyngeal cancer. Despite aggressive treatment, he succumbed to complications Nov 1st. His way-too-premature passing is a huge loss for the CPR community.
Please keep his wife Mai and their two children Thomas and Therese in your caring thoughts. For those who’d like to correspond or send condolences, please let me know and I’ll pass on that contact information.
Questionnaire Results
You know how they say that staying regularly in touch with your fans is the key to your success?
Well, staying in touch has been catch-as-catch-can in the CPR world. Partly the challenges of technology; partly my own multi-project scatter; partly the psychological toll of dealing with the relentless toxic behaviors of a vile MRTC cabal while also trying to stay as objective as I can consulting with a stream of rights-abused docs seeking guidance; and of course the array of personal stuff we all have to deal with. And none of this is made any easier navigating the larger existential crises trying to make sense of a world seemingly gone mad … well, all that (and more) is the reason for the delayed follow-up. I wanted you to know that as I didn’t want any of CPR’s devoted fans to assume it was laziness or disinterest (or worse, that I’ve truly lost it).
In the summer newsletter, I sent out a survey seeking input on CPR’s initiatives - and we had a robust response! Thank you to all who responded, many with very thoughtful comments sharing their specific MRTC concerns and hopes for CPR’s attention to them.
Results of our poll
There were three poll-type questions
1) Are there particular topics you'd like to see CPR more fully address – whether on our website or in our "Physician Interrupted" blog? Please check all topics you'd like to see us cover.
Here are the top 3:
Better understanding of the concept of "peer review" and what constitutes "sham peer review.” 68%
Rights and duties of medical boards and licensees in handling complaints or concerns. 61%
How to determine whether you need legal representation and how to select a lawyer. 61%
(here’s the full array, rank ordered1)
Discussion
And so it appears that the potential topics we listed captured the attention of the majority of respondents. That said, in our upcoming webinars, we can’t go wrong in offering an exploration of any of these. And so, that’s what we’ll do.
2) CPR Zoom Discussion
In order to more fully hear members' concerns and have an opportunity for Q&A, we plan to host free periodic CPR Zoom meetings, likely beginning 8pm EDT on a weekday evening and lasting ~ 1 hour. How interested are you in attending?
Summary - Zoom Discussion ~ 75% Interested
3) Launching a private, subscription-based membership site for physicians only
We are launching a private, subscription-based membership site for physicians only (with membership registration verification screening and host moderation) which will offer access to highly relevant articles and specialized resources, private interactive discussion groups (applications separately screened to ensure safety), private member chat, and 1-1 trained peer support. Might you be interested in participating in such a private membership community? (Not a commitment; just gauging interest.)
Summary: That’s a whopping 80% possibly interested or definitely interested in learning more.
Overall Poll Summary:
There’s broad interest in all of the topics we propose.
There is broad interest in getting together for a zoom meeting both to learn from various authorities about the key issues CPR’s about and to develop a collaborative agenda.
And there’s broad interest in learning more about a private physician community to discuss safely amongst ourselves the immediate challenges to physicians’ rights.
On behalf of CPR, I deeply appreciate the active interest you’ve shown.
Next Steps
So, from this encouraging feedback, we’re planning an open Zoom for Tues Dec 13th, 8pm EST, 5 pm PST. We’ll lay out the agenda in the days ahead. I’ll post a separate announcement with the registration link.
The Deceptive “Safe Harbor” Laws – New Article on Physician Interrupted (on Substack)
I’ve posted another piece on the Physician Interrupted blog. It’s a deeper dive into the deceptive “safe harbor” laws that are cropping up, and in particular, the recently enacted DE version. My take: each is essentially a sting operation that likely commits at least three legal or ethical violations. They select out one population of people for special screening (physicians); they bait-and-switch using the promise of complete safety and confidentiality; and they thoughtlessly and dangerously violate the ethical principles of an entire profession of workers, that of the diverse mental health professionals whose very work hinges on the assurance of sacrosanct confidentiality. On top of these, they essentially create a profound betrayal of trust among the physician community as a whole by daring to pull off such a devious ensnarement, at that, under such a pseudo-compassionate guise.
Future Envisioning
Moving from Documenting Catastrophic Career-Harm Scenarios to Desired State
As we continue to define the expansive contours of the challenges to physicians’ rights and well-being, it’s more important than ever to build our community of informed physicians and caring supporters and make clear to the larger physician community the threats to their career viability and to their patients’ well-being. And not only must we continue to educate the physician community about these various threats, we’ve got to begin envisioning what it is that we want to see put into place. Not only to confront these rights incursions but to change the overall power dynamic so that the predominant emphasis is on genuinely fostering physician well-being and ensuring fairness in all licensing, credentialing and career viability matters.
Lastly, a Slight Shift in Where Our Newsletter Originates
Because Substack (currently hosting the Physician Interrupted blog) is so user-friendly, and now has developed a separate chat feature (available on its iOS app), it seems most sensible to move the CPR newsletter creation over to Substack.
We had already begun toying with various ideas for naming the newsletter, and “The Rhythm Strip” seemed catchy (you know … CPR, heart, beat (ahem), codes, ekgs, rhythm strips …).
While the CPR website stays in place, we’ll be shifting all of CPR’s subscribers over to The Rhythm Strip which will be CPR’s official newsletter. And, like the Safe Harbor summary above, pieces on Physician Interrupted and other relevant blogs will be succinctly summarized and linked to. And since all subscribers to The Rhythm Strip will now be members of the larger Substack community, it’ll be a breeze to switch between newsletters.
And I suspect it’ll make it a lot easier to get out a newsletter on a more routine basis.
Hopefully, there won’t be any significant snags in the transition; it should be seamless and invisible to you.
In the meantime, to get you started on Substack, I’m cross-posting this nearly identical newsletter to its new home The Rhythm Strip on Substack. When you jump over there to read it, it will first ask you if you’d like to join The Rhythm Strip newsletter (for free, of course). If you’re not yet a Substack member, it’ll ask you for your email address (that’s because Substack’s universe of newsletters all get sent out via email). Have no hesitation in registering newly there. And presuming you used the same email at which you’re receiving this, when we transfer the CPR subscriber list, Substack will already have your email.
If you’ve not already done so, be sure to download the Substack app on your phone (see button below). And if your phone is in the iOS / iPhone system, do check out the new Chat feature as I’m hoping it will enable productive dialog among us.
Looking forward to your participation in our upcoming gatherings!
Kindest regards,
Kernan
Rank Ordered:
Better understanding of the concept of "peer review" and what constitutes "sham peer review.” 68%
Rights and duties of medical boards and licensees in handling complaints or concerns. 61%
How to determine whether you need legal representation and how to select a lawyer. 61%
How to optimally prepare for your encounter with any of the above entities. 47%
How to protect yourself in the event that you want to get professional mental health services. 46%
Rights and duties of PHPs (physician health programs) or their comparable "health professionals assistance program". when referred for some form of evaluation. 43%
How to protect yourself if you need to "blow the whistle" on wrongdoing within your organization.43%
How to handle harassment in your work setting. 39%
Rights and duties of ACGME programs and of PGYs when facing an adverse action that may affect their continued training. 21% (this may reflect the proportion of PGYs on our mailing.
What’s important to note is that our subscriber base may not be reflected in the survey demographics (for any number of reasons).