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Georgia On Our Minds

Throwing Down the Gauntlet in Support of Michael Langan, M.D.

A Three Part Expose’

by:

Anne Phelan-Adams, M.D.

Part I


Prologue

Part II

Part III

Louise B. Andrew, MD JD FACEP, a former liaison from the American College of Emergency Physicians to the Federation of State Medical Boards, is credited with commending state Physician Health Programs (PHPs) as “helpful to struggling doctors” and “safe alternative(s) to suffering in silence.”[1] In a 2017 article titled Physician health programs: ‘Diagnosing for dollars’?, medical doctor Dinah Miller reports:

In her May, 2016 column in Emergency Physician’s Monthly, Andrew noted, ‘A decade later, and my convictions have changed dramatically. Horror stories that colleagues related to me while I chaired ACEP’s Personal and Professional Well Being Committee cannot all be isolated events. For example, physicians who self-referred to the PHP for management of stress and depression were reportedly railroaded into incredibly expensive and inconvenient out-of-state drug and alcohol treatment programs, even when there was no coexisting drug or alcohol problem.’[2]

Dr. Michael Langan explains:

In 2006, I went to a Massachusetts-based Physician Health Program (PHP) seeking advice on tapering off a narcotic I was legitimately prescribed for pain related to adult onset chicken-pox and shingles. I was only taking the medication at night and it was not problematic except I wanted to stop taking it, but had difficulty due to withdrawal symptoms. As with any doctor referred to (or who refers himself to) a PHP, I ended up spending more than three months in an out-of-state cash only inpatient rehab facility, and signing a five year treatment contract. All of these contracts require drug and alcohol testing, regardless of a doctor’s reason for original referral, as PHPs forbid use of any and all licit as well as illicit substances of potential abuse including alcohol.

Langan is referencing his consultation with John Knight, then an Associate Director at Physician Health Services, Inc. (PHS), a nonprofit PHP and affiliate of Massachusetts’ physician disciplinary agency, the Massachusetts Board of Registration in Medicine.

Dr. Michael Langan

Heeding John Knight’s informal recommendations, Dr. Langan underwent drug testing which revealed a metabolite of the Vicodin® his physician properly prescribed him, but no other drugs of potential abuse, including alcohol. PHS Director, Dr. Luis Sanchez, referred Langan to the nonprofit’s preferred addiction treatment facility – “The Talbott Center” in College Park, Georgia – where he stayed at his own expense for more than three months. Believing he would receive a fair evaluation, Dr. Langan brought with him to Talbott a copy of his lab test, positive for a metabolite of hydrocodone, and a letter from the manufacturer confirming the substance, found in his urine, was a metabolite of the Vicodin® his personal physician prescribed him. Langan also took with him to Talbott results of hair and fingernail tests confirming he had not consumed alcohol or any other controlled or illegal substances in the previous three to six months.

Geriatrics, the branch of medicine or social science dealing with the health and care of old people.

Dr. Langan came to Georgia’s Talbott Center in January 2007 with an exemplary record as a physician. In his thirteen years at Harvard Medical School and ten years at Massachusetts General Hospital (MGH), Langan was never professionally disciplined or threatened with a malpractice claim. He was highly regarded by his peers and patients. Langan had chosen to specialize in geriatrics, a branch of medicine requiring particular compassion, patience, wisdom and exactitude. Yet, before any evaluation was started, Talbott’s Medical Director, told Langan that he (i.e., Langan) was “in denial” and if he did not accept treatment for his “addiction”, he would never practice medicine again.


Talbott’s Dr. Steven Snook, a licensed psychologist, conducted two neuropsychological tests on Dr. Langan. One test was the Wechsler Adult Intelligence Scale (WAIS), a commonly used “IQ” test, to assess cognitive function. While Snook reported that Dr. Langan tested in the “high average to superior” range, this score was about 20 points below what he previously and then subsequently scored on the same instrument. The discrepancy is significant as the WAIS is known to be a highly reliable instrument.

The other test Snook administered was the “Minnesota Multiphasic Personality Inventory” (MMPI), a screening test for personality and psychological disorders. As a Talbott agent, Dr. Snook reported that Langan’s MMPI test scores suggested he was defensive, guarded, somewhat grandiose, and deceitful. Dr. Langan was so taken aback by the assessment that, after leaving The Talbott Center, he asked a MGH neuropsychologist to obtain the raw data and score sheet on which the assessment was based. She indicated that Langan’s test scores were the epitome of normal; troubling since the interpretation of MMPI test scores are fairly standardized. Dr. Langan accordingly reported the incident and Dr. Snook to the Georgia Psychological Association. At its insistence, Snook submitted a corrected MMPI report on Dr. Langan and a one sentence apology to Langan for the inconvenience the misinterpretation caused him.

Contracting under the barrel.

While at Georgia’s Talbott Center, Dr. Langan had a urine drug screen that was negative for all substances tested, including alcohol and opioids. He also had a 12-panel hair test for any drugs of abuse he might have consumed in the previous three to six months that was also negative. Nonetheless, at the time of his discharge from Talbott, Dr. Langan was diagnosed with alcohol dependence absent supporting history or evidence of withdrawal, and cognitive as well as psychological dysfunction. Langan knew the diagnoses were spurious, but he also knew that to continue practicing medicine he would have to agree to whatever conditions imposed upon him as an alleged “impaired physician.” Reluctantly, he signed a five-year letter of agreement with the PHS, stipulating that he completely abstain from alcohol and any other substances of potential abuse, take naltrexone to help prevent relapse, and submit to frequent random drug and alcohol testing. Langan was also required to participate in an outpatient treatment program from June 20, 2008 to July 16, 2008.

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[1] See, Miller, Dinah MD. (2017, December 5). Physician health programs: ‘Diagnosing for dollars’? Retrieved at https://www.mdedge.com/psychiatry/article/153573/depression/physician-health-programs-diagnosing-dollars [2] Id.

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