The strange saga of Tom Horiagon MD vs. the Colorado Medical Board

{The following was writing for the October issue of the Four Corners Free Press.}

On Sept. 8, I read a well-written but misleading letter to the editor in the Durango Telegraph. The letter dismissed ColoradoCare Amendment 69 and went on to praise the perfection of our current Colorado workers comp arrangement. The author, a big-time insurance executive, skipped over the many reasons so many workers feel abandoned, cheated and locked out by what they experience as an adversarial workers comp insurance bureaucracy.

Too many workers find themselves forced to deal with insurance representatives, investigators and regulatory agents who seem to view every claimant as an enemy.

Instead of being allowed to focus on resolving questions and healing, injured workers too often find themselves having to struggle for legitimate compensation from a hostile system.

After reading the letter I felt compelled to give voice to the ignored side of this story. For my response I did a lot of internet trawling for information and my, oh, my, the onslaught of ugly stories and sad facts overwhelmed me at times.

First, revelations of the scandalous health-insurance executive perks, bonuses, golden parachutes and such that have been paid for by developing a culture dedicated to rejecting claims.

Physician suicides, courtesy of our profits driven medical industry.

(originally posted September 17th, 2016)
These past few days I’ve been spending my spare time trying to learn more about Dr. Tom Horiagon MD, MoccH and his conflict with the Colorado Board of Medicine, or more accurately with some powerful bureaucrats who seem to think they are above the law.

One of the things I was curious about was why he become involved with Colorado Physician Help Program (CPHP) in 2011 and then with the Center for Personalized Education for Physicians (CPEP).  Embarrassingly someone like me, who knows little of the state of today’s medical industry, might first suspect drug or alcohol dependence.  It had been gnawing at me so I wrote him another email asking him about it.

His answer blindsided me: 

In 2011 I was an intensivist at St Mary's Hospital in Grand Junction and I worked hours that were so intolerably long, I was not getting home for days on occasion, needed IV's to remain upright and that sort of thing.  I wrote a letter to my colleagues at Western Colorado Lung Center stating that my condition was deteriorating and I needed a change in schedule or format or contract or something.  My colleagues took the letter to St. Mary's Hospital administration who immediately convened a committee to try to find something wrong with my patient care.  

They worked in secret for year and finally presented me with a list on concerns never raised before (except one I discussed), and initiated a quasi-legal process to exclude from the hospital staff and report me to the state board.  I became suicidal, never had an attorney help, and "lost" the fair hearing.  I started making pretty significant suicide efforts and I reached out to CPHP for help.  I closed my practice and moved back to my home in the Front Range.

Later he added:

Physician suicide is VERY frequently precipitated by these board actions (see Pam Wible MD or Michael Langan MD or Kernan Manion MD on this topic).

That sent me back to the internet and the only way to describe what I found is to share it.  I keep thinking this is what the corporate obsession with profits has achieved for USA’s medical arts.  Time to make a course change, reject the corporate mindset with all it's ills and refocus medicine on healing !

 Vote Yes On Heath Care Reform Amendment 69

ColoradoCare

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400 Doctors Commit Suicide Every Year

Published by PhysicianForFairness on May 14, 2014 | < 3 minutes

https://www.youtube.com/watch?v=3XIZwws-s4U

Dr. Pamela Wible from Oregon explains that 400 doctors commit suicide every year. 

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Colorado Medical Board "adjusts" policy 40-3 Physician Patient Relationship

In doing more research I found this example of the subtle way that our Colorado Medical Board (CMB) is slowly dehumanizing our medical system and evolving it into a corporate industry.

My source is “The Colorado Medical Board Abolished The Hippocratic Duties” written by Dr. Horiagon MD MOccH October 10th, 2015

He starts his story: 

“In the wake of complaints about Colorado physicians involved in occupational medicine and other types of "forensic" practice who violated the Colorado Medical Practice Act Policy 40-3 addressing the doctor-patient relationship, the Colorado Medical Board, without much notice, essentially eliminated the duties embodied in the Hippocratic (and other professional medical oaths) to accommodate corporate interests.”

Then he presents the before and after of CMB 40-3 Policy Statement and I must say it’s creepy the way the thing got artfully watered down.  (Green background represents the old policy statement, pink is the revised version.)

Here is the original policy:

40-3 Policy Statement Regarding the Physician/Patient Relationship

Date Issued:

11/13/97

Date(s) Revised:

7/1/10

And here is the new policy:

40-3 Policy Statement Regarding the Provider/Patient

Date Issued: 11/13/97

Date(s) Revised: 7/1/10; 8/20/15

Purpose: To clarify the Colorado Medical Board’s position concerning the physician/patient relationship

Purpose: To clarify the Colorado Medical Board’s definition of, and position concerning the provider/patient relationship

POLICY: The following statement reflects the policy of the Colorado Medical Board regarding the physicians it licenses.

POLICY: The Colorado Medical Board (“Board”) adopts the following policy regarding the provider patient

relationship:

A Colorado physician has both medical-legal and ethical obligations to his or her patients. These are well established in both law and professional tradition. 

The prevailing model of medical practice, as it is implemented by some plans, may result in an inappropriate restriction of the physician's ability to practice quality medicine. This may create negative consequences for the public. It is incumbent that physicians take those actions they consider necessary to assure that the procedures in question do not adversely affect the care that they render to their patients

{ Why would the fundamental principles summarized in that paragraph be eliminated? }

Colorado Open Records Act pries into Pinnacol Assurance’s dirty laundry

 and they don't like what they found.  Not much to add to this one, it speaks volumes by itself.

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Judge orders Pinnacol to comply with CORA on golf trip

Joseph Boven  |  August 20, 2010

http://www.coloradoindependent.com/59990/judge-orders-pinnacol-to-comply-with-cora-on-golf-trip

After suing KMGH Channel 7 to block a Colorado Open Records Act (CORA) inquiry into expenses related to an “extravagant” golf trip to Pebble Beach, Calif., Pinnacol Assurance was told Thursday by a Denver District Court judge that the state workers’ compensation giant should adhere to the same CORA requirements as any other public entity.

“This is the right decision under the law and the right decision for the people of Colorado,” said Sen. Morgan Carroll, D-Aurora, who testified before the court Thursday. “If we learned anything over the past year, it is that Pinnacol needs to answer to injured workers, to the businesses it serves, and to taxpayers about how it does business, just like any governmental agency. I’m glad the courts agreed.”

Carroll serves on the Legislative Audit Committee that released Pinnacol’s financial and performance audit in June. That report found numerous faults with Pinnacol’s procedures and practices.

Dr. Horiagon responds to Pinnacol's Phil Kalin's Amendment 69 bashing.

For an introduction to this response by Dr. Horiagon 
visit this link

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Response to Phil Kalin

By Tom Horiagon MD MOccH

(http://workerhealth.vpweb.com)

This commentary is written is response to an article appearing in:  http://www.journal-advocate.com/sterling-columnists/ci_30282396/amendment-69-damaging-workers-comp-system

Mr. Kalin's assertions fly in the face of the facts. 

Let's address the big errors: Kalin cites the CHI report that had to use very tortured and adverse assumptions in order to derive a year 10 deficit. This long-range prediction assumes no dynamism or adjustment by the ColoradoCare board of directors, no structural cost savings, no effects of decreased administrative costs, no effects of decreasing unnecessary capital expenditures in over-served areas, and adverse assumptions about Federal actions. 

It is also worth considering the source. CHI is an extension of the hospital lobby and hospital networks that thrive by market segmentation and running away from under-served populations will be losers under Amendment 69. 

The claim that Colorado's workers compensation system is one of the nation's best is beyond preposterous. The notion that ColoradoCare would take away access to occupational medicine specialists in Colorado is a lie. 

The fact is that hardly any of the physicians participating in Colorado worker's compensation have any training in occupational medicine beyond what they got in the Level II certification course. 

The Regional OSHA Director cannot recall ever receiving a notification from a Colorado physician about unsafe or unhealthy work environments. 

Why start this blog? + Intro to Dr. Horiagon's response to Kalin

{Originally published September 11, 2016}

My little excursion into ColoradoCare's Amendment 69 has snowballed on me.  All I was doing was researching my response to the Pinnacol CEO's flippant letter to the Durango Telegraph because I have personal reasons to be irritated with Pinnacol Assurance's dishonest practices, but I had no idea...

It's turned into an adventure of dark discovery that just keeps on going.  I documented the first leg of this journey in my previous post.  One of the articles that didn't make the cut