The Regulatory Capture of American Medicine by the Drug and Alcohol Testing, Assessment and Treatment Industry

Another incisive piece by Dr. Langan on the crucially important concept of “regulatory capture” of a market sector, in this case the Physicians Health Program.  Clearly, Medical Licensing Boards (MLBs) have mastered the art of regulatory capture, essentially writing legislation which includes stipulations that essentially allow them to write their own rules as they see fit. Then, covered by that state’s sovereign immunity, they’re essentially tin-pot dictators. Then, allied with PHPs who are extended the same sovereign immunity with utterly no oversight or accountability and, which in multiple states, are alleged to have neglected (and thwarted) all means of due process, one has a co-conspirator in the regulatory capture. Now two “state agencies” (in quotes because the recent SCOTUS FTC v. NC Dental decision throws their claim of “state agency” into major question) operate in tandem to both capture the regulatory process by which physicians operate and then collude with other states’ MLBs and PHPs to ensure pan-country (and essentially worldwide) total regulatory control over the professional licenses of physicians.

Clearly, this is not what state legislatures had in mind. And clearly,  federal courts have no idea about the concept of “regulatory capture” of what should otherwise be a low-level administrative function. However, MLBs and PHPs have leveraged their power in this arena to such dictatorial levels that they have essentially overthrown from within all means and understandings of justice which a professional licensee is constitutionally entitled to.

There is much to be alarmed about here. While it may have started out as benign and well-intentioned, the slippery slope is extreme, and in the context of utterly no oversight or accountability, the consequences are dire.

Disagree with an approach to treating Lyme disease? Adjust the criteria defining Lyme disease and then find the doc guilty of practicing outside of the regs. (see Jemsek case in NC / 4th Circuit). Disagree with a pesky internal whistleblower who’s calling attention to billing irregularities, get a crony to file an anonymous complaint. Don’t like someone’s stance on pro-choice or including gun violence in the clinical dialog, report anonymously to the MLB. Or, if you’re a board member or staff, simply get the process rolling of your own accord via secret meetings.

Yes, it’s gotten that dangerous.