PNAP Case workers — Do Not Trust Them

Medical professionals or their employers call PNAP case workers and intake administrators for numerous reasons.  The initial complaint call against the licensee  generates the “Letter of Concern.”  It is the response call from the licensee to PHMP/PNAP/SARPH/PAP that starts the proverbial ball rolling.  Here are several important facts each licensee should be aware of before calling PNAP.

PNAP/PAP/PHMP caseworkers are told to not tell inquiring licensees the truth. PNAP and PHMP caseworkers are instructed to emphasize the worst possible legal and licensing consequences if there is no cooperation.  PNAP/PHMP caseworkers are instructed to intimidate and scare licensees into the program. PNAP caseworkers are instructed to tell licensees about the costs of the Mental and Physical Evaluation and court fees.  PNAP caseworkers are instructed provide the minimum legal information possible.

PNAP caseworkers do not know the law.  PNAP/PHMP/PAP case workers are not trained in the several health care boards’ regulations.  PHMP/PNAP/PAP case workers do not understand the legal implications of the wrong advice they give. PNAP case workers do not know how to tell the truth.  Some PNAP caseworkers may be in the program too.


For every medical professional, agreeing to the initial PNAP assessment is the worst thing you can do. Current conflicts between the DSM-IV and DSM V alcohol use disorder – mild, moderate, or severe – are creating significant issues in determinations of impairment for PNAP assessors.  I have learned that the PNAP assessors could be  calling the PNAP caseworker and managers, who help the assessor diagnosis an impairment. This is improper.

PNAP and PHMP assessments should be performed independently, by appropriately trained medical professionals. PNAP and PHMP supervisors (Simpson and Knipe) should not be consulted on diagnosis. This type of diagnosis cooperation smacks of a pre-ordained determination of an impairment to insure medical professionals go in the program.  Please understand the above is not an anecdote or a hypothetical scenario. I have been told about PNAP supervisors providing supplemental questions and facts to assessors to insure a determination of impairment and a conclusion that the monitoring program is required.  Ethically, any assessor/PNAP consultation is improper.

This tells me that the system of initial communication with PNAP (in which they lie to you) and the read assessment process renders this entire program unacceptable. Be careful.  Call me.

Social Media and Health Care Employers

The expanding nature of my professional licensing, administrative law practice requires  me to evaluate all forms of social media and my use of texting and email.  I affirmatively chose to not engage in group texts, emails, Facebook, Snapchat, and/or Instagram.  My emails are legally oriented and do not espouse personal opinions of the prosecutors, witnesses, opposing counsel, or any judge before whom I practice.  My blogs, this blog, is where I espouse my legal opinion as to current social conduct and legal norms as they intersect with the legal issues my professional clients, aspiring or otherwise, confront.

However, many clients are confronted with their employer’s social media policies that potentially in fringe on their legal and privacy rights.  Employment based disciplinary policies relating to social media are independent of, and incorporated throughout, health care employment manuals.  These employment contract policies, while vague, are extremely strict and prohibitive in nature as they pertain to group texts and emails, not just Facebook, Instagram, or Snapshat, involving medical students, interns, and residents.

Disciplinary protocols for violating vague social media policies are becoming a huge area of concern.  Recently I was contacted by a third year medical student of a prominent local residency program.  He was suspended for twenty nine days for violating his hospital’s email and texting policy.  The policy, derived from a combined reading of the hospital’s sexual harassment/disruptive behavior guidelines and Social Media Policy, is startling.  Content restrictions, whether on personal or work smart phones, limit any communication associating the hospital, any activity during work hours, and must conform to the hospital’s over arching goals against “intimidation and disruptive behavior.”   What is that?

Surprisingly, the policy/rules inform all residents there is NO expectation of privacy to any blog, email, text (group or otherwise), or other social media post. Violations are based upon conduct that may “tarnish the reputation or brand of the residency program”.  Any communication must not suggest, in any manner, a relationship to or on behalf of the hospital. The policy also states if any form of social media is created in the future and not mentioned herein, these rules apply.
Obviously sexual harassment of any sort warrants discipline.  But discipline predicated upon “private” conversations on a multi-person group chat (twenty) of the appropriateness of a new chief resident, not conducted in any denigrating fashion, is startling.   Conditioning employment on NO EXPECTATION OF PRIVACY and no DISRUPTIVE BEHAVIOR (again — what is this?) is extreme.
Hospital administrators and residency program managers are running scarred trying to calm the herd of cats under their managerial umbrella.  Hard working, pent up smart medical students are now not allowed to have any opinion about any aspect of their medical training program, let alone voice that opinion in a private email to anyone.  Such will be interpreted as disruptive for which there is no privacy right.
Similar to the sixties, these institutions are now enforcing a no-voice of dissent policy. Targeted to any potential anonymous blogger, micro chatter, texter, or group chatter, dissension, opinion, and personality are being searched out and disciplined.  The right to be enrolled in these programs does not include complete and unfettered right of free speech.  Upon enrollment, residents, employees, interns, and licensed medical and nurse practitioners are being told to stop talking, criticizing, commenting, discussing anything about their employer.
Medical residents, staff doctors, union or non-union nursing staff, admitted practitioners, and just about any other licensee practicing their medical profession in the orbit of the local hospital must be aware of these entities’ manuals, practices, and social media policies and how they are being applied.  Unilateral enforcement of these contract provisions (meaning the doctor or resident can’t due the hospital for talking bad about them) limits negotiating strength, employment security, or admission rights to that hospital.
Keep you opinions to yourself.  Do not include ANY inappropriate comment (whatever that is) about any person, thing, policy, or practice in group text or email, facebook, instagram, Snapchat.  The people and departments enforcing the entity’s new media policies are not from this decade or century.  Their interpretation of “what is fair and proper” is not the same as the young resident, intern, or doctor.
%d bloggers like this: