Doctor Troubles

This is the post excerpt.

I am starting a new blog post website.  Although it is called “Doctor Troubles”, I am hoping to make this site available for all health care providers, clinical or behavioral, to tell their tales of exhilaration or woe from their professional lives.  (Of course, HIPAA protections and patient confidentiality will always be observed to the hilt.)  This photo came with the website from WordPress.  I would like to think of it as a sunrise, a new beginning.  The origin of this site was that there have been so many potential clients who I cannot represent who are pursuing honorable careers in difficult times.   I realize that I have only personally encountered the tip of an iceberg.   I think that there is a contribution we can receive from taking a look at the overwhelming mass that would otherwise be virtually invisible.

I will not be providing any legal counsel on this website.  Please do not misperceive my opinions as legal advice.  I will try my best to remind everyone as conspicuously as I can from time to time.  I firmly believe that this ethical concern about giving legal counsel should not shut me up or shut me off as long as I conduct myself responsibly in this domain.

That said, you are welcome to join me here.  I will simply quote one of my favorite character’s catch phrases.  “I’m listening.”


“Psychology”, what’s in a word

The regulatory authority over “psychology” and careers “psychological” was given a jolt when a 5th Circuit court case opinion regarding the Texas State Board of Examiners of Psychologists questioned a basic legal foundation of the regulation of the practice of psychology. This questioning had to be answered so that the Texas regulatory agencies with power in the mental health care sphere could do their regulatin’.

A pillar of modern mental health therapy is the “talking cure.”  Your family, friends and neighbors, unsolicited and generally unpaid, talk you into and out of thinking positively about yourself almost daily.  Your high school wrestling coach, the cheerleader squad sponsor and your boss pull down a paycheck for talking to you in a raised voice about your “attitude.”  They seem to know exactly what will cure you.

Compare such talking to professional mental health therapy with the significant addition of testing and drugs.  There is often someone taking some responsibility for “progress”, talking you up instead of down, but rarely will this kind of talker guarantee a cure.  The main point here is how do we distinguish between mere helpful talking and professional helpful talking?  Are these people all “practicing psychology?”

Maybe so, according to our new law, as of September 1, 2017.  It is easy to read the new law as saying, “The “practice of psychology” means the observation, description …. of and intervention in human behavior by applying education, training, methods and procedures for the purpose of:  preventing,….remediating, or eliminating:….undesired behavior.”  That covers just about everybody who doles out advice.  “Psychological services” carries the circular definition of being within the “practice of psychology.”  Not quite enough grist for the mill.

If you offer or provide psychological services in a professional relationship, you are practicing psychology.  If you are a psychologist or a psychological associate offering or providing psychological services, other than lecturing, for money outside your regular salaried “non-psychology” duties, you are practicing psychology.  However, you will not be engaged in the practice of psychology based solely on offering guidance effecting mental health if you do not represent that you are either licensed to practice psychology or that you are professionally “practicing psychology” as long as you are: (1) not engaging in such conduct in the context of a professional relationship; (2) offering guidance in the context of professional relationship that is not focused on mental health care; or (3) the guidance is some structured program that supports the guided with self-identified mental health care goals.

“Self-identified goals” seems to fit right into advice from the “framily” and careers, such as my own attorneyhood, that incorporate a lot of guidance for our clients.  We are still dealing with mental health here, but there is some distance from the elements of assessment, evaluation, analysis, diagnosis and treatment that characterize “professional” mental health care providers.  Crucial distinction.

And I see that our time is up.  Ironically, the question originally approached will have to be resolved through rulemaking by the very state agency that drove into that litigation ditch in the first place.

First Posting for Doctor Troubles

Once upon a time, I thought that we were living in a culture that would eventually “rise to meet the road” of health care in the developed world.  I had the belief that we were getting somewhere, albeit not as instantaneously as I would have liked to see more than 35 years ago when I obtained a Master’s of Public Health from the University of Texas.  And not at expeditiously as I would have preferred more than 30 years ago when I became a licensed attorney.

As Dylan suggested in a song, “I was so much older then, I’m younger than that now.”

As predictably as I have flipped out about the Dark Side direction our government has taken since January, I have been rejuvenated by an invisible and indivisible force.  And this rising force is directly proportional to the voices of the many.   The voices that I have been hearing about the unacceptable turning away from human rights and planetary responsibilities.

And there are voices that I have been hearing about a legal and regulatory system that increasingly insists that the only important standard of care is the bottom line.   And that anyone who places human welfare above that bottom line or approaches their human mistakes with contrition and accountability is going to get crushed.

I cannot provide legal representation to most of these voices for a variety of reasons. Some of them are personal, financial, ethical, political or a combination of those reasons. But I sincerely believe that all of these voices need to be heard.  It is a just a small corner in the grand march of human events in the 21st century, but there are a lot of folks who share that small corner.  And the common thread to stitches their stories together as health care providers is a trouble on their minds about health care.  They all care.  They have all been hurt.

Being an attorney, I have spent a lot of time figuring out what questions to ask.  I am usually chock full of questions.  Just ask me about it.

Please understand if I do not have the answer to most of these questions.  I will admit to having a lot of opinions and relatively few answers.

This site and my time on this site is devoted to bringing those voices and stories to you, because whoever you are, you may have the answers.   Actually, I know that you have the answers.  It’s only a matter of time before you speak up.

Feel free to speak here.  Thanks.