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Medical Whistleblower
November 2008
Volume 3 Issue 11


                                         Medical Whistleblower’s
                                                   Canary Notes
  Inside this issue:



   The White Coat           2 –3
   Barricade

   The Cost to the Crimi-   3         Witness Intimidation
   nal Justice System

   What is Intimidation?    4
                                      Witness intimidation involves witnesses cru-
                                      cial to court proceedings being threatened in
                                      order to pressure or extort them not to testify.
  The Stalking Resource Center        The term “witness” is used to refer both to vic-
The National Center For Victims of
             Crime
                                      tims and to bystanders who could provide in-
                                      formation to police. The term “victim” is used to denote the victim of the initial crime. The
 For Victim Assistance, please call
                                      refusal of key witnesses to testify commonly renders a case with inadequate physical
         1-800-FYI-CALL
   M-F 8:30 AM - 8:30 PM EST,         evidence void in a court of law. This is a significant problem that has many lawmakers
   or e-mail gethelp@ncvc.org
                                      considering tough penalties for intimidating a witness as in example the state of Kansas,
                                      where it is a criminal misdemeanor, or, if found to be aggravated a felony.
         From NPR
                                      How common is witness intimidation? It is difficult to know because the crime is greatly
  National Public Radio
                                      under reported and also when intimidation is successful neither the intimidation nor the
   http://www.npr.org/
templates/story/story.php?            original crime are reported. Many witnesses drop out of the investigation process long
    storyId=4628606
                                      before an indictment or court appearance. Witness intimidation plays a role in many
May 3, 2005 · Rep. Elijah             types of crime. Witness intimidation, however, is not the same as repeat victimization.
Cummings (D-MD), former               Although in both cases the same offenders may be responsible for multiple events, their
head of the Congressional
                                      motives are different. In witness intimidation, the intent is to discourage the victim from
Black Caucus, talked
                                      reporting a crime to police or from cooperating with prosecutors, whereas in repeat vic-
about his efforts to combat
witness intimidation. He              timization, the motive is often acquisitive.
promoted legislation to
provide $90 million to help           Medical Whistleblowers who witness criminal activity or have been victimized by a crime
local police forces protect           are sometimes reluctant to come forward and report incidents to police or to assist in the
witnesses to crimes who               prosecution of offenders. In the medical community there are generalized community
feel threatened by the
                                      norms that discourage doctors, nurses and other medical professionals from cooperat-
accused criminals.
                                      ing with a criminal investigation.
Page 2                                  Medical Whistleblower’s Canary Notes                                                        Volume 3 Issue 11




The White Coat Barricade
Within the nursing community this witness intimidation has led to what has been called the
White Coat of Silence - nurses keeping silent about mistakes done by doctors or other
hospital staff. Within the doctor’s network which frequently includes upper management at
the hospital or administrative level of the organization or even collaboration with the State
Medical Board, this is called the White Coat Barricade because it entails also the authority
over medical licensing not just silence at the level of co-workers within the hospital. Many
times the criminal offenders in the medical community have close social and professional ties with upper management of
the hospital, the National and State Medical Associations, the State Medical Boards and even local and state govern-
mental officials.    Within the academic medical community threats against tenure or promotion are commonly used and
in the medical research community the threats are often related to limiting grant funding or access to research facilities.


Within a hospital or medical research setting intimidation can entail direct threats or violence to discourage a particular
                             doctor, nurse or researcher from providing information to the investigators on a particular case.
                             In cases of corruption of hospital management and direct fraud, through the hospital’s own bill-
                             ing system, the intimidation can be a wide spread problem. In these types of cases the bullying
                             and workplace hostility create a general sense of fear that settles over the work environment like
                             a blanket and causes all hospital or research staff to be silenced. Even if the intimidation is nei-
                             ther violent nor life-threatening, the very threat of a reprisal to a doctor can mean severe com-
                             promise of his/her career. Medical professionals must work in an environment that demands pa-
                             tients trust them. Anything that erodes that trust in the doctor-patient relationship will impair the
                             nurse’s or doctor’s ability to practice.


Threats are much more common than actual physical violence and are in fact just as effective in deterring cooperation.
Some witnesses may experience only a single incident of intimidation, but others experience a pattern of intimidation of
escalating series of threats and actions that become more violent over time. The example of one person successfully
retaliated against, has a chilling effect on the cooperation of all other witnesses. Those who may hear of the intimidation
may then decline to cooperate because they fear retaliation. The removal of one doctor’s medical license or significant
impairment of his/her ability to practice, creates an atmosphere of fear will deter other medical personnel from cooperat-
ing with law enforcement.

           Snitches Get Stitches Youth Gangs and Witness Intimidation in Massachusetts http://www.ncvc.org/ncvc/main.aspx?
           dbName=DocumentViewer&DocumentID=42548

           Creating an Effective Stalking Protocol Developed by the National Center for Victims of Crime in conjunction with the U.S. Depart-
           ment of Justice Office of Community Oriented Policing Services for law enforcement agencies seeking to improve their responses to
           stalking. It focuses on the need to establish collaborative partnerships with the community and to develop protocols for early interven-
           tion, preventive action, and proactive problem-solving in stalking cases. http://www.ncvc.org/ncvc/main.aspx?
           dbName=DocumentViewer&DocumentID=32560

           Stalking POP Guide Developed by the National Center for Victims of Crime and funded by the Office of Community Oriented Policing
           Services, U.S. Department of Justice, this Problem Oriented Policing guide contains practical, field-tested guidance on stalking preva-
           lence, prevention, and effective responses. http://www.ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentID=35207
Medical Whistleblower’s Canary Notes                               Volume 3 Issue 11                             Page 3



The White Coat Barricade (Continued)
Since many acts of intimidation are committed at a witness’s home, workplace, or school,
or during the normal course of the witness’s daily activities, minimizing the opportunities
and avenues by which witnesses come into contact with offenders can reduce the inci-
dence of intimidation. This becomes extremely difficult if the Medical Whistleblower is re-
porting someone on the staff, in upper management, or in a governmental position. Nui-
sance phone calls are a particular problem for doctors and medical professionals, who
need to be on call for their critical patients, or who need to have contact with the public in
their routine workday. Withdrawing from social contact may increase the witnesses’
sense of safety but drastically alter their professional life and isolate them from emotional
support.


Under the current system of Medical Quality Review in which any person can make an
anonymous complaint against a doctor, nurse or medical professional, criminals often
make fabricated complaints and then have their own identity protected by immunity while
                                                                                                  Research in Brief, The
the false allegations cause an undercover investigation of the medical witness. Thus the          Rights of Crime Victims -
very system supposed to protect the public from bad doctors has the exact opposite effect         Does Legal Protection Make
                                                                                                  a Difference? You may also
of protecting the criminals and intimidating the Medical Whistleblowers. Law enforcement
                                                                                                  request a copy of the Re-
agencies always contact the State Medical Board regarding any criminal matter affecting a         search in Brief, The Rights of
medical professional, thus alerting anyone on the State Medical Board and their friends           Crime Victims - Does Legal
                                                                                                  Protection Make a Differ-
that an investigation is in progress, this is akin to the police dragging a witness in an inner
                                                                                                  ence? (NCJ 173839, 11
city neighborhood out into the street and interrogating him/her in front of gang members.         pages) from the National
                                                                                                  Criminal Justice Reference at

The Cost to the Criminal Justice System                                                           1-800-851-3420. At this 800
                                                                                                  number you can also use the
                                                                                                  automated NCJRS Fax-on-
The costs of witness intimidation to the criminal justice system include wasting significant      Demand service to have a
                                                                                                  copy faxed directly to
time and resources spent by the police, inability to protect the public, suspects not being       you. http://www.ncvc.org/
charged, and cases abandoned or lost in court. In illegal drug trafficking, organized crime,
gang, money laundering and violent crimes, intimidation is common. But it is also preva-
lent in cases of hate crimes, domestic violence, sexual crimes, harassment, prostitution
and sex offenses. Intimidation has also been linked to drug diversion, substance abuse
treatment fraud, guardian abuse, and large scale medical fraud. Intimidation is less likely
in property crime such as burglary. Intimidation usually takes place where law enforce-
ment has little ability to do surveillance and protection such as at the witness’s home,
while the witness is at school or at work, or while the witness is doing daily chores or go-
ing to a social event. But witnesses are also intimidated at crime scenes, at the police
station and even on the witness stand. Once a suspect has been charged and arrested
the likelihood of intimidation increases. So it is crucial to protect witnesses from intimida-
tion in order to curtail crime.
Medical Whistleblower
                                                                  The information contained through the Medical Whistle-
                                                                  blower Canary Notes Newsletter is provided for general
                                                                  information only. The information provided by the Medial
   Dr. Janet Parker                                               Whistleblower Canary Notes does not constitute legal or
   P.O. Box C                                                     professional advice nor is it conveyed or intended to be con-
   Lawrence, KS 66044                                             veyed in the course of any adviser-client discourse, but is
   Phone: 360-809-3058                                            intended to be general information with respect to common
   Fax: None                                                      issues. It is not offered as and does not constitute legal or
   E-mail: MedicalWhislteblower@gmail.com                         medical advice or opinion. It should not serve as a substitute
                                                                  for advice from an attorney, qualified medical professional,
                                                                  social worker, therapist or counselor familiar with the facts
   We are on the Web!
                                                                  of your specific situation. We encourage you in due diligence
   MedicalWhistleblower.googlepages.com                           to seek additional information and resources before making
                                                                  any decision. We make no warranty, express or implied,
                                                                  concerning the accuracy or reliability of the content of this
                                                                  newsletter due to the constantly changing nature of the legal
   Supporting the Emotional Health of All Whistleblowers          and medical aspects of these issues .
   and their Friends, Supporters and Families.




                                     What is Intimidation?
Legal Series Bulletins Created      The courts have attempted to balance the witness safety ver-
for the Office for Victims of       sus a defendant’s Sixth Amendment right to cross-
Crime, Office of Justice Pro-
grams, U.S. Department of           examination. Many court opinions have emphasized the rights
Justice, these bulletins provide
                                    granted to defendants by the Sixth Amendment of the Constitu-
crime victims with clear and con-
cise information about key legal    tion. As many crime victims can attest, the criminal is often
issues:
                                    afforded more rights by the justice system than the victim. This
http://www.ncvc.org/ncvc/
                                    is even more evident in cases of being victimized in a medical workplace. The State Medical
Strengthening Antistalking Stat-
utes                                Board presumes the public has the right to anonymity for any and all complaints against a
                                    medical practioner. In attempting to prove allegations against the whistleblower false, Medi-
The Crime Victim’s Right To Be      cal Whistleblowers run into a system that lack of Due Process protections at the level of Peer
Present
                                    Review or the State Medical Board. Medical Whistleblower intimidation can include:
Enforcement of Protective
Orders
                                    Confronting witnesses verbally, Implicit            Parking or loitering outside the homes of wit-
Restitution: Making It Work         threats, looks, or gestures                         nesses,

Ordering Restitution to the Crime
Victim                              Explicit threats of violence, Actual physical       Damaging witnesses’ houses or property,
                                    violence, property damage,
Victim Input Into Plea                                                                  Threatening witnesses’ children, spouses,
Agreements
                                    Threats to revoke medical licenses, child cus-      parents, or other family members, killing or
Privacy of Victims? Counseling      tody or immigration status                          injuring pets, assaulting or even murdering
Communications
                                                                                        witnesses or their family members.
                                    Making nuisance phone calls, Sending notes

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Medical Whistleblower Canary Notes Newsletter 37 Witness Intimidation Nov. 2008 Vol. 3 Issue 11

  • 1. Medical Whistleblower November 2008 Volume 3 Issue 11 Medical Whistleblower’s Canary Notes Inside this issue: The White Coat 2 –3 Barricade The Cost to the Crimi- 3 Witness Intimidation nal Justice System What is Intimidation? 4 Witness intimidation involves witnesses cru- cial to court proceedings being threatened in order to pressure or extort them not to testify. The Stalking Resource Center The term “witness” is used to refer both to vic- The National Center For Victims of Crime tims and to bystanders who could provide in- formation to police. The term “victim” is used to denote the victim of the initial crime. The For Victim Assistance, please call refusal of key witnesses to testify commonly renders a case with inadequate physical 1-800-FYI-CALL M-F 8:30 AM - 8:30 PM EST, evidence void in a court of law. This is a significant problem that has many lawmakers or e-mail gethelp@ncvc.org considering tough penalties for intimidating a witness as in example the state of Kansas, where it is a criminal misdemeanor, or, if found to be aggravated a felony. From NPR How common is witness intimidation? It is difficult to know because the crime is greatly National Public Radio under reported and also when intimidation is successful neither the intimidation nor the http://www.npr.org/ templates/story/story.php? original crime are reported. Many witnesses drop out of the investigation process long storyId=4628606 before an indictment or court appearance. Witness intimidation plays a role in many May 3, 2005 · Rep. Elijah types of crime. Witness intimidation, however, is not the same as repeat victimization. Cummings (D-MD), former Although in both cases the same offenders may be responsible for multiple events, their head of the Congressional motives are different. In witness intimidation, the intent is to discourage the victim from Black Caucus, talked reporting a crime to police or from cooperating with prosecutors, whereas in repeat vic- about his efforts to combat witness intimidation. He timization, the motive is often acquisitive. promoted legislation to provide $90 million to help Medical Whistleblowers who witness criminal activity or have been victimized by a crime local police forces protect are sometimes reluctant to come forward and report incidents to police or to assist in the witnesses to crimes who prosecution of offenders. In the medical community there are generalized community feel threatened by the norms that discourage doctors, nurses and other medical professionals from cooperat- accused criminals. ing with a criminal investigation.
  • 2. Page 2 Medical Whistleblower’s Canary Notes Volume 3 Issue 11 The White Coat Barricade Within the nursing community this witness intimidation has led to what has been called the White Coat of Silence - nurses keeping silent about mistakes done by doctors or other hospital staff. Within the doctor’s network which frequently includes upper management at the hospital or administrative level of the organization or even collaboration with the State Medical Board, this is called the White Coat Barricade because it entails also the authority over medical licensing not just silence at the level of co-workers within the hospital. Many times the criminal offenders in the medical community have close social and professional ties with upper management of the hospital, the National and State Medical Associations, the State Medical Boards and even local and state govern- mental officials. Within the academic medical community threats against tenure or promotion are commonly used and in the medical research community the threats are often related to limiting grant funding or access to research facilities. Within a hospital or medical research setting intimidation can entail direct threats or violence to discourage a particular doctor, nurse or researcher from providing information to the investigators on a particular case. In cases of corruption of hospital management and direct fraud, through the hospital’s own bill- ing system, the intimidation can be a wide spread problem. In these types of cases the bullying and workplace hostility create a general sense of fear that settles over the work environment like a blanket and causes all hospital or research staff to be silenced. Even if the intimidation is nei- ther violent nor life-threatening, the very threat of a reprisal to a doctor can mean severe com- promise of his/her career. Medical professionals must work in an environment that demands pa- tients trust them. Anything that erodes that trust in the doctor-patient relationship will impair the nurse’s or doctor’s ability to practice. Threats are much more common than actual physical violence and are in fact just as effective in deterring cooperation. Some witnesses may experience only a single incident of intimidation, but others experience a pattern of intimidation of escalating series of threats and actions that become more violent over time. The example of one person successfully retaliated against, has a chilling effect on the cooperation of all other witnesses. Those who may hear of the intimidation may then decline to cooperate because they fear retaliation. The removal of one doctor’s medical license or significant impairment of his/her ability to practice, creates an atmosphere of fear will deter other medical personnel from cooperat- ing with law enforcement. Snitches Get Stitches Youth Gangs and Witness Intimidation in Massachusetts http://www.ncvc.org/ncvc/main.aspx? dbName=DocumentViewer&DocumentID=42548 Creating an Effective Stalking Protocol Developed by the National Center for Victims of Crime in conjunction with the U.S. Depart- ment of Justice Office of Community Oriented Policing Services for law enforcement agencies seeking to improve their responses to stalking. It focuses on the need to establish collaborative partnerships with the community and to develop protocols for early interven- tion, preventive action, and proactive problem-solving in stalking cases. http://www.ncvc.org/ncvc/main.aspx? dbName=DocumentViewer&DocumentID=32560 Stalking POP Guide Developed by the National Center for Victims of Crime and funded by the Office of Community Oriented Policing Services, U.S. Department of Justice, this Problem Oriented Policing guide contains practical, field-tested guidance on stalking preva- lence, prevention, and effective responses. http://www.ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentID=35207
  • 3. Medical Whistleblower’s Canary Notes Volume 3 Issue 11 Page 3 The White Coat Barricade (Continued) Since many acts of intimidation are committed at a witness’s home, workplace, or school, or during the normal course of the witness’s daily activities, minimizing the opportunities and avenues by which witnesses come into contact with offenders can reduce the inci- dence of intimidation. This becomes extremely difficult if the Medical Whistleblower is re- porting someone on the staff, in upper management, or in a governmental position. Nui- sance phone calls are a particular problem for doctors and medical professionals, who need to be on call for their critical patients, or who need to have contact with the public in their routine workday. Withdrawing from social contact may increase the witnesses’ sense of safety but drastically alter their professional life and isolate them from emotional support. Under the current system of Medical Quality Review in which any person can make an anonymous complaint against a doctor, nurse or medical professional, criminals often make fabricated complaints and then have their own identity protected by immunity while Research in Brief, The the false allegations cause an undercover investigation of the medical witness. Thus the Rights of Crime Victims - very system supposed to protect the public from bad doctors has the exact opposite effect Does Legal Protection Make a Difference? You may also of protecting the criminals and intimidating the Medical Whistleblowers. Law enforcement request a copy of the Re- agencies always contact the State Medical Board regarding any criminal matter affecting a search in Brief, The Rights of medical professional, thus alerting anyone on the State Medical Board and their friends Crime Victims - Does Legal Protection Make a Differ- that an investigation is in progress, this is akin to the police dragging a witness in an inner ence? (NCJ 173839, 11 city neighborhood out into the street and interrogating him/her in front of gang members. pages) from the National Criminal Justice Reference at The Cost to the Criminal Justice System 1-800-851-3420. At this 800 number you can also use the automated NCJRS Fax-on- The costs of witness intimidation to the criminal justice system include wasting significant Demand service to have a copy faxed directly to time and resources spent by the police, inability to protect the public, suspects not being you. http://www.ncvc.org/ charged, and cases abandoned or lost in court. In illegal drug trafficking, organized crime, gang, money laundering and violent crimes, intimidation is common. But it is also preva- lent in cases of hate crimes, domestic violence, sexual crimes, harassment, prostitution and sex offenses. Intimidation has also been linked to drug diversion, substance abuse treatment fraud, guardian abuse, and large scale medical fraud. Intimidation is less likely in property crime such as burglary. Intimidation usually takes place where law enforce- ment has little ability to do surveillance and protection such as at the witness’s home, while the witness is at school or at work, or while the witness is doing daily chores or go- ing to a social event. But witnesses are also intimidated at crime scenes, at the police station and even on the witness stand. Once a suspect has been charged and arrested the likelihood of intimidation increases. So it is crucial to protect witnesses from intimida- tion in order to curtail crime.
  • 4. Medical Whistleblower The information contained through the Medical Whistle- blower Canary Notes Newsletter is provided for general information only. The information provided by the Medial Dr. Janet Parker Whistleblower Canary Notes does not constitute legal or P.O. Box C professional advice nor is it conveyed or intended to be con- Lawrence, KS 66044 veyed in the course of any adviser-client discourse, but is Phone: 360-809-3058 intended to be general information with respect to common Fax: None issues. It is not offered as and does not constitute legal or E-mail: MedicalWhislteblower@gmail.com medical advice or opinion. It should not serve as a substitute for advice from an attorney, qualified medical professional, social worker, therapist or counselor familiar with the facts We are on the Web! of your specific situation. We encourage you in due diligence MedicalWhistleblower.googlepages.com to seek additional information and resources before making any decision. We make no warranty, express or implied, concerning the accuracy or reliability of the content of this newsletter due to the constantly changing nature of the legal Supporting the Emotional Health of All Whistleblowers and medical aspects of these issues . and their Friends, Supporters and Families. What is Intimidation? Legal Series Bulletins Created The courts have attempted to balance the witness safety ver- for the Office for Victims of sus a defendant’s Sixth Amendment right to cross- Crime, Office of Justice Pro- grams, U.S. Department of examination. Many court opinions have emphasized the rights Justice, these bulletins provide granted to defendants by the Sixth Amendment of the Constitu- crime victims with clear and con- cise information about key legal tion. As many crime victims can attest, the criminal is often issues: afforded more rights by the justice system than the victim. This http://www.ncvc.org/ncvc/ is even more evident in cases of being victimized in a medical workplace. The State Medical Strengthening Antistalking Stat- utes Board presumes the public has the right to anonymity for any and all complaints against a medical practioner. In attempting to prove allegations against the whistleblower false, Medi- The Crime Victim’s Right To Be cal Whistleblowers run into a system that lack of Due Process protections at the level of Peer Present Review or the State Medical Board. Medical Whistleblower intimidation can include: Enforcement of Protective Orders Confronting witnesses verbally, Implicit Parking or loitering outside the homes of wit- Restitution: Making It Work threats, looks, or gestures nesses, Ordering Restitution to the Crime Victim Explicit threats of violence, Actual physical Damaging witnesses’ houses or property, violence, property damage, Victim Input Into Plea Threatening witnesses’ children, spouses, Agreements Threats to revoke medical licenses, child cus- parents, or other family members, killing or Privacy of Victims? Counseling tody or immigration status injuring pets, assaulting or even murdering Communications witnesses or their family members. Making nuisance phone calls, Sending notes