A physician suspended for prescribing opioids puts his case under the microscope in this debut book.
America’s opioid epidemic has focused attention on doctors who negligently prescribe powerful painkillers, with some even being charged with murder in the overdose deaths of patients. In 2015, the Michigan Board of Medicine suspended the license of Youssef, an Egyptian native who supposedly prescribed more than 25,000 controlled substances in a year. Among other things, the board said he failed to “consider the use of other treatment modalities or non-narcotic medications for the treatment of pain.” But in his impassioned account of the case, Youssef argues he suffered a miscarriage of justice because of a “legal felony”—a doctrine that protects those who act in a “quasi-judicial” capacity from being sued over their actions. Quasi-judicial immunity, he asserts, is a “back window for committing crimes under the protection of the law” that enabled the officials involved in his disciplinary proceeding to ruin his life and injure thousands of his patients. “I was not the first one or the last to be destroyed,” he laments, adding that “hundreds of physicians have been injured by nonsense complaints and felonies of obstruction of justice under the haven of the absolute quasi-judicial immunity.” Youssef goes deep into the weeds of his case, reproducing verbatim documents filed with the administrative court and as part of an appeal. These are relatively intelligible compared to some of the author’s commentaries, which are marred by his haphazard command of English (“The Chairman of the Internal Medicine Program at Jamaica Hospital, who got 100 percent pass rate for five successive years, was looking for six years to be the only one in America”). There are some intriguing nuggets—for example, patients of a sanctioned doctor may find it difficult to get pain medication from another physician due to the “stigma of sanction.” But readers may tire of the book’s relentless polemic, in part because it doesn’t allow space for Youssef to reveal anything about himself or discuss the problems encountered by physicians treating chronic pain. He also fails to consider that quasi-judicial immunity promotes uninhibited, independent decision-making. The author may have a right to feel aggrieved, but rather than a “legal felony,” the doctrine may be a legal necessity.
This work’s fervent argument leaves little room for legal nuances or an analysis of the challenges facing doctors who treat chronic pain.