From Licensed Physician to Unlicensed Coach
From Licensed Physician to Unlicensed Coach
Less than an hour from Boston, Newburyport is a popular getaway on the Massachusetts coast. Last May, along with articles about bird watching, girls’ lacrosse and the Newburyport Chocolate Tour, the local paper carried disturbing news about one of the area’s best known residents, Keith Ablow, MD, prolific author, regular guest on morning TV, and a prominent psychiatrist with offices in both Newburyport and New York.
The Massachusetts Board of Registration in Medicine had alleged that Ablow, “engaged in sexual activity and boundary violations with multiple patients, diverted controlled substances from patients, engaged in disruptive behavior, including displaying and pointing a firearm on multiple occasions in a manner that scared an employee, and procured his license renewal fraudulently.” On May 15, 2019, after determining that the psychiatrist represented “a serious threat to the public health, safety or welfare,” the Board summarily suspended his license.
The original complaint against Ablow had been filed in 2012 in New York. According to a recent New York Times article, the state Office of Professional Medical Conduct responded several years later by issuing a warning. The regulator told Ablow that “he had failed to render proper care and treatment and that he prescribed medications inappropriately.” He was warned to avoid boundary violations.
But, said the Times, “There was no punishment for this; his license to practice psychiatry in New York remained in good standing.” Only after investigating the same patient’s complaints, as well as those of four other female patients and several former employees, did the Massachusetts Board suspend Ablow’s license. Surprisingly little has changed as a result.
Rebranding as a Life Coach
Before the Board ruling, Ablow had been seeing patients at his home office in the town’s historic district. He still is. The only difference is that now, instead of “Keith Ablow, MD,” he has rebranded his practice as “The Ablow Center for Mind and Soul.”
Ablow now calls himself a life coach, mentor and pastoral counselor. None of these careers is regulated by the state or federal government. In fact, according to one website offering certification online, “The best thing about life coaching is that anyone can be a coach!”
Since the industry is unregulated, nothing stops Ablow from using his medical credentials to bolster his credibility. His website boasts about his 25 years as a practicing psychiatrist, his degree from Johns Hopkins School of Medicine, and his years teaching at Tufts University School of Medicine. And Ablow still offers to help people with the same kinds of issues he did as a practicing psychiatrist, including “low mood, anxiety, negative thought patterns, low self-esteem, overeating, addiction and difficulties in relationships,” according to his website. There is no mention of the fact that his medical license has been indefinitely suspended.
Sounds a Lot Like Practicing Without a License
According to Stephen Schenthal, MD, MSW, founder of PBI Education (who himself has journeyed forward following disciplinary action), there are two serious problems with what Ablow is doing. First, he is evading the regulatory system that exists to protect the public. Despite the fact that his license has been suspended, Ablow is still using his medical credentials, training, and expertise to provide many of the same services he did before. “Sounds a lot like practicing without a license to me,” says Schenthal.
And Ablow is not alone. Dr. Bob Weathers is a “recovery coach” in Irvine California. His website tells visitors that he “holds a PhD in Clinical Psychology from Fuller Graduate School of Psychology, an American Psychological Association-approved doctoral program in Pasadena, California.” It also mentions his “teaching and training [of] graduate-level mental health providers at several southern California universities” and his numerous articles in “respected professional reference books, journals, and edited volumes.” It does not mention that “Dr. Bob” surrendered his psychologist’s license in 2010 after admitting he had sexual intercourse with a former patient.
Schenthal’s problem is not with the field of coaching, whose practitioners work collegially with clients on rethinking priorities and achieving goals. The problem, he says, is when someone like Ablow or Weathers suggests he is qualified to do more, to treat mental health issues like anxiety and addiction, and to manage the complicated dynamic that develops between therapist and patient.
The whole reason boards license physicians in the first place is to assure patients they can trust their doctors without reservation. When the Massachusetts Board suspended Ablow’s license, it was announcing that board members no longer believed Ablow was worthy of such trust. Withholding that information from patients makes a mockery of the Boards’ judgment. “I don’t know what Ablow does with his coaching patients,” admits Schenthal. “But I do know that citing his professional credentials and not admitting he lost his license will encourage exactly the kind of openness and trust he abused as a therapist.”
PBI faculty member Catherine Caldicott, MD points out that Ablow’s patients are unlikely to question why he calls himself a life coach rather than a psychiatrist. “Nor should they,” she adds. “It is not a patient’s job to find out whether or not their doctor has a valid license. As a matter of public safety, such patients have a right to know about the troubling past of the physicians they trust with their care.”
A dangerous shade of gray
Some fields are black and white. Surgeons who have lost their license cannot continue operating on patients. Period. But the field of coaching and counseling occupies a gray area. Can a psychiatrist like Ablow or psychologist like Weathers continue to help people with personal problems after their license has been suspended? It’s a judgment call. If a board determines that what someone is doing is therapy, rather than counseling, they might issue a cease and desist order, says attorney and PBI faculty member Jon Porter. “If someone were to be harmed as a result of that person’s actions,” he adds, “the local DA could charge them with the unlicensed practice of medicine, which is a criminal violation.”
For Schenthal, it boils down to what the patient thinks. “How are Ablow’s patients supposed to know whether they are receiving licensed therapy or unregulated counseling,” he asks. “After all, it’s not like a psychiatrist with a suspended license can simply erase everything they learned during their professional career.” When they see a coaching client, they will inevitably rely on their years of professional training and clinical experience. Schenthal points to a situation in which a male therapist whose license had been suspended continued seeing a female patient as her life coach. “When the patient was asked how she viewed the practitioner now that he was her life coach,” says Schenthal, “she said she saw him as a therapist.”
Violators Who Ignore What They’ve Done, Are More Likely to Do It Again
The second problem Schenthal sees in cases like these is that the offending physician fails to take personal responsibility for their conduct. That not only put their patients at risk, it jeopardizes their own ability to learn from their mistakes.
People facing serious discipline tend to go through stages, according to Schenthal. Those who manage to turn their lives around get past the initial instinct to deny the problem and enter a dark period of guilt and shame. They acknowledge the harm they have caused and develop empathy for their victims. It’s only then that they grasp the necessity of making difficult changes. “Change is hard. Without real pain, it’s pretty much impossible,” explains Schenthal.
That’s why boards allow boundary violators to see patients again only after they are convinced that the provider has taken responsibility for what they have done and the pain they have caused. Evaluators know that those who refuse to accept responsibility are unlikely to change, and all too likely to repeat their violation.
“What concerns me is people who basically ignore the board’s discipline by slipping into an unregulated field,” says Schenthal. “They avoid a lot of pain. But they are far more likely to make the same mistakes all over again.”
No one knows how many of those who lose their license keep their history to themselves and go on to become life coaches or unlicensed counselors. The number is probably small. But according to Schenthal, a growing number are tempted.
“I see it all the time. Therapists in our remedial classes tell me they’d rather just forget about the board discipline and become life coaches or even religious counselors instead,” Schenthal says. “It’s another form of denial, which prevents physicians from confronting what they have done and why.”
The goal of remedial programs like those offered by PBI Education is to help people transform their lives. That takes introspection, personal growth, professional remediation, and a kind of personal reinvention. Rebranding is a whole lot easier. It is also far more perilous for all concerned.
Read More Blogs from PBI:
- Revisiting Moral Courage as an Educational ObjectiveDr. Catherine Caldicott’s invited commentary, “Revisiting Moral Courage as an Educational Objective,” was recently published in Academic Medicine, the Journal of the Association of American Medical Colleges.
- If It Isn’t Documented, It Didn’t HappenGood record keeping protects patients and clinicians alike.
- What PBI Education Learned by Studying RecidivismIn a new article, PBI Medical Director Catherine Caldicott, MD documents the challenges to recidivism research and recommends improvements.
- Remedial Education: New Opportunities in the 21st CenturyPresented at the 2022 Federation of State Medical Boards/Administrators In Medicine Spotlight Poster Hall
- Regulatory PowerYour Regulator Granted You Your License. They Can Also Take It Away.
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- Revisiting Moral Courage as an Educational Objective
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