Medical board cool to testing

Monday, June 5, 2000 | 9:39 a.m.

RENO -- A proposal that would require physicians to take competency tests every 10 years has received a cool reception from the state Board of Medical Examiners.

Larry Lessly, the board's executive director, said the proposal "to weed out the totally bad doctors" would put Nevada on the "cutting edge" of medical regulation.

No other state requires competency testing.

"We never hear of the vast, vast majority of physicians after they get licensed," Lessly said. "The people we deal with are those with complaints, which are a minority of the doctors, as it should be. But we don't know if they are competent into 10 years of their license."

He proposed the state board, which regulates doctors, present the proposal to the 2001 Legislature -- one of several proposals the board considered sending to legislators next February. Another proposal, also coolly received, was to allow nurse practitioners to prescribe medicine.

Several members of the board, which is composed mostly of physicians, raised objections to the competency tests.

Dr. Susan Buchwald, a Reno surgeon, said she could not pass a general competency exam but is certified periodically to practice her specialty.

Dr. Robin Titus, a board member from Yerington, said many doctors are still practicing medicine with procedures that may be 20 years old, yet they "use good medicine." She said the board needs to be careful about pitting old medical measures against new medical practices.

Doctors already take 20 hours of continuing education every year, but Lessly called that "useless." He said the 1987 Legislature "forced that down our throat and it does nothing."

Lessly said a licensed physician in another state who wants to practice in Nevada must have passed a major examination in the past 10 years before being allowed to work in this state. His suggestion would require it of all doctors.

Board members, saying they need more time to study the issue, will hold a special meeting later this summer to decide whether to include it in their package to the Legislature.

Board members were also reluctant to endorse a proposal from advanced nurse practitioners that they be allowed to prescribe drugs for patients of doctors they work with.

Janet Haw and Donna Dominquez, both advanced nurse practitioners, told the board it would be a tremendous benefit to the patient and the physician. They argued they should have the same rights as a physician's assistant. By 2005 they will be required to have master's degrees.

A number of organizations, including the state Pharmacy Board and American Association of Retired Persons, support the plan, they said.

But Dr. Joel Lubritz of Las Vegas said he viewed it an "encroachment" and said it would give "the ability to someone other than physicians to practice medicine."

One proposal that received a favorable reception came from Dr. Joel Bower, medical director of St. Rose Dominican Hospital in Henderson. He wants the board to support a bill setting up a special category for doctors who retire but who want to continue treating patients for free in medically underserved areas.

Bower said three other states have similar programs and such physicians could treat people with no medical insurance. It would cut back on uninsured people going to the emergency rooms of hospitals when they get run-of-the-mill illnesses, he said.

"We have a large underserved number of people in Henderson," he said. Bower suggested doctors under the program should enjoy limited liability from malpractice suits for giving their services free.

Lessly also proposed discipline of doctors who, while working for HMOs, profit from denying needed care to patients.

Another proposal would subject physicians to disciplinary action if they have sexual contact "with patient surrogates or key third parties, which exploits the physician-patient relationship in a sexual way." At present doctors can be disciplined only for having sex with their patients.