Medical board is praised in audit

By Cy Ryan

Friday, Dec. 5, 2003 | 11:19 a.m.

RENO -- The state board that regulates doctors, which was sharply criticized during the last legislative session, is doing a good job protecting the public from incompetent physicians, according to an audit released today.

Presented to the state Board of Medical Examiners, the audit, done by the Federation of State Medical Boards, found the state board "meets or exceeds its statutory responsibility" in regulating the profession.

Dr. Cheryl Hug-English, board president, said the audit supports the fact the board "is doing a good job."

Among the audit's findings:

Hug-English noted that the audit recognized her belief that changes made in the Legislature are making it more difficult for the board to police the profession.

She said the board is struggling with one of the changes that would permit the board to waive its requirements and allow licensed physicians in from other states, without meeting Nevada standards.

Sen. Randolph Townsend, a major critic of the board, said he thought the audit's recommendation that the board "needs to stay in touch" with doctors and those who file complaints was "very good."

Townsend, R-Reno, chairman of the Legislative Commission, said he intends to create a subcommittee to look into the recommendation to repeal laws enacted by the 2003 Legislature that changed the way the board did business.

One law allowed the board to waive its rules to allow physicians to practice in Nevada if they were licensed in other states. The board rules, among the strictest in the nation, say a doctor must graduate from an accredited medical school and have three years of postgraduate training.

The law has resulted in an influx of applications for waivers fromo doctors licensed in other states who don't meet Nevada requirements.

The audit said it does not expect the present board to waive its rules, but future boards may not be as tough. It said the current strict standards are "among the most consumer-patient-protective in the entire nation."

It said the law allowing waivers would permit physicians who have minimum standards to get licensed in Nevada.

The Legislature also changed the law so the examiners board could take disciplinary action against a physician convicted of a felony, only if it related to the practice of medicine. The former law said the board could take disciplinary action if the conviction involved moral turpitude.

It said the change would permit improper sexual activities by doctors.

"Under this new language, the board is greatly disadvantaged in its ability to protect the public," the audit said.

Townsend said he intends to name Sen. Ann O'Connell, R-Las Vegas, and Assembly Majority Leader Barbara Buckley, D-Las Vegas, to the subcommittee to hold hearings and come back with recommendations. He said he was "troubled" that the audit did not look into some of the ways the board operated, including why the board built up a large cash reserve.

The audit said hospitals are not reporting malpractice cases to the examiners board for action. Fewer than 2 percent of the complaints filed came from hospitals, where most of the cases of malpractice occur. The audit suggested the board work more closely with hospitals to report malpractice cases.

Mike Tymczn, spokesman for Valley Health System, said he believed doctors and staff at Valley, Summerlin, Desert Springs and the new Spring Valley hospitals were already working appropriately with the state board when it comes to reporting medical errors and malpractice.

"Patient safety is a hallmark concern," Tymczn said this morning. "Whether it's a physician or an administrator or an employee, we're keeping a very keen eye out."

The audit, which was ordered by the Legislature and cost $27,874, said the board should do further criminal background checks of those who apply for licenses. The board now relies on information submitted by the applicant. The board should check with the National Crime Information System run by the Justice Department to verify the criminal records of those seeking licenses, the audit said.

This lack of verification is one of the few areas where Nevada falls below the national model, the audit said.

As for the board's relationship with the state's physicians, auditors noted the examiners and the Nevada State Medical Association have contrasting missions but "neither should be antagonistic to the other." It noted the society is an interest group and the board is a regulatory organization.

Larry Matheis, executive director of the Nevada State Medical Association, said the board's inaction at the height of the medical malpractice crisis only fueled the "strained relations" cited by the audit.

"There is a concern in the physicians' community that the board doesn't really seem interested in addressing the problems they face," Matheis said. "One way to improve those relations is for the board to listen and respond to criticism rather than become defensive."

Matheis said he was looking forward to reading the audit and would review the conclusions with his organization's members. When the audit was first proposed there were concerns raised about it being conducted by the federation, which is a trade group, Matheis said.

"It will be interesting to see whether the audit is truly the independent assessment legislators said they wanted," Matheis said.

In addition to criticism from doctors and legislators that the board failed to help physicians in the medical malpractice crisis, Southern Nevada doctors complained the board seldom meets in Las Vegas and doesn't listen to their concerns.

The board recently spent more than $30,000 to install a television system to videoconference its meetings to Las Vegas.

There were also complaints about the board's secrecy.

The report recommended that public records of disciplinary cases be placed on the board's website. The board disseminates public information but the audit said there was a "distorted picture" of the board in the recent Legislature.

It recommended junking its $60,000-a-year television advertising program and hiring a full-time public information specialist to inform the public of the board's mission.

The report found that the board "uses its fees efficiently; however, safeguards could be improved." It said some of the financial audit recommendations in the past have not been implemented.

The nine-member state board is appointed by the governor.