LETTER TO THE EDITOR:

Medical board must follow due process

Thomas J. Scully, Reno

Sun, Mar 23, 2008 (2:03 a.m.)

Regarding the Endoscopy Center of Southern Nevada, I wish to clarify how the State Board of Medical Examiners functions in disciplinary matters.

If a physician is found “guilty” of performing unsafe medical procedures after a formal hearing by the board, the physician will be disciplined.

While the prehearing investigation into the accusation is conducted, due process and the procedures of the board should proceed in an orderly fashion, including the recusal and temporary replacement by the governor of any board member who has a conflict of interest or the appearance of such. There is ample precedent for this process and it does not require the member to resign.

Calling for the resignation of a board member suggests that the member has done something wrong, unfairly impugning that person’s reputation without evidence.

The executive director is an employee serving at the pleasure of the board, with no authority to discipline a physician. He administers the board and carries out its policies and directives.

Regarding the Endoscopy Center of Southern Nevada, the board has no authority over nurses, hospitals or outpatient clinics and investigates only complaints about physicians referred to it.

Furthermore, three board members correctly recused themselves, and the executive director recommended to the governor names of temporary replacements to adjudicate this case.

The writer, professor of pediatrics emeritus and former dean of the University of Nevada School of Medicine, was a member of the State Board of Medical Examiners for 16 years until his retirement from the board in 1996.

Discussion: 6 comments so far…

By Beezie

3/23/08 at 10:58 a.m.

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The public has it's hackles up due to the amount of time it takes the board to respond. What amount of time do you need to react appropriately? Let's see...your response time is sluggish and then there's the appearence the board doesn't have broad enough representation in a case where 1/2 of the board had political, financial or social ties to Desai. Recusal might be ok in the short term and you guys might believe you are acting appropriately. Honestly, we get the fact you want to make sure due dilligence is done and the right people have their licenses revoked however the slow response by the board and it's ties to Desai make the board appear inept and it really doesn't instill any public faith in the board. Other state boards suspend licenses pending the outcome of investigations and trials,they have broader representation and don't reek of political or financial incest. Licenses in other states are restored without a black mark against the physician if no wrong doing or conflict of interest is found. Why is the process so bassackwards in this state? Because business and politics supercede public health in Nevada. If you want to change the public perception of the board as sluggish,unresponsive and outmoded then start with broadening it's membership and suspension of licenses pending the outcome of trials and investigations.
By Beezie

3/23/08 at 11:10 a.m.

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One last item."Calling for the resignation of a board member suggests that the member has done something wrong, unfairly impugning that person’s reputation without evidence."

There are sins of omission and comission. Guilt by omission is still guilt.
By localcitizen

3/24/08 at 5:31 a.m.

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I agree that public perception can be damaging and that everything should be done to make sure that those guilty in the Endoscopy case and that the docs who testified they lied in the mistrial that just happened should be punished. However, it is not true that other states suspend licenses pending outcomes of investigations or trials. A suspension would cause a report to the Data Bank, which would cause various problems to those found not guilty. It is very difficult to undo those problems and the report is on the record forever. Hospitals can suspend privileges, but state licensing boards cannot and do not suspend licenses until investigations are finished or unless the board decides that the doctor is an immediate danger to the public and even then, a hearing is held immediately and facts must be presented. Perhaps this course should have been taken instead of the "gentleman's agreement" for Desai to stop practicing. That was merely a PR ploy, and not a very good one since the rest of the docs are still practicing. As far as punishment for malpractice trial outcomes, just because a jury feels sympathy, doesn't mean that malpractice was committed. Our legal system is extremely flawed - in fact most countries don't use juries.
By susanekg

3/24/08 at 8:19 a.m.

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Actually, the Medical Board can call an emgergency meeting and temporarily suspend a physicians' license pending a formal hearing. Although NV's Medical Board, which currently ranks among the 5 worst medical boards in the country, fails to use this option as often as it could, it has regularly issued these suspensions in response to reports that doctors have been engaged in dangerous behavior or criminal activity.

In this case, resignations are called for not only because these Board members were rendered ineffective due to their ties to Desai, but also because they had been serving despite profound conflicts of interest. For example, Daniel McBride had been serving as Chairman of a medical malpractice insurance company while he was reviewing malpractice cases for the Medical Board.

The Med Board has a long history of violating its mandate by placing the interests of doctors above the interests of patients. The agreement the Board forged with Desai to protect his record conforms to its usual pattern. Find out more by visiting http://faculty.uml.edu/sgallagher/NSBME.... or Googling "Snake Oil Salesmen Hit Jackpot in Nevada."
By Beezie

3/24/08 at 10:24 a.m.

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To localcitizen,
You are right and I do agree just becasue a jury finds sympathy does not mean there was intent to do any harm or failure to meet standards of care as the physician. However, failure to do the right thing-in this case call an emergency meeting,temporary suspension of licenses as susanekg pointed out-is a failure by the board to act in a timely manner and is failure by omission. They need to go if they can't respond approriately relative to the level of crisis or threat to public health.
By localcitizen

3/24/08 at 11:20 a.m.

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If susan read the Nevada Revised Statutes and knew anything about medicine, she would know that to summarily suspend a physician would require findings that continued practice would endanger the health, safety, and welfare of his patients. Contrary to what she may believe, summary suspension is not an action that is used freely throughout the country as it requires evidence of immediate danger and is therefore, not legally supported in most cases. These practices were evidently going on for years and while I am outraged at them, the centers are no longer in operation and the board would find it difficult legally to summarily suspend. I also would like them to take some action and I agree the board members should go, but like it or not, we are still bound by laws and I'm sure that susan would want her due process rights protected. Investigate on an expedited basis and then take whatever discipinary action is required. I guess the major question would be - who is going to do the investigating?