Sunday, November 1, 2015

When Should a Doctor Lose His License?

This afternoon, as I write this, a professional football player was ejected from a game for committing the transgression of unnecessary roughness.  This infraction should be taken seriously in a game where violence is not only legal, but desirable.  I’ll leave it to the reader to imagine how unnecessary the roughness was if it resulted in an ejection. 

It is self-evident to any thinking person that the human body is not designed to withstand the punishment of this game.  Keep in mind that most of us are only seeing the actual games, and not the hundreds of hours of brutal practicing.  I take care of an octogenarian who played for the Cleveland Browns decades ago.  While this profession lifted him out of a Pennsylvania steel town, it is challenging for him to identify a part of his body that is working properly.   The National Football League (NFL), which showed us all last year how they fumbled their domestic violence issues, has belated admitted what most first graders would readily recognize.  Getting smashed in the head hundreds of times per season over many years is not good for the human brain. One must wonder about engaging in an activity that requires a helmet and body armor for protection.


Legalized violence

There are rules to govern this mayhem, and sometimes a player is kicked out.

Are errant physicians kicked out of the medical profession?  Yes, it does happen, but these are rare events.  Some have argued that there is a ‘white coat wall of silence’ that protects physicians who need to be sanctioned or sidelined.  A few times a year, I receive a list of Ohio physicians who have been disciplined by the State Medical Board of Ohio.  Most of these offenses involve personal substance abuse.  ‘Pill mill’ doctors are also targeted.  Physicians who engaged in improper and inappropriate behavior with patients are on the list, as they should be.

Losing a medical license is the most serious professional sanction that a physician can receive.  Such a penalty should be implemented only for a egregious act, or a pattern of wrongdoing, provided that the physician has been afforded due process. 

When do readers think that a doctor should be tanked?  I’ll offer a few hypothetical scenarios below.  Let me know if the physician is salvageable or should be cut loose.
  • A gastroenterologist misses a diagnosis of colon cancer three years in a row.
  • A surgeon refuses to repair a patient’s hernia because the patient has no insurance and cannot afford the operation.
  • A physician is a recovering alcoholic and is now found guilty of a DUI.
  • A review of a psychiatrist’s medical records confirm that 10 patients committed suicide in the past 36 months.
  • An internist is found guilty of domestic violence.  No drugs or alcohol are involved.
  • An investigative reporter discovers that an orthopedist was paid $250,000 last year to promote a medical device to colleagues across the country, and never disclosed this relationship.
  • A physician is discovered to be double billing Medicare over the past year.
  • A physician persists in asking one of his patients to date him.
Do these offenses merit surrendering a license?  Would this be unnecessary roughness?  



3 comments:

Carole said...

The obvious answer is YES of course. Now those who have or would commit these types of illegal and unethical acts would disagree and say no! - reason I'm just human, boohoo!! There's always lie, deny and justify- getting a great lawyer seems to work for most. Oh plus the famous SILENCE of their OWN now that's special and honorable amongst these shady cowardly characters. So no worries!
Sorry can't stand crooks or liars... Incompetence and remorse can be corrected and forgiven though. True remorse!!!
But to be completely honest we people, public, (patients) know most of these scenarios can be successfully covered- up with team effort.

A. Banterings said...

Answer: It depends….

The psychiatrist might be the only one in a rural (depressed) area that sent more than its fair share of soldiers to the Middle East only to return with PTSD. The psychiatrist might be the only one who takes on patients abused in the healthcare system (because all physicians deny that a patient could ever be abused).

But on the other side of the coin…

What about the physician that requires a annual pelvic exam to dispense birth control?

How about Dr. Twana Sparks? (Links: The ENT Surgeon Who Gave Genital Exams and Doctor accused of inappropriate exam behavior to return to practice, with conditions )

How about Dr. John Hagmann? (Links: US doctor allegedly sexually abused trainees and injected them with ketamine, Army Doctor Tortured Pigs, Simulated Date Rape For 'Experiments', and This Doctor Just Lost His License For Performing Horrifying Sexual Experiments On His Students)

The crème de la crème has to be Dr. Dix P. Poppas… (Links: Dr. Demento: Dix P. Poppas and his Cruel and Horrifyingly Usual Sexually Violent and Violating Perpetration of Girls and Intersex Children..., The not so good touches of Dr. Dix Poppas (web site cache), and Leading Cornell Doctor Performing Genital Cutting )

Al Monte said...

Thanks Doctor, There may have been others, but this is the first time I've seen a doctor ask this question. I worked in the Florida Medicare system for over 24 years, and reviewed regularly the quarterly disciplinary reports, and can tell you there are many physicians that should be sanctioned immediately if not sooner. The reports are generally written in legalease, and many times you have to read between the lines. The outcomes generally describe the offenses, for example, how would you interpret, must take a course in ethics, and may not be in the same room as a female patient without a matron, or may not treat female patients altogether, and must have a supervising physician for a period of 2 years, and report to the board every six months, and pay a fine of $10,000. The facts are the medical boards of the country know who the bad guys are. Physicians are no different than any other segment of society and the bell curve is alive and well. That is, the vast majority of them are honest and want the best for their patients, but the 10 percent on either side of the bell is also true. OIG and justice department minimum estimated fraud is 10%. I am not sure if other states require it, but in Florida, assignment of a supervising physician for a period of 1 year or more is a sure fire way of telling he or she needs to be reported to law enforcement. Secondly, and more importantly, the boards regularly come in contact with complaints and deal with physicians who abuse or take advantage of patients. It is my opinion that there should be zero tolerance for this. All colleges and universities offering degrees in medicine should be required to offer courses in Medicare, Medicaid, CHIP, and health insurance. If they don't pass, they don't get a degree. All of the medical boards should require proof of passing, and CEUs in the same. Also, medical boards should refer patient abuse cases to law enforcement. It is my experience many times the reports are handled by the board and other physicians. Proven facts and conviction of fraud and abuse should be grounds for a life time revocation of billing privileges and medical license. If you read the disciplinary reports, you may come away with a different point of view. I suspect they would not want you to read them. From your writings I suspect you are one of the truly good guys out there.

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