Carolinians For Health Care Access

Continued Vigilance Necessary 

The General Assembly has tightened the laws three times (1993, 2003,and 2009).  History has taught us that we must continue to be vigilant. In 2009, nine integrative practitioners are in various stages of investigation by the N.C. Medical Board. There were neither patient complaints nor patient harm.

On August 6, 2009 SB 958 was ratified. 

The legal changes of SB 958 are a substantial improvement to the current laws.   Healthcare providers will have much better due process during an investigation. However anyone can file a complaint (patient dissatisfied with bill or suspicious family members or envious MDs). The Board has the responsibility and power to investigate complaints. Once the complaint is filed, the health provider and practice are exposed to a total review.  Physicians should come to the Risk Management Seminar to find out how to limit legal exposure. 

North Carolinians have lost their Integrative Medicine physicians in the past.  The Board has run several physicians to other states, permanently suspended their licenses, or restricted the treatments the physicians can use. Patients through CHCA must continue to join together to be prepared if more legislation is needed to protect access to integrative practitioners.
History of the NC Medical Board’s actions: www.ncims.com/History.html

Specific cases of undisciplined malpractice and the harassment of Integrative Medicine physicians are described below:

The Medical Board Discipline - summary (last year information available)

10/31/03 – The Raleigh News & Observer reports that Public Citizen, a national consumers’ group, ranked NC 45th out of 51 state medical boards in the nation for its 2002 record of disciplining doctors accused of providing substandard care, abusing drugs and alcohol, making sexual advances or committing other offenses that put the public in danger. This was occurring at a time when the NCMB was actively trying to take the licenses of physicians performing Integrative Medicine, in which no evidence of harm was reported and benefits were observed.

• Only 18% of physicians with four or more malpractice payments were disciplined.
• Eleven physicians of multiple medical malpractice incidents that caused permanent patient injury were not disciplined by the Medical Board. Those injuries ranged from operating on the wrong body part to improperly performing surgery.
• Meanwhile, 7% of physicians who practice innovative integrative medicine have been disciplined for a single occurrence, ranging from recommending supplements available at his office to an incident of a rare side-effect that resulted in no permanent physical injury.

1990-2002
 

However the Board took the license of a physician for testifying against a physician in a malpractice case. The court overruled the decision saying “that a physician cannot be stripped of his medical license for opinions he offered in testimony during a medical malpractice trial.” (The News & Observer, April 23, 2003)

MEDICAL BOARD HARASSES INTEGRATIVE MEDICINE PHYSICIANS - YET, MALPRACTICE AND MEDICAL ERRORS GO UNADDRESSED BY THE MEDICAL BOARD

It is currently estimated that around 225,000 Americans die in hospitals annually from the side effects of medications and errors made by hospital personnel. This makes hospital care the third leading cause of death in the United States, behind heart disease and cancer. (Starfield b. “Is US Health Really the Best in the World?” Journal of the American Medical Association, 2000:284(4): 483-5.)

Studies have found that patients who die in hospitals often die of preventable causes. Seventeen (17%) percent of intensive care “serious or fatal adverse events” are preventable. Fourteen (14%) percent to twenty-seven (27%) percent of deaths from acute myocardial infarction, pneumonia, or cerebrovascular accident (36% of hospital deaths) are preventable. (Journal of American Medical Association, 200;284:95-97)

According to the National Practitioner Data Bank and the Public Citizen’s analysis, disciplinary actions (license suspension, revocation, or restriction of clinical privileges) were taken against only 8.1% percent of physicians with two or more malpractice payouts. (Public Citizen’s Congress Watch “Medical Misdiagnosis in North Carolina, April, 2003). Meanwhile, 21% of integrative medicine physicians have had to hire attorneys to answer investigations or appear before the Board. This is compared to 1.1% of the all physicians.

The Board took the license of a physician for testifying against a physician in a malpractice case. The court says “that a physician cannot be stripped of his medical license for opinions he offered in testimony during a medical malpractice trial.” (The News & Observer, April 23, 2003)

Known Informal Interviews Against Integrative Medical Physicians each cases means thousands of dollars in attorney fees. Also a “fishing expedition.”

• Without so much as a complaint against him, a Medical Board investigator visited one Integrative Medicine physician of mid-eastern decent five times since 9/11/01 with no charges. The investigator inquired about a variety of topics, inquiring about research participation, requesting patient records, and requesting information about the doctor’s investments. Physician is still in limbo as of September 2003.
• There was no patient complaint, but one physician has been harassed by numerous visits by the Medical Board examiners and someone from the FDA. The investigators have asked him explain the use of various therapies.
• A physician was investigated by the Board in response to a complaint generated by a patient who didn’t want to pay the bill. Even though the Board found no irregularities with his billing procedure, they launched an investigation into his use of injectable Vitamin B12 and hair analysis. The EPA uses hair analysis as a screening modality. Charges dropped.
• A patient submitted a complaint to the NCMB and filed a lawsuit at the same time. Her attorney interviewed the physician and dropped the charges within three weeks. The Board continued their investigation. The physician was assured that an “expert familiar with these treatments” would review his case. The investigator called the physician with two questions from the "expert" and the nature of the questions clearly indicated that this "expert" knew nothing about the treatments.
• The NC Medical Board summoned another Integrative Medicine doctor to an informal hearing about his use of B12 shots, hair analysis, and his “practice in general”. After thousands of dollars in defense legal fees, the charges were dropped, the charges were dropped.
• The Board sent a letter to a medical laboratory located in NC, asking that the lab submit to them a list of all of their North Carolina physician clients that ordered hair analysis, a test that they believe is invalid. Hair analysis reliability has extensive documentation in authoritative texts such as Harrison’s Textbook of Internal Medicine and EPA’s use in identifying heavy metal toxicity.

Known Discipline Against Integrative Medicine Physicians

• An integrative medicine physician offered to speak before an AIDS support group about nutrition and vitamin treatments. The Board charged him with unethical solicitation of patients, even though the presentation never took place. The Board failed to notify him that he was being charged. A Board attorney contacted the doctor personally and told the doctor he did not feel it was right that the doctor had not been notified of a hearing date pending charges against him. Had the Board attorney not alerted the physician on his own accord, the doctor would have lost his license by default simply by not showing up to a hearing. Meanwhile, there are weekly advertisements in the newspapers about medical lectures. The physician’s license was revoked with a year suspended sentence.
• A physician had his license suspended for two months because of a complaint against him regarding a rare side effect of a complementary therapy. This Board penalty was levied on the physician at the same meeting at which the Board provided no significant penalty against other physicians who had been found guilty of sexual improprieties with their patients. During his hearing, the Board refused to even to hear his scientific evidence.
• A gastroenterologist was reprimanded for recommending to his patients vitamins and supplements that could be purchased at his practice. Now, he is required to not accept any compensation for sale of vitamins and supplements to his patients. He was held to a different standard than other physicians that sell crutches, eyeglasses, contacts, lab test, and variety of other items.
• A physician testified against another physician in a malpractice case. The Board revoked his license on the basis of his medical opinion in court. His testimony was consistent with other expert witnesses testifying at the trial.

Undisciplined Cases of Malpractice

• Physician Number 28985 made 10 malpractice payments between 1991 and 2000 involving four obstetrics-related problems, delay in delivery, two incidents of improper management of treatment, five incidents of improper performance of surgery, two incidents of failure to diagnose, and delay in diagnosis. The damages add up to $2,285,250.
• Physician Number 28838 made four malpractice payments between 1993 and 1998 involving failure to diagnose, wrong diagnosis, performing two unnecessary surgeries, improperly performing a surgery, and failure to order appropriate medication. The damages add up to $5,665,000.
• Physician Number 29204 made five malpractice payments between 1991 and 2002 involving three incidents of failure to identify or treat fetal distress, two incidents of delay in treatment of identified fetal distress, an improperly performed vaginal delivery, improper choice of delivery method, and failure to diagnose a patient. The damages add up to $4,185,000.
• Physician Number 65196 made four malpractice payments and lost one malpractice judgment between 1994 and 2001 involving a surgery-related problem, improperly performing surgery on a patient, performing surgery on the wrong body part of a patient, improperly positioning a surgical patient, and a delay in diagnosing a patient. The damages add up to $2,283,750.
• Physician Number 84891 made four malpractice payments between 1995 and 1999 involving improperly managing two surgical patients, ordering the wrong dosage of a medication, two incidents of improperly performed surgery, and failure to perform surgery. The damages add up to $1,812,500.
• Physician Number 28923 made four malpractice payments between 1993 and 2002 involving two improperly performed surgeries, improperly positioning a surgical patient, failure to obtain consent for surgery, and administering the wrong medication. The damages add up to $1,801,250.
• Physician Number 141714 made four malpractice payments between 1999 and 2001 involving three surgery-related problems, improper performance of surgery, a diagnosis-related problem, and delay in diagnosis. The damages add up to $995,000.
• Physician Number 28980 lost four malpractice judgments between 1993 and 1994 involving three incidents of improperly performing tests and a wrong diagnosis. The damages add up to $950,000.
• Physician Number 66632 made four malpractice payments between 1995 and 1997 involving delay in diagnosis, performing surgery on the wrong body part, improperly performing a surgery, improperly managing a surgical patient, and two incidents of delay in treatment. The damages add up to $767,500.
• Physician Number 68327 made five malpractice payments between 1995 and 2002 involving two incidents of performing unnecessary surgery, three incidents of improperly performing surgery on a patient, and failure to diagnose a patient. The damages add up to $793,750.
• Physician Number 28846 made six malpractice payments between 1991 and 2001 involving two surgery-related problems, two incidents of improperly managing a surgical patient, improperly performing surgery, and leaving a foreign body in a surgical patient. The damages add up to $750,000.