How to Reduce the Risk of Being Disciplined by the State Medical Board

The tradeoff between quality and quantity of medical regulation
State medical boards are under public pressure to increase their disciplinary rates.

Manuscript Title

 

How to Reduce the Risk of Being Disciplined by the State Medical Board

Running Title

 

Medical Board Considerations

Names and affiliations of all contributing authors

 

Brett Snodgrass, M.D. DrSocial Ltd. http://drsocial.org

Contact details for Corresponding Author

 

Brett Snodgrass, M.D.
468N Camden Drive
Suite 200
Beverly Hills, California
Telephone:               1 (916) 893-1722
Fax:                   1 (877) 991-6435
Email:               brettsnodgrass@icloud.com

Manuscript words

 

341

Keywords

 

Medical board, state agency, licensure, competency, assessments

Governance, regulation, physician discipline

Funding statement

 

The author received no funding.

 

 

How to Reduce the Risk of Being Disciplined by the State Medical Board

 

Even if physicians’ provide good medical care and behave ethically, it does not guarantee that they will avoid discipline by their State Medical Board (SMB).1,2 SMBs are under public pressure to provide protection from “bad doctors,” and they appear to be doing so when they discipline physicians. The majority of research regarding the performance of SMBs is strictly quantitative.

The Missouri SMB tried to punish Dr. Paskon for prescribing opioids and benzodiazepines for chronic pain patients and for providing the standard-of-care to myriad patients.3 After four and a half years of costly litigation, the Honorable Commissioner John J. Kopp, JD, ruled that each of the SMB’s 137 charges vs. Dr. Paskon was unmeritorious.4

This author reports that the Missouri SMB made false claims against him in court regarding (1) the lumpectomy ischemic intervals of more than 20 women with breast cancer, (2) numerous Joint Commission violations, and (3) an unnecessary level of two to four b unilateral neck dissections. As a mere citizen, this author could not obtain the medical records to prove his innocence, and the SMB created a preponderance of false evidence, including perjurious depositions.

In 1985, Arnold S. Relman M.D. wrote, “Physicians brought before a state board for disciplinary actions often do experience ‘a monumentally destructive disruption’ of life. But that doesn’t alter the fact that the proceedings are likely to give the accused physicians every opportunity to clear charges against them. They can also launch legal counteraction which has a powerful dampening effect on the zeal of would-be accusers and judges.”5

The opportunities to prove innocence have dissipated with the change of laws to a lesser burden of proof.6,7 This creates a situation where a preponderance of false evidence and perjury can create a guilty verdict. In addition, physicians no longer have the powerful legal counteractions, which existed in 1985.6

Physicians are encouraged to protect themselves, and their families, from nefarious or reckless SMBs by routinely hiring an attorney when they need to interact with SMBs.

Finally, medical regulation needs to be changed from a sciolistic system, which punishes excellent care to a “just culture.”

References

  1. Mishler v. State Bd. of Med. Examiners, 849 P. 2d 291 – Nev: Supreme Court 1993.

https://scholar.google.com/scholar_case?case=5539688962490335552 Accessed October 01, 2016.

  1. Snodgrass, B. Novel Insight into the Quality of Assessment of Physicians.

Health Care: Current Reviews. 2016;4:1-4.

  1. State Board of Registration for the Healing Arts v. Paskon, No. 02-1491 HA (Mar. 27, 2007). https://archive.org/details/Missouri-SBRHA-vs-Dr-Pakson. Accessed October 01, 2016.
  2. State Board of Registration for the Healing Arts v. Paskon, Second Amended Complaint. No. 02-1491 HA (December 27, 2004). http://168.166.15.111/DataTier/Documents/Repository/0/0/7/7/8cee2b62-12fc-4084-995e-bf4cca7494ed.tif Accessed October 01, 2016.
  3. Relman AS. Professional regulation and the state medical boards. N Engl J Med. 1985;312:784-5.
  4. Alan J. Mishler, M.D. v. Nevada State Board of Medical Examiners, 94 F.3d 652 (9th Cir. 1996).
  5. Neil, C. Medical Board Investigations: Legitimate or Kangaroo Courts? Medscape. Mar 15, 2016.
How to Reduce the Risk of Being Disciplined by the State Medical Board

Links to Every State Medical Board

The links are below, but first consider

Patient L.T. died from gross negligence four hours after the nurse gave him seven different medicines intended for a seizure patient. LT was on dialysis and cpuld not excrete the thousands of milligrans of gabapentin and other sedating medicines. Instead of preventing this from occurring again by training the nurse to follow the standard-of-care, Dr. Jeffrey Carter MD, Kevin O’Malley JD, David Poggemeier MD, and the other Missouri Medical Board members chose to spend two years in a failed effort to blame Dt. Surendra Chaganti for the death. The aformentioned SMB members never apologized for that or for their failed five year effort to punish Dr. Chaganti for a clerical error on a job application.

O’Malley, Poggemeier, and Dr. James DiRenna are bureaucratic who caused an Honorable Administrative Law Judge Sreenu Dandamudi to write on court records that the State Medical Board of Missouri Misrepresented EvidenceExternal Linkin a failed effort to fraudulently revoke the medical license of Dr. Antoine Adem .

Links to Every State Medical and Osteopathic Board:

Alabama Board of Medical Examiners and Medical Licensure Commission of AlabamaExternal Link

Alaska State Medical BoardExternal Link

Arizona Medical BoardExternal Link

Arizona Board of Osteopathic Examiners in Medicine and SurgeryExternal Link

Arkansas State Medical BoardExternal Link

Medical Board of CaliforniaExternal Link

Osteopathic Medical Board of CaliforniaExternal Link

Colorado Medical BoardExternal Link

State of Connecticut, Department of Public HealthExternal Link

Delaware Board of Medical Licensure and DisciplineExternal Link

District of Columbia Board of MedicineExternal Link

Florida Department of Health, Division of Medical Quality Assurance (MDs)External Link

Florida Department of Health, Division of Medical Quality Assurance (DOs)External Link

Georgia Composite Medical BoardExternal Link

Hawaii Board of Medical ExaminersExternal Link

Idaho State Board of MedicineExternal Link

Illinois Department of Professional RegulationExternal Link

Medical Licensing Board of IndianaExternal Link

Iowa Board of MedicineExternal Link

Kansas State Board of Healing ArtsExternal Link

Kentucky Board of Medical LicensureExternal Link

Louisiana State Board of Medical ExaminersExternal Link

Maine Board of Licensure in MedicineExternal Link

Maine Board of Osteopathic LicensureExternal Link

Maryland Board of PhysiciansExternal Link

Massachusetts Board of Registration in MedicineExternal Link

Michigan Board of MedicineExternal Link

Michigan Board of Osteopathic Medicine & SurgeryExternal Link

Minnesota Board of Medical PracticeExternal Link

Mississippi State Board of Medical LicensureExternal Link

Missouri Board of Registration for the Healing ArtsExternal Link

Montana Board of Medical ExaminersExternal Link

Nebraska Board of Medicine and SurgeryExternal Link

Nevada State Board of Medical ExaminersExternal Link

Nevada State Board of Osteopathic MedicineExternal Link

New Hampshire Board of MedicineExternal Link

New Jersey State Board of Medical ExaminersExternal Link

New Mexico Medical BoardExternal Link

New Mexico Board of Osteopathic Medical ExaminersExternal Link

New York State Board for MedicineExternal Link

North Carolina Medical BoardExternal Link

North Dakota State Board of Medical ExaminersExternal Link

State Medical Board of OhioExternal Link

Oklahoma Board of Medical Licensure and SupervisionExternal Link

Oklahoma State Board of Osteopathic ExaminersExternal Link

Oregon Medical BoardExternal Link

Pennsylvania State Board of MedicineExternal Link

Pennsylvania State Board of Osteopathic MedicineExternal Link

Rhode Island Board of Medical Licensure and DisciplineExternal Link

South Carolina Board of Medical ExaminersExternal Link

South Dakota Board of Medical and Osteopathic ExaminersExternal Link

Tennessee Department of HealthExternal Link

Tennessee Board of Ostepathic ExaminationExternal Link

Texas Medical BoardExternal Link

Utah Division of Occupational and Professional LicensingExternal Link

Vermont Board of Medical PracticeExternal Link

Vermont Board of Osteopathic PhysiciansExternal Link

Virginia Board of MedicineExternal Link

Washington State Medical Quality Assurance CommissionExternal Link

Washington Board of Osteopathic Medicine and SurgeryExternal Link

West Virginia Board of MedicineExternal Link

West Virginia Board of OsteopathyExternal Link

State of Wisconsin Medical Examining BoardExternal Link

Wyoming Board of MedicineExternal Link

Patient L.T. died from gross negligence four hours after the nurse gave him seven different medicines intended for a seizure patient. LT was on dialysis and cpuld not excrete the thousands of milligrans of gabapentin and other sedating medicines. Instead of preventing this from occurring again by training the nurse to follow the standard-of-care, Dr. Jeffrey Carter MD, Kevin O’Malley JD, David Poggemeier MD, and the other Missouri Medical Board members chose to spend two years in a failed effort to blame Dt. Surendra Chaganti for the death. The aformentioned SMB members never apologized for that or for their failed five year effort to punish Dr. Chaganti for a clerical error on a job application.

Medical Board Members sneaky
Medical Board Investigator willing to win his case against a doctor at any cost. He is planning and plotting how to conceal evidence and make his department look good.
Medical Board Bureaucrats made false promises.
MedicalnBoard Members vowed to protect the public, but instead exploited killed patient LT, lied about care of breast cancer patients, and

issues related to job applications.

Links to Every State Medical Board