Two exemplary tales of medical license suspensions vigorously opposed and overturned

Townsend Letter for Doctors and Patients,  June, 2005  by Marcus A. Cohen

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My recent Townsend columns about the Office of Professional Medical Conduct (OPMC), the New York agency that disciplines MDs for substandard practice, have been short on good news. There was one thoroughly positive development: two bills to restrain the OPMC from abuse of due process had passed both houses of the Legislature during the summer of 2004 and needed only Governor George Pataki's signature to become law. Pataki vetoed them at the end of the year (see my column in April), chilling hope of immediate health-care reform in the Empire State.

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An earlier series I had published on the OPMC in the Townsend Letter (2001-2003) documented disciplinary actions by the OPMC which flouted New York laws and Health Department regulations meant to insure fair proceedings. That series also suggested that the word "proceedings" for those actions is too mild, too neutral. If one scrutinizes and adds up the due process abuses reported, and calculates the losses in pocket and reputation to doctors--omitting the "collateral damage" to patients dependent on them--one carries away the impression that these flawed investigations and prosecutions resemble back-alley muggings more than they do the orderly, civil administrative hearings they are presumed to be.

Townsend readers are prone to believe that state medical boards disproportionately target providers of complementary and alternative medicine (CAM). True, but in general the boards seem to train their sights on physicians who, having distanced themselves from the herd, make easy prey.

Doctors specializing in CAM by definition depart from community practice. Others get hit for using standard therapies in ways frowned on by a majority of mainstream practitioners, for instance; MDs who treat chronic Lyme disease with long-term IV antibiotics. Others appear to come under fire largely because they have solo practices and often treat patients without supervision by institutional review boards (IRBs). Still others are tracked by insurers who find the treatments given by these doctors in conflict with patterns of use that the insurers approve; the insurers then notify the state medical boards, calling for penalties to force the doctors to conform to insurance industry standards.

Lately, I've heard allegations of racial and ethnic bias in state medical board disciplinary actions. The prejudice seems chiefly directed at black MDs, including physicians born and medically trained in the US and those born and educated in medical schools abroad. Since 9/11, in at least several states, the proportion of MDs with names common in the Middle East and the Indian subcontinent has risen noticeably. I'm now investigating these apparently prejudiced prosecutions.

This column is about two MDs whose licenses were suspended, who then refused to serve as game animals, hiding in the tall grass to escape detection or pursuit, and pounced back on their attackers. One case, dating to the mid-1990s, involved the California medical board; I detail this case here. The second, quite recent, involves the OPMC; I mention it here for its precedent-setting value but reserve extended coverage for a column in the near future. In both, political factors appear to be the prime activators.

Dr. James S. Tate, Jr., chair of the Council on Clinical Practice, the National Medical Association (NMA), provided the earlier story. I interviewed him over the phone, expecting aid in collecting evidence on the scope of medical board bias against black physicians. At the beginning of the interview, he recalled the case which made him aware that such prejudice appeared to be a serious problem. The case was so arresting in its origin and outcome, it compelled me to feature it here.

Dr. Rosalind Scott is the first black woman to earn board certification in cardio-thoracic surgery. In 1995, she held the position of Assistant Chief of Surgery at Martin Luther King, Jr., Hospital and Medical Center, situated in a black neighborhood in Los Angeles. At the time, the Chief of Surgery was black, too. Many attending and resident physicians were black.

One evening, the surgical chief asked her to stand in and supervise recoveries from emergency surgery, a duty routinely requiring the supervising physician to drop into intensive care units periodically to assure that no medical problems were cropping up.

That evening, the first Asian member of the LAPD had the misfortune of sticking his face into a botched drug bust in the neighborhood served by Martin Luther King. Rushed to this hospital with 14 bullets in him, the trauma staff fought to save his life, giving him 22 pints of blood. To no one's great surprise, he succumbed two days later.

Gil Garcetti was the LA District Attorney in those days. He had gained national attention by indicting O.J. Simpson for murder, and reportedly was ticked after the case went to trial and the jury cleared Simpson. Some black LA newspapers blasted him as a publicity-hungry racist during Simpson's indictment and trial, reflecting the perception of many blacks in LA (and around the nation).