The panels also grant licenses and investigate complaints. Although their meetings are usually open to the public, physician discipline is typically discussed behind closed doors.
Many boards prefer not to take away a doctor's license to practice. "Regulators believe that many problems can be resolved with probation and by putting restrictions on a physician's license," according to a release from the Federation of State Medical Boards.
William L. Harp, a physician and executive director of the Virginia Board of Medicine, said he could not comment on specific cases but defended his panel's record. If the Virginia board is aware of an impaired doctor, he said, it moves swiftly to take action.
"The practice of medicine is on the honor system," he said. "Once you get your license . . . the board assumes that you're out there taking good care of patients until we hear otherwise."
But Harp acknowledged that the system has flaws. "You can't catch every single thing."
He said medical boards should become more proactive in assessing doctors and patient safety instead of using the current system, which primarily reacts to complaints.
The Virginia board did not discipline Herman A. Garrett, an anesthesiologist licensed in Virginia. Garrett has struggled with drugs and alcohol off and on since he was a resident at Georgetown University, according to Kentucky medical board records. In 1991, Georgetown officials placed him on leave for his "chemical dependency," the records show. In 1992, he pleaded guilty to driving under the influence in Georgia and received a suspended sentence and fine, according to the records.
"Physicians are no different than any other individual," Garrett said in an interview. "I was just a person who liked to change the way I feel through using chemicals. It may be illegal, but I didn't perceive it as wrong."
Garrett, who injected himself with drugs up to 10 times a day, admitted stealing drugs while working at a Kentucky hospital, medical board records show.
His abuse of fentanyl, a synthetic morphine, was the "crescendo" that prompted him in 2001 to surrender his Kentucky license in lieu of revocation, he said in the interview. He has been in rehab twice. The Virginia board stated in a 2003 order that he was in a "well established recovery monitoring program."
Garrett, 42, argued that he and other physicians have a right to return to medicine despite relapses.
"Do we as a society want to say that because you've had this problem, you're no longer eligible to participate in the capacity that you're trained in?" he asked. "There are some stunningly good professionals in recovery."
Suit Over Drugs
Nancy Rodriguez, a Loudoun County mother of four, claimed in a 2001 lawsuit that gastroenterologist Joseph Shaw Jones used drugs meant for her.
Rodriguez had gone to Jones for a colonoscopy in 1998 on the recommendation of her doctor. When she arrived at Loudoun Hospital Center for the procedure, Jones asked the nurse to go and change the music piped into the room, Rodriguez recalled in an interview.
"That's when he changed the drugs," she said. "That was the only time I was alone with him. That was the only time he could have done it."
Rodriguez was awake during the procedure and told Jones she felt sharp pain, she said. "He said, 'We're almost finished.' I told him it hurt."
She later found out through media reports that Jones had tampered with drugs meant for patients. Nurses reported that "they heard a number of his patients screaming during procedures," according to Virginia medical board records. Hospital staff members also reported that Jones had glassy eyes on one occasion and slurred speech on another.
The Virginia medical board gave Jones several chances. Even though he was battling drug and alcohol addiction in 1989, the board gave him a license to practice. In 1993, the board found that he had violated specific terms of a 1992 order to abstain from drugs and alcohol. And in 1999, after he used drugs meant for patients while performing colonoscopies and endoscopies, board members reprimanded him and fined him $10,000. Still, they let him keep practicing.