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D.C. Board Rarely Punishes Physicians

The District's record of taking serious disciplinary actions against doctors has repeatedly ranked at or near the bottom of a national comparison of medical boards by the Washington-based Public Citizen's Health Research Group. The D.C. board has "consistently been one of the worst in the country," said Sidney M. Wolfe, the group's director.

When the District does discipline a physician, it is usually in response to action by another medical board rather than on its own initiative, records show. Between 1999 and 2004, the D.C. medical board disciplined 49 physicians, according to board records. Thirty-four of the physicians -- nearly 70 percent -- were punished based on action taken elsewhere. By comparison, that figure was 16 percent in Maryland and 12 percent in Virginia, records show.

Among members of the D.C. Board of Medicine are Andrea D. Sullivan, left, Ronald Simmons, James A. Towns and Lawrence A. Manning. (Preston Keres -- The Washington Post)

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"There's nothing wrong with reciprocal action, but that should not make up the majority of disciplinary action they take," said Wolfe, a physician.

The medical board takes months, sometimes years, to investigate complaints and decide a case. In June 1999, the board took up a complaint from a woman who alleged that her doctor performed a gynecological procedure without her consent. It took two years before the board determined that the investigative report "did not substantiate any violations" and closed the case.

When it comes to fines, physicians in the District often fare better than they would elsewhere. When doctors are caught practicing without a license in the city, for example, the D.C. board levies a fine generally between $10 and $100 for each month they practiced illegally. Virginia, by comparison, can fine as much as $5,000 per infraction; the figure in Maryland can go as high as $50,000.

The D.C. board also has reduced or forgiven many of its fines at the doctors' request. A doctor who worked for the Washington Metropolitan Area Transit Authority practiced without a D.C. medical license for four years while she worked at the agency on a contract. She was fined $4,800 by the medical board. After paying $2,900, she said she couldn't afford any more, and the board forgave the rest in 2001, records show.

Positive Drug Tests Overlooked

Joel A. Guiterman, an internist in the District, tested positive for the painkiller hydrocodone or other drugs several times between 1998 and 2003, D.C. medical board minutes show. The board is aware of his substance abuse and has considered his case behind closed doors at several board meetings, but it has failed to discipline him or take him out of practice.

"He's been monitored," said James R. Granger Jr., executive director of the D.C. medical board.

When Guiterman tested positive in 1999, the board didn't discipline him. It voted to punish him when he failed another drug screen in 2000 but ultimately did not act because "there were no apparent violations" of city law, according to board records. When he didn't pass a drug test in 2001, the board voted to suspend him but never did. That same year, the board granted Guiterman's request and reduced the number of drug tests he was required to take from three per week to one per week "because of the time and financial hardship involved," according to board minutes.

Guiterman declined to discuss the matter or his treatment by the board. "I don't see any advantage to me to have my name in the paper," he said.

In the case of Gary L. Malakoff, Vice President Cheney's internist at George Washington University Medical Center, D.C. medical board officials said they were not told that for five years, Malakoff misused prescription drugs. Granger said neither the hospital nor the D.C. Medical Society, which was supposed to monitor him, informed the board about his drug use.

"Dr. Malakoff has not been on the board's radar screen, although the substance abuse . . . is apparently of long standing," Granger wrote in an internal memo to a health department investigator in July after Malakoff's drug use became public.

Even after learning of his drug use, the board waited six months before suspending his license. By that time, the hospital had suspended him and he was in a rehab program in Williamsburg, according to hospital and board records obtained by The Post.

For some doctors, the city has become a haven, because its medical board has tolerated infractions that Maryland or Virginia considered serious enough to warrant discipline.

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