D.C. Plans Greater Physician Oversight
Tuesday, May 24, 2005
District lawmakers said yesterday that they will beef up the staff that investigates medical complaints and processes licenses in an effort to strengthen discipline and oversight of doctors and other health care providers.
The city will hire three investigators and two licensing specialists and transfer two lawyers from the attorney general's office, said Neil O. Albert, deputy mayor for children, youth, families and elders. All seven will work for the Health Regulation Administration, which oversees the Board of Medicine.
The announcement came just before the start of a three-hour public hearing on the performance of the Board of Medicine and its oversight of city doctors. Council member David A. Catania (I-At Large), chairman of the council's Committee on Health, said he scheduled the hearing after a series of Washington Post articles last month reported that the District's 11-member medical board rarely disciplines troubled doctors, including those who have been punished in other states for criminal convictions, questionable medical care or sexual misconduct.
"The system's broken, let's all be honest about it," Catania said. "Everyone just needs to acknowledge their responsibility."
Medical board officials, several of whom testified yesterday, defended their performance.
"Nobody slips through the cracks," said William E. Matory, a physician and chairman of the medical board.
But board officials have said that they have just two people to investigate about 45,800 health care licensees and must share those investigators with more than 20 District boards and commissions. By comparison, Virginia has 50 full-time and nine part-time investigators, and Maryland has eight investigators.
"I think they now recognize there's been a staffing shortage," Albert said. "I don't think they did before."
Catania said the District has been "lazy and lax" in its responsibilities to ensure that the public is protected from troubled doctors. The council will redirect nearly $500,000 from the Department of Health for the new hires, Catania said, and the funds will be available Oct. 1, the start of the new fiscal year.
Yesterday's hearing included testimony from physicians, lawyers and residents who said the medical board's inability to discipline doctors is long-standing.
"The behavior of the troubled physicians profiled in the Post series is completely unacceptable," said Victor Freeman, a physician and president of the Medical Society of the District of Columbia. "Patients were clearly and tragically at risk. The Medical Society and our members remain disturbed that such actions apparently went undetected by the Board of Medicine for too long and then, when identified, were not addressed promptly and aggressively."
Sidney M. Wolfe, a physician and director of Public Citizen's Health Research Group, urged lawmakers to put more information about a doctor's history on the Internet. For too long, he said, the public has been "kept in the dark" about a doctor's competence.
"They are kept ignorant . . . of prior criminal convictions or whether their surgeon ever removed the wrong organ or operated under the influence of a judgment-impairing narcotic," Wolfe said. Unlike Virginia, Maryland and many other states, the District does not include disciplinary action against a physician on its Web site.
Evonne Barber, testifying from a wheelchair, told the committee of her repeated complaints to a District vascular surgeon of pain in her legs. After five months of complaints, she said, the surgeon treated her in the hospital and discharged her. Two weeks later, the pain returned and she was diagnosed with an infection and clots, something she said the surgeon should have discovered earlier. Since then, both of her legs have been amputated. She did not know at the time that the surgeon had been investigated by the Maryland medical board for questionable medical care of five patients, one of whom died, records show.
"I could not have found out this information by looking on the District of Columbia Web site," Barber said.
Catania also said doctors who abuse drugs and alcohol should be removed from practice until they get help. More than two dozen physicians with substance abuse problems known to the D.C. medical board between 1999 and 2004 have not been disciplined, even though six lost their licenses in other states.