The commission established more than a year ago to discipline and weed out incompetent and corrupt doctors in the District of Columbia is unable to do so, even though it knows of several instances of physician abuse, according to the commission chairman.
The commission knows of cases involving a physician suspected of selling phony medicial excuses to malingering workers, two doctors who apparent negligence resulted in patient deaths and several physicians suspected of selling various types of narcotics. But it is unable to act because it has never been given a staff or a budget, says the chairman.
"The public has a body it thinks is monitoring physician conduct, and it isn't, said Dr. L. Thompson Bowles, chairman of the Commission on Licensure to Practice the Healing Art.
"Let's tell the public, 'You're not protected here,'" said Bowles, who is also the dean for academic affairs at the George Washington University Medical Center. "Let's not tell the public it has a commission that's doing the job."
The commission was established by the City Council in late 1976, over the veto of Mayor Walter E. Washington, following intense lobbying by the leaders of the city's medical community.
The need for such a body, empowered not only to license but also to discipline physicians, became apparent at the time of the Robert Sherman case.
Dr. Sherman, an obstetrician-gynecologist, ran an abortion clinic in the city and had more than a dozen malpractice suits filed against him, including at least one for wrongful death. He has since been indicted for second degree murder inconnection with the death of one of his patients.
At the time of the Sherman incidents, the Medical Society of the District of Columbia decried the fact that it had no legal power to discipline physicians and that the city's licensing body at the time was only empowered to grant or suspend licenses. The city agency had insufficient manpower and resources to investigate complaints.
The new commission was created in an effort to remedy that situation and has sweeping powers including granting, suspending and revoking licenses, imposing fines for medical misconduct and enforcing a basic code of conduct that includes possible jail terms for violations.
However, Bowles said in an interview, the present commission is almost as ineffective as the agency it replaced.
Bowles submitted a budget request for $345,000 - the same amount the commission is expected to bring in through licensing fees - for the fiscal year starting Oct. 1, but Mayor Washington trimmed the amount to $199,000, Bowles said.
Then Congress refused to fund the commission as an independent agency, arguing that the city has too many boards and commissions. The money for the licensure commission was placed in the budget of the city's Department of Economic Development, but the budget of that agency was also trimmed, leaving it with less money than it had in previous years.
Bowles said the commission is now relying on the Department of Economic Development for staff work and investigators. He praised DED chief James Hill for trying to help the commission.
The department, however, is responsible for licensing and inspecting 22 professions and trades, including plumbers, electricians, air conditioning repair persons, real estate sales persons and barbers, in addition to physicians.
Bowles said that while the Economic Development Department's investigators have done some work for the commission, they are not properly trained to conduct what, in most cases, amount to medical malpractice investigations.
Bowles said that for about the past six months the commission has suspected a physician in the downtown area of "selling sham sick certificates for a fee . . . anywhere from zero to 10 a day, at $10 to $15 each. The police had a plant in there," said Bowles, but have not yet developed enough evidence to move against the physicians.
Another physician being investigated by the commission as well as by the District police has allegedly been selling prescriptions for diet pills and narcotics out of his offices in a lowincome area of Northwest Washington and a suburban Maryland county.
A Washington Post reporter who spent about an hour in that physician's Washington waiting room saw patients disappear into the physician's inner office and reemerge in as little as a minute and one-half.
A woman whom the reporter accompanied to the physician's office later said she was given prescriptions for Lasix, a powerful diurectic, and an amphetamine-like diet drug without being given a physical examination.
The woman said she told the physician, whom she had visited a few years earlier, that she wanted to lose weight. She is not overweight on the basis of standard medical charts, but she said the doctor gave her the prescriptions and told her to pay him directly, rather than the receptionist. "That's the way we do business in the ghetto," the woman quoted the doctor as saying as he took her cash payment.
Bowles said that complaints were filed by citizens against two other physicians, each of whom was alleged to have caused the death of a patient through incompetence. One of the physicians was pressured into retiring, said Bowles, but the commission has been unable to take action against the other because the agency lacks the staff to establish the necessary case.
The commission is now receiving eight to 10 complaints against physicians a month, said Bowles, and he added that the most serious complaints are the least likely to be processed by the commission.
While Bowles continually stressed what he regards as the generally high caliber of medical care provided by physicians in the city, he said. "A small handful can do a hell of a lot of damage and they're not being properly monitored now."
For the first time, the city has a commission - made up of eight physicians, two members of the public and two city officials - to monitor physician conduct but, Bowles said, the monitoring is simply not being done.
"The public responsibility charged to the commission is going untended," he said.