The Maryland Board of Examiners of Optometry waited nine years before it even allowed a nationally prominent optometrist licensed in Virginia and the District of Columbia to take a qualifying exam.
The Maryland Commission on Medical Discipline has such a confused structure that routine complaints against doctors can be passed four times between the commission and local medical societies before they are resolved, causing months of delay.
The Maryland Board of Examiners of Nurses, which looks into charges of drug abuse and unprofessionalism among the state's 65,000 nurses, handles its complaint files so poorly that state examiners found several of the files missing or misfiled.
These deficiencies were among many uncovered by state legislators as part of the first systematic study of the 38 professional boards charged with licensing everyone from architects to pharmacists and protecting the public from unscrupulous practices.
For the most part, the boards operate with little public scrutiny, although the professionals they regulate affect the lives of most of the state's citizens. Under the state's "sunset" law enacted three years ago, the legislature is required to evaluate each of the boards by 1982 and determine whether it is needed.
The evaluations by the legislature's Department of Fiscal Services began last year and are scheduled to be be completed in the next several days. In a series of reports and in hearings this week before the Senate Finance committee, a few common themes emerged.
Although the licensing functions generally are handled efficiently, the legislative unit found the public isn't being protected fully because of deficiencies such as secret meetings, long delays in resolving complaints and a lack of investigative staff.
Only one board, the 12-year-old Board of Sanitarian Registration, was judged unnecessary, chiefly because most health departments do not require sanitarians -- officials who inspect a wide range of facilities, from restaurants to mobile homes -- to be licensed.
Another, the Board of Examiners of Landscape Architects, has no disciplinary power, according to the legislative study, and never has received a consumer complaint. But the board, which like most in Maryland pays for itself through licensing fees, is important for industry self-identity and should continue, the study concluded.
The health boards, on the other hand, are crucial to public safety in licensing professionals and handling consumer complaints, but according to the reports suffer from a host of problems related to lack of money and accountability.
The Board of Examiners of Optometry, for example, does not regularly notify the public of its meetings and held its June session over dinner at a hotel. Similarly, the State Board of Psychologists rarely announces its meetings, which are held in a private hospital, often on Saturdays.
Secrecy also hampers the Maryland Commission on Medical Discipline, as its investigations are handled by local medical societies, which are accountable only to member doctors. This situation creates "the potential for bias" and for "uneven quality of investigations," the Legislature was told.
Complaints against doctors also are handled in a cumbersome way, with the cases passing between the commission and medical societies up to four times, the legislative unit found.
Dr. John E. Adams, chairman of the Commission on Medical Discipline told the Senate Finance Committee that he personally monitors local societies to weed out bias.
Del. Paula Hollinger, (D-Baltimore), urged that the public be told that doctors, not state agents, investigate complaints. "People should know this," said Hollinger. "It just adds to the perception that doctors, pharmacists and nurses protect each other."
Adams defended the process, saying 35 percent of complaints against doctors result in disciplinary action, a rate that makes Maryland the fifth most stringent state, according to the National Federation of State Medical Examiners.
The commission also takes at least five months to handle most cases, the Senate committee was told, because of a dramatic increase in the number of complaints against Maryland doctors. The Commission's backlog stands at 201 cases, double that of 1979. Despite a recent complaint in a legislative audit that the commission makes no effort to inform consumers of its existence, complaints have increased 421 percent -- to a record 589 cases in 1981 -- over the past five years.
"People are demanding more from professionals, especially their doctors," said Carol Strickland, a legislative analyst.
The legislative reports also found frequent absences by the consumer members of several boards and poor handling of complaints by the nursing and dental boards.
Dr. C. Ronald Franks, a Grasonville dentist and secretary of the dental board, said a lack of investigative staff has caused complaints to linger unresolved for up to three years. "This report makes it clear that people have been put off, put off and put off. Some cases are so old that witnesses are unwilling to come forward because they've lost interest."
Franks, and representatives of several other licensing boards, support a bill, which passed the House of Delegates last year but not the Senate, which would raise license fees in order to add investigators. "I just find it alarming that we have so many commissions without staff or support to do their jobs," said Sen. Dennis Rasmussen (D-Baltimore County.)