ANNAPOLIS, JAN. 25 -- Maryland Gov. William Donald Schaefer is set to announce a major overhaul of the state's system for disciplining physicians, including a proposal to hire full-time investigators and hearing examiners to look into complaints lodged against doctors.
The system of physician discipline in Maryland, now plagued with delays and widely criticized as lax, would get a massive infusion of funds over the next three years, with its budget and staff more than doubling in the first year alone.
Schaefer, who will unveil his proposal Tuesday, also will ask the General Assembly to approve legislation during the current 90-day session that would automatically suspend the medical license of a doctor convicted of a crime of moral turpitude.
A series of articles in The Washington Post this month detailed cases of doctors who were allowed to continue to practice after being convicted of serious crimes -- in one case raping a patient -- or being found incompetent by the state Commission on Medical Discipline.
The Post found that the 11-member commission, established in 1968, rarely bars incompetent or unethical doctors from practicing and has revoked only 18 licenses in two decades.
It disciplined 11 doctors in fiscal 1987 and ended the year with a backlog of 735 cases. There are about 11,000 practicing physicians in the state.
The governor wants to abolish the commission and the state Board of Medical Examiners, the body that issues and renews licenses, and establish a single agency in their place.
The Schaefer administration proposal appears to go a long way toward addressing what many critics view as shortcomings in the system, but it is unlikely to appease those who blame some of the problems on the powerful role played by the state medical society in disciplining doctors.
Many critics of the system, including legislators and reform-minded doctors, have complained that the current commission is too much a creature of the medical establishment.
Like the commission, the board that would replace it would be dominated by physicians nominated by the medical society, though administration officials said today they have not yet determined how many doctors will sit on it.
The commission, a part-time, volunteer board, currently refers most complaints against doctors to the medical society, the Medical and Chirurgical Faculty of Maryland, or Med-Chi.
Med-Chi relies on a volunteer panel of physicians to investigate complaints, then sends its findings back to the commission for action.
Under the system proposed by Schaefer, investigators would conduct a preliminary review of all complaints, in part to determine their urgency and priority.
Those involving fee disputes or allegations of inadequate medical care would be sent to Med-Chi for investigation by a peer review committee.
New state regulations would set minimum uniform standards to guide peer review investigations.
Med-Chi would then send its findings back to the new state board. If the medical society found evidence of wrongdoing, a hearing officer, similar to an administrative law judge, would hold a hearing and recommend action to the full board.
Among the biggest problems in the way the system currently operates, according to those involved in it, is that the medical society has no expertise in how to build a legal case against a doctor.
In addition, the part-time commission does not meet often enough to hold many hearings, resulting in case delays. Critics also contend that the backlog has made commissioners more willing to give doctors lesser penalties in order to dispose of the cases without time-consuming hearings.
The commission and the Board of Medical Examiners each now have an administrator and a small clerical staff. Schaefer's plan calls for the addition of 14 positions and $430,000 in additional funds the first year.
In three years, with the proposal fully enacted, there would be 24 added staff members and a budget increase of $800,000.
Administration officials said the state attorney general's office will provide greater support to the new board. Currently, one assistant attorney general is assigned to the commission full-time and several other provide part-time help.
Money for Schaefer's proposal was not included in the budget package he sent to the General Assembly last week. But aides said it will be included in a budget supplement that will be submitted to the 188-member legislature in the coming weeks.
The proposal is not expected to face major hurdles in the legislature, where several legislative leaders have called for changes in Maryland's system of disciplining doctors.