Opinion by Consumer Advocate Tim Bolen
The Maryland Board of Physicians woke up last week to find that the Maryland legislature, which they thought, I guess, was completely asleep, had quietly, and very thoroughly, conducted a formal investigation of the board’s operation. The legislative committee in charge of this secret investigation issued a two-hundred page report scalding the department, virtually declaring the board incompetent and working against the interests of the people of Maryland.
In a moment I will show you flaming excerpts from this report.
Last April 28th, 2011 famous mercury issue attorney Bob Reeves had called me, asking me to look into, as a Crisis Management Consultant, the Maryland Geier situation and give him, and the Geiers, my Opinion and make some Recommendations. I did that, both publicly and privately. You can read my original public analysis by clicking here.
One thing I had pointed out, both publicly and privately, was that, in my opinion, the board, itself, was operating, not for the people of Maryland, but for special interests (the vaccine construction) – I pointed out specifics. I pointed out that licensing boards, despite their own ideas of how they operate, do NOT operate without oversight, and that whatever that oversight in Maryland was, it needed to be activated immediately.
There are in Maryland, three separate systems in place that can, and do, provide constant oversight of the Maryland Board of Physicians (Medical Board). There is a fourth that, although not constantly operating, can be brought into the fore with specific action: (1) The board is part of the Department of Health and Mental Hygiene and as such its operation is supposed to be reviewed by that department. (2) The Maryland legislature in two parts; (a) the Senate Education, Health, and Environmental Affairs Committee, and (b) the House Health and Governmental Operations Committee, (3) the people via the Maryland Public Information Act (PIA), and (4) the Court system.
The first oversight option is now, and will be for some time, a waste of time. For the department is headed by Joshua Scharfstein, vaccine promoter extraordinaire. But all of the others have merit. What has been activated, quite strongly, is option number two, and it was done with gusto. Why? Because the Maryland Board of Physicians was STRONGLY WARNED by the legislature before, in 2003, and CHOSE NOT TO COMPLY.
What can happen?
The Maryland legislature maintains control of licensing boards in several ways. State legislatures are the apparatus that pass laws regarding how they want licensing boards to operate. Some boards, once they are sitting, become arrogant, and pretty much blow off the policies set in place by the lawmakers inserting their own versions of policy in place – like right here in Maryland.
Over the years this “their own version” situation became so common that most State legislatures passed what are called “Sunset Review” laws that, in fact, automatically, and periodically, CANCEL licensing boards, forcing those boards to come to the legislature and BEG and PLEAD to be renewed, going through an investigative procedure started, automatically, by a review of their operation by a selected, and standing, legislative committee.
And that, people, is what started the procedure ending up with a two hundred page MEGA-CRITICISM of the Maryland Board of Physicians. Joshua Scharfstein, shocked to his knees, is begging the legislature to give the board one more year to clean up its act, pointing (insert laughter here) at the attack on the Geiers as though it was a good thing.
But, the Maryland legislature is well aware, due to the two-hundred page report, that over eight hundred (800) complaints, went not only un-investigated, but un-processed in any way, while the entire board staff, including every supervisor, investigator, analyst, whatever, focused ONLY on the Geier case. Apparently, under secret orders, every board asset was then, and is now, being focused on the Geiers. To no avail.
Just below is an excerpt from the report’s conclusion. I have bolded significant parts:
“Despite the progress made by MBP, significant challenges face MBP and its allied health advisory committees. Perhaps most significant is the growing backlog of complaints and the ongoing increase in the timeline for complaint resolution. The addition of new allied health professions to the jurisdiction of MBP raises the question of what the relationship between MBP and the respective allied health advisory committees and the role of the committees in regulating allied health professions should be. Another challenge facing the board is how effectively it balances the need for openness and transparency with the needs of licensees. Finally, whether the board is using its resources in the best way to meet these challenges continues to be an issue.
MBP plays a key role in protecting the public health and welfare, and there is no question that MBP and its allied health advisory committees should continue to exist. The purpose of this report and its recommendations is to help MBP and its committees improve their ability to protect the public health and welfare and meet the challenges facing them. However, based on past performance, the Department of Legislative Services (DLS) has significant concerns about whether the recommendations, especially those contained in legislation, will be complied with by MBP. The board has failed to implement key recommendations and requirements from previous sunset evaluations and sunset legislation. Also, DLS found that MBP fails to comply with several statutory requirements regarding (1) complaint investigation files; (2) provision of contact information on the board website regarding medical malpractice information; (3) obtaining peer review reports; (4) public disclosure of board filing of charges; and (5) compliance with the Open Meetings Act. The board additionally fails to adopt regulations even when required by law.
Based on these findings, DLS recommends that the termination dates of MBP and its allied health advisory committees only be extended for one year until July 1, 2014. Also, any statutory changes recommended in this evaluation should be implemented through legislation adopted in the 2012 session of the General Assembly. In the meantime, DLS should be required to make a recommendation regarding further extension to the Senate Education, Health, and Environmental Affairs and the House Health and Government Operations committees by October 1, 2013. The recommendation should be determined based on the progress of MBP in complying with the recommendations of this report and the submission of a follow-up report by MBP to DLS.”
Words from the Baltimore Sun…
In an article titled “Audit criticizes state medical board for backlog of complaints” it said
““The state Board of Physicians has a serious backlog of complaints and a growing timeline for resolving it, according to a newly released legislative audit of the agency charged with protecting the public from bad doctors.
It also isn’t keeping complete records and its actions lack transparency, sometimes in violation of open meetings laws, the review says.
The review comes ahead of the General Assembly session in January, when lawmakers are to consider reauthorizing the medical board, which expires under a “sunset” provision. It also comes six years after auditors first outlined similar problems with the board and nine years after the board was remade to address lax protection of consumers.
“The board faces significant challenges moving forward,” the review reads. “Also, based on past performance, [the Department of Legislative Services] has significant concerns about whether the recommendations, especially those contained in legislation, will be complied with by [the medical board]. The board failed to implement key recommendations and requirements of previous sunset evaluations and sunset legislation.”
The 21-member board includes 13 doctors and five consumer members. For fiscal 2012, it has an appropriation of $8.6 million and 68 staff, who are responsible for licensing and overseeing 43,000 medical professionals.
During fiscal 2011, it handled almost 1,730 complaints, including 739 that continued from the previous year.
By the year’s end, it closed almost 900, leaving more than 800 pending. It took 164 formal actions, more than in previous years, the review noted. Some recent high-profile actions include revoking the license of Mark G. Midei, a Towson cardiologist accused of placing unnecessary stents, and suspending the license of Mark R. Geier, a Rockville doctor accused of mistreating children with autism. Both have appealed the decisions.
Complaints come to the board from the public, as well as from boards in other states and other providers. The majority involve allegations that doctors did not meet the standard of care or that their actions were unprofessional or immoral.”
You can read the entire article by clicking here.
Then in another article titled “Outside consultant considered for embattled Board of Physicians – Recent audit found problems with enforcement, transparency” the Baltimore Sun said:
“The state Board of Physicians, slammed in a recent legislative audit for its dysfunction, told a panel of lawmakers Wednesday that it could get on track in another year by hiring an outside consultant and instituting long-awaited guidelines.
The chairman of the board, however, disputed that so much was wrong and noted several high profile actions it had taken in recent years, which include revoking the license of Mark G. Midei, a Towson cardiologist accused of placing unnecessary stents and suspending the license of Mark R. Geier, a Rockville doctor accused of mistreating children with autism.
“I feel like the Board of Physicians is being taken to the woodshed,” said Dr. Paul Elder, the chairman and an Anne Arundel County physician, to the Senate Education, Health and Environmental Affairs Committee. “The board works hard and does a good job protecting the public.”
The lawmakers, who write legislation to reauthorize the 21-member board periodically under a “sunset” provision, appeared skeptical. They said they’ve waited years for the board charged with protecting the public from bad doctors to clear a backlog of cases, institute sanctioning guidelines for doctors and develop transparent and consistent practices.
This was the first opportunity to hear from the board about a set of criticisms made by legislative auditors ahead of the next sunset, including some that have been leveled as early as 2003. The auditors made 46 recommendations for correcting the problems.
The subcommittee chairwoman, Sen. Joan Carter Conway, said the board had been flouting statutes designed to make the system fair to doctors and protective for the public. “It’s unconscionable,” she said.
Sen. Edward R. Reilly, an Anne Arundel Republican, said he understood the challenges of overseeing 43,000 health professionals and the tight budget constraints but said too much of the board’s work was done in secrecy. He also said, “It’s our job to say the backlog is unacceptable.”
The excerpts bolded above are the most important parts.
What does this all mean?
What is very clear is that the Maryland Board of Physicians sees itself as above the law – and is heading for a major fall. Whether that fall comes from the Maryland legislature, from the Governor’s office, or from the court system remains to be seen.
What could happen? A lot. Many States have taken hard action against recalcitrant licensing boards. In California, for instance, the legislature forced a two-year monitor on the board, releasing the board only after it adopted the monitor’s recommendations. California also, shut down the entire Dental Board one time, firing all of the board members – and the Governor appointed all new members.
What it really means is that the Maryland legislature has given the Geiers a huge gift they can use against the board and its staff in Federal Court. For, the legislature has made it publicly clear that the board is operating outside of DUE PROCESS.
The Maryland Board of Physicians is DEAD MEAT.
Tim Bolen – Consumer Advocate