Injured patients who want to help and be heard,
click here.
Thomas Jefferson said that given the choice between
government without newspapers and newspapers without government, he would choose
newspapers.
In medicine we have government without newspapers. Patients
cannot find out what they need to know to make informed choices. No one in
medicine records or reports the information patients need to know the most. So
patients will have to do it.
Ohio State Medical Board
AKA: state medical board of Ohio
Are healthcare professionals worthy trustees of patient safety in spite
of their biases and self-interests?
In Britain they don't think so (see Reform).
To investigate the question in the USA, the disciplinary actions of the Ohio State Medical Board are analyzed on this page. This is public information that, as far as we can determine, never has been
analyzed in this way, which in itself is an important comment on healthcare professionals as worthy
trustees of patient safety (as is this other information about the state medical board of Ohio).
The board receives about 3000 complaints per year, roughly half from patients. As an example, I have analyzed their results for the year 2001. (A
cursory overview of two additional years found the same results). In 2001 it appears that not one single complaint filed by a patient resulted in justice or discipline. In that year there were a mere of 143 disciplinary actions (a
percentage that is normal for them), but most were the equivalent of secretarial actions, responses to actions taken elsewhere. These numbers are public record and
can be gotten from the Ohio State Medical Board.
Of the 143 total disciplinary actions:
35 were "Out-of-State," which means the board responded to someone else's
investigation
36 were responses to criminal convictions - again, someone else's investigation
2 resulted from Department of Defense investigations
So the first 73, or slightly more than half, have nothing to do with complaints filed by patients in Ohio or investigations conducted by Ohio State Medical Board
investigators.
Of the 70 cases remaining:
48 cases were impairment issues. These typically result from a physician voluntarily entering a recovery program or sometimes getting too many DUIs (both
of which create paperwork/trails). Having these result from complaints filed by
patients and/or investigations conducted by the board would be unlikely.
Of the 22 cases remaining:
8 were continuing education compliance issues (paperwork)
2 were automatic suspensions resulting from failures to pay child support
(paperwork)
1 was a massage school whose problem was noted as "school app issue" which
sounds like more paper work.
Of the 11 remaining disciplinary actions:
6 involved prescribing issues, sometimes with
additional charges
1 was fraud in obtaining license
1 was unlicensed practice
1 simply was listed as fraud
1 combined impairment, criminal actions and licensing issues
1 was a voluntary surrender of license after minimal standards of care issue(s)
It's unlikely that even any of these last 11 resulted from complaints filed by patients. The
odds of a patient's complaint resulting in justice effectively are zero.
Are Health Care Professionals reliable trustees of Patient
Safety?
This might be all we need to know to understand why the rate
of unnecessary death and injury in medicine does not improve. This might be all
we need to know about whether peer review ever can clean up medicine.
Things for which no one is disciplined include sexual abuse,
rape, assault and the myriad other evils in which humans indulge when normal inhibitions (like consequences) are removed from their environments.
Diagnostic
evidence is extremely difficult to obtain (see
wall of
silence) and regarded with no esteem by the board when it is obtained (as is covered in more detail elsewhere on this site). The testimony of the
patient carries no weight either. That's what a complaint is - the testimony of
the patient. If it carried any weight at the OSMB, at least some of the
complaints of patients would move forward to discipline. But talk to a few of
the people who have been through the process if you want first hand testimony
about that.
No patient can be expected to understand how
this works and to know how to find a paper trail even if one exits.
How many patients complained about Dr. James Burt without the Ohio State Medical Board
doing anything? Mutilating hundreds of unsuspecting patients does not leave a
paper trail. Who would create one? Not the nurses (see
survey). Not the hospital. Certainly not the doctor himself. If patient testimony were considered evidence, on the numbers alone the Burt case supplied more than enough. If diagnostic evidence ever were regarded as being substantial or probative, all the injuries sustained by these women would have meant something to the Ohio State
Medical Board.
When the Ohio State Medical Board finally revoked Dr. James Burt's license it was in response to an
investigation done by a news team (who considered patient testimony and diagnostic evidence to be
probative).
Four years after Burt had been exposed, the Ohio State
Medical Board still was claiming to be investigating the medical personnel who
failed, and/or refused, to report him. No one ever was disciplined as far as can
be determined. Not even
Arthur Richard Schramm. If they did not do enough of
an investigation to discipline him, they cannot be doing meaningful
investigations of anyone.
Arthur Richard Schramm co-authored
a paper with Burt that made such
outrageous claims that anyone who read it would have to have serious doubts
about Schramm's fitness as a medical practitioner even without worrying about
his association with Burt. The state medical board not only did not question
whether he participated in it, they did not even figure out if knew about it.
Eventually, Schramm got a criminal record that immediately
would have been brought to the attention of any public school and resulted in
his dismissal. But apparently such things are of no concern to the state medical
board. They allowed him to continued prescribing controlled substances to
addicts who were in his care and trading sex for drugs.
The public thinks that someone watches these things. No one
does.
When the Ohio State Medical Board still was claiming to be
investigating the medical personnel who failed, and/or refused, to report Burt,
the public believed them. But that is not what the Ohio State Medical Board does. That
is not what other state medical boards do either. They may have asked some questions
of the medical personnel who did not report Burt, but they did not discipline
anyone for failing to report him. They did not even find a reason to wonder
about Arthur Richard Schramm. Schramm did not get disciplined until twenty years
later, and then only because a stepson with access to Schramm's files made a
case to the State Medical Board that even they could not ignore. But they did
not do the investigation. Someone else did. And it was an investigation that
could not have resulted from complaints filed by individual patients. Their
testimony is not regarded as probative by the OSMB and it is not shared with
anyone else. It is buried where patients cannot learn what they did about the
problems and cannot learn from the experience of other patients.
The Rest Of The Complaints
So what happens to all the rest of the complaints? Out of roughly 3000 complaints that are filed during any year,
between 2,800 and 2,900 are dismissed, often for lack of evidence. When they cannot dismiss a case for lack of evidence, they have been known to
sit on a case until it is cold and then dismiss because of suddenly discovering that
they are not charged with enforcing the laws applying to that case. Which is a
perfect way to prevent the laws from being enforced in medicine.
Police departments, often as a
matter of policy, do not duplicate investigations done by other agencies. And no
one but the police is authorized to investigate crimes and bring them to county
prosecutors. Once a medical board accepts a criminal case, the police no longer
will, and the medical board thereby has guaranteed that no one authorized to bring criminal charges ever will investigate it.
This is having it both ways. They accept cases
they are not authorized to accept and then dismiss them as though the accused
are innocent. When they cannot dismiss them, they decide that they were not charged by
law to handle them, and then they dismiss them on that basis. Which has the same
effect as finding the accused innocent.
By this arrangement, medical boards themselves almost never have
to find anyone guilty. They just respond to it when someone else does and use
that to claim to be policing medicine. Patients can have their lives intentionally ruined
by miscreants in medicine, for example by sex abuse. Is sex abuse a crime or is it
not? If it is, the Ohio State Medical Board legally cannot accept those cases. It does
accept them. And it does dismiss them. It is not a law enforcement agency
authorized to investigate and prosecute crimes. So it doesn't matter how much evidence is
presented by the patient. If the amount of evidence is so compelling that the
case cannot be dismissed for lack of evidence, suddenly they discover, as though
for the first time, that they are not authorized to investigate crimes, and they
dismiss is on that basis.
It was on that basis that they should not have accept
criminal cases. When this was pointed out to them multiple times,
it made no difference. They are a guild that represents the interests of health
care professionals, not patients. By accepting such cases, they can protect
colleagues. They are inclined to do that rather than to protect patients. By
accepting such cases, they protect
miscreants in medicine by causing the cases to become impossible to be pursued by anyone
else.
All of this suggests that healthcare professionals are not
fair, impartial and motivated in matters requiring them to discipline their own
colleagues. It suggests that the well being of patients is not their highest
priority.
What's frivolous is the way claims are treated
The Ohio State Medical Board is regarded as one of the best
boards in the country. It is considered to be a model for the others. And yet
the odds of its arriving at justice in response to the complaints of patients
effectively are zero.
Although the board members work hard for little compensation and make difficult decisions,
they share the perspective of the people they are supposed to discipline, not
the perspective of the patients who need to be protected. All indications are
that it is run by and for healthcare professionals with an investigative arm set
up to placate, if not defeat, patients while claiming to do the opposite. I had
written extensively about that here, providing information to support that
conclusion, but because of the nature of jurisprudence in this country, had to
remove it. And I'm not even allowed to say much about that. That fact alone
should ring alarm bells.
No organization can rise
above the constraints of its leadership
There are people who spend their lives learning to be
managers. They get advanced degrees in management fields. They become junior
executives and climb the management ladder learning as they go. That is not what
physicians do. The physicians who end up in charge of an organization like the
Ohio State Medical Board are not people with the tools or the time or the
inclination to understand
the organizational problems of the bureaucracy they lead. On the board they act
more as jurists more than managers anyway.
Citizens think that licensing agencies exist to ensure competence and to protect citizens. Most do not. The Ohio State Medical Board is one of the best
organized and best funded boards in the country. But it is run by physicians who used it to lobby the Ohio state government to enact liability limitations to protect physicians.
They did not use it to lobby the government to enact measures that would protect
patients.
Protecting physicians appears to be its real agenda, not protecting patients. Even with 22 full-time investigators the odds of its arriving at justice in response to a patient's complaint effectively are zero. With all of its resources, it has been organized by the
constituency that it is supposed to oversee. It may be that physicians who think "frivolous" whenever they think "lawsuit" also think "frivolous" whenever they think "complaint."
One is forced to conclude that the Ohio State Medical Board thinks that
its job is to protect medicine from bad patients.
Patients in Ohio who have been the victims of violence or
abuse or neglect in healthcare settings would best be advised not to waste
energy on the Ohio State Medical Board's complaint process (and there is reason to believe that many
give up once they attempt to - something else that the board
has not studied and refused to allow to be studied when I asked to do that) unless they
first have gotten the problem investigated by third party and can provide an undeniable paper trail
and witnesses. That would be a very rare situation. And even then, it would be
unlikely to produce results.
The rock bottom foundation of patient safety is criminal law
but no one enforces it in medicine.
Privately I
shared with them what I discovered about them. Naively I thought they would want
to know. They didn't. The Ohio State Medical Board now stonewalls me. They won't
respond either to email or phone calls from me. They won't release to me
information that they are required to make public and they won't answer my
questions. If their real concern was protecting
patients, would they behave this way?
Since they will not use the information to protect
patients, I published it here in the hope that someone else will.
If you want to say something about any of my
sites, my phone number is on almost every page. So is my
email address. There even
are Feedback Forms where you can communicate
anonymously. I am listening. I will be sensitive to what you say.