Ohio State Medical Board
as a model of medical boards in general
It is run by people who share the same conflict of
interest
that
made patient safety an issue in the first place
As the
American Iatrogenic Association says, "Keep in mind that state medical
boards are generally comprised of physicians. As with all such agencies that
regulate occupations, members of these boards feel a personal and professional
kinship with those who they regulate. In other words, doctors do not regulate
doctors effectively. Claims to the contrary notwithstanding, a state medical
board does not operate in your interest." An analysis of
the disciplinary actions of the OSMB complies with that. No disciplinary
actions could be found that definitely resulted from complaints filed by patients. This suggests a bias toward physicians and away from patients, unless one believes that complaints filed by patients never have merit.
Naively thinking that a board of directors charged with
running a bureaucracy would want data on how they are doing, I contacted them to
report my findings. Their response was that they have good procedures. That may
be so, but according to the numbers, they are not getting good results from
them. An organization can be no better than the people in it. At the state
medical board of Ohio we see bureaucrats behind closed doors with no real
accountability and with disinclinations to find truth or arrive at discipline.
After all, this is the organization that lobbied the government to pass
liability limitation laws to protect physicians. It is run by physicians who
share the perspective of the people they are supposed to discipline, not the
perspective of the patients who need to be protected. If the
analysis of their disciplinary actions means anything, it means that the people who think "frivolous" whenever they
hear "lawsuit"
must also think "frivolous" whenever they hear "complaint."
Patient Complaints
When a patient begins the complaint process with the Ohio
State Medical Board, figuring out who they are is only the beginning of the
obstacles faced by patients. There also is an Ohio State Medical Association
that represents doctors. There also are other boards for various other
disciplines in medicine. The task of figuring out to whom to complain will
eliminate many legitimate complaints at the outset without their ever being
filed. I have discussed that with people at the medical board and they don't
want to receive anymore complaints. They believe they receive too many already.
An organization honestly interested in solving the problems of patients would
want to elicit complaints, not eliminate them before they are heard. When
a patient telephones the Ohio State Medical Board, the patient encounters a phone matrix at the end of which is a message that doesn't mention filing complaints, but is the correct place to leave a message if that is why the patient is calling. (By clicking phone matrix you can listen to a recording of it. How many
senior citizens could make it to the end of that phone matrix? And that recording was made with the benefit of already knowing all the correct options to choose.) No one ever answers that line. The patient always is directed to leave a message. When the patient does that and waits for the return call, the patient always will wait
for the rest of the day without receiving a call. The call comes the next day. A normal patient won't know that and likely will have given up waiting and might not at the phone the next day. If not, the medical board leaves
a message that says that they tried to contact the patient, and that is the last
the patient will hear from them. The patient must call them again, go through
the matrix, and leave another message that once again will not be returned that
day. One can lose a week going through this process before figuring out that one
needs to camp out by the phone on the day after leaving them a message. When a patient finally gets them on the phone, the patient is told that a form will be mailed. Evidence
is disappearing. The trail is getting colder. Witnesses are becoming less and less valuable as
the time passes before anyone even attempts to identify who they are. The form sent to the patient says for the patient to gather the diagnostic evidence. This puts the patient in the position of having to schedule appointments with doctors in order to
create that diagnostic evidence (in our
experiences and conversations with the Ohio State Medical Board, they appear to be unaware of the near impossibility of getting physicians to create diagnoses
that indict a colleague - see white wall of silence).
If the patient ever manages to accomplish this task, months if not years easily
can have passed as the trail grows colder and colder.
The evidence that patients are supposed to gather is supposed
to be "reliable, probative, and substantial," but the Ohio State Medial Board will not say what is reliable, probative and substantial. They will list things
to send, like x-rays, but the Ohio
State Medical Board does not move toward
justice as a result of those things, as their disciplinary actions show.
If the patient manages to gather and send what has been requested, the state medical board of Ohio then often sends an investigator to speak to the patient. But to read how that works, read my section on
Ohio State Medical Board investigators. In our experience they don't even find witnesses.
They don't know what questions to ask or what documents to look for. The don't
show an interest in doing their job. They don't
even find existing paper trails and, if the paper trail presented to them is too long, in our experience they never read it. When the victim points this out to an investigator's superiors, they are unresponsive. Does this sound like a civil bureaucracy operating behind closed doors with no meaningful
scrutiny? And here's one more wrinkle. If you are calling to report a crime, you are calling an agency with no authorization
or facility for enforcing criminal law. But they accept criminal cases and then dismiss
them as though they did. If the patient is such a good investigator that he or
she presents overwhelming evidence of the crime (without witnesses that might
not be possible), after shuffling it around for a couple of years, they have
been known to issue a letter to the patient saying that they are not charged
with enforcing the laws applicable in the case. In other words, when it will
protect physicians they do take charge of criminal cases and reject them. When
it won't protect physicians, they recognize that they are not authorized to
investigate crimes.
One way or the other they manage not to discipline anyone as a
result of complaints filed by patients. They discipline physicians only when someone else, like the police,
comes to a finding that puts the state medical board in the position of being required by law to respond.
The OSMB is one of the most respected state medical boards in
the country. The Health Research Group at Public Citizen did a study (http://www.citizen.org/publications/release.cfm?ID=7166)
of state medical boards in which it ranked the OSMB as the only one of the USA's
fifteen largest states to be represented among those with the highest
disciplinary rates. But even though it disciplines a higher percentage of
physicians than other large states, it manages to avoid doing it in response to
complaints filed by patients. It is hard to regard this as anything other than
one more example of the antipathy that medicine holds for the experience of
patients. Healthcare professionals report adverse events less than 2% of the
time. Patients are the only source for most of that
information. And the OSMB dismisses it as though it were frivolous in almost all
cases. |