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IAMRA 2016 Conference

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    June 18, 2016 8:02:28 PM PDT


    The International Association Medical Regulatory Authorities Will Not Disucss The Lack of Research About Regulatory Misconduct at their 2016 Meeting – However, Research of State Medical Board Disciplinary Processes is Needed to Improve the Quality of their Regulation



    Four case reports from the USA provide examples of medical regulation that have either jeopardized patient safety or evidenced corruption and incompetence on behalf of a state medical board (SMB). The records of each case were made public by the Nevada (NV) or Missouri (MO) SMBs. Dr. Mishler was forced to litigate his defense to the NV Supreme Court where, in 1993, all of the SMB’s charges were dismissed with prejudice. In addition to wrongfully disciplining Dr. Mishler, the SMB concomitantly protected a possibly negligent practitioner with questionable billing practices.1 Furthermore, the SMB violated its privacy policy by sharing confidential information with Dr. Mishler’s neurosurgical colleagues. The next three physicians were victims of the MO SMB. Dr. S.P. was family medicine physician who cared for an under-served population of Medicaid patients.2 Dr. S.P. endured 4.5 years of harassing litigation because the SMB demonstrated a fundamental lack of competent medical knowledge and filed false claims in court misrepresenting drug classes and FDA indications. After 4.5 years, in 2007, the SMB was given a defeating judgment on every one of their 137 allegations against a doctor who provided excellent patient care.3 The SMB tried to discipline Dr. A.A. for providing excellent care.4 The SMB was unable to interpret the clinical guidelines, and they misrepresented the documents that their expert witness used to form their opinion. The Honorable Commissioner Sreenu Dandamudi described the SMB’s conduct as “unfathomable and deeply disturbing,” and “wholly unworthy of a state agency.”4 The SMB spent 5.1 years in a failed effort to discipline Dr. S.C. for a clerical omission in a job application. They filed many false claims in court such as “Marinol is contraindicated in the elderly.”5 In conclusion, further study of SMBs is warranted with the aim of ensuring a consistent level of regulatory quality.


    1. Mishler v. State Bd. of Med. Examiners, 849 P. 2d 291 - Nev: Supreme Court 1993. Accessed January 5, 2016.
    2. Commission MAH. State Board of Registration for the Healing Arts v. Paskon, Second Amended Complaint. No. 02-1491 HA (December 27, 2004). Accessed January 5, 2016.
    3. Commission MAH. State Board of Registration for the Healing Arts v. Paskon, No. 02-1491 HA (Mar. 27, 2007). Accessed January 5, 2016.
    4. Commission MAH. State Board of Registration for the Healing Arts v. Adem, No. 12-0526 HA (Sept. 24, 2013). Accessed January 5, 2016. 
    5. Chaganti v. MO Bd. HA; WD77746; March 10, 2015. Accessed January 5, 2016. 

    This post was edited by Brett Snodgrass at June 18, 2016 8:35:19 PM PDT