Last week was a big antitrust week for the new law firm of Bona Law PC. First, it was the ABA Antitrust Spring Meeting, where antitrust lawyers from all over the world descend upon Washington, DC to obsess over antitrust and competition for several days. Second, I was writing an antitrust brief in a significant antitrust case.
Finally, I argued at a motion-to-dismiss hearing in the caseDr. Yvoune Kara Petrie, DC v. Virginia Board of Medicine, et al. I represent Yvoune Petrie, a doctor of chiropractic, in an antitrust lawsuit (Sherman Act, Section 1) against the Virginia Board of Medicine and several of its board members. Update: We survived the motion to dismiss."
With my clients request and permission, I thought I would tell you a little more about it"."
A Growing number of leaders in healthcare are beginning to realize the VA Scandal is a misnomer. It is more appropriately termed Healthcare Scandals exposed. The V.A. Scandal probably came to national attention as it was exploited for partisan politics. The Scandal at the VA is probably not much different than the scandal at UMKC-Pathology, and that is not much different than other scandals which intermittently rock hospitals around the country. Another factor that may have brought the VA Scandal to national attention is the relatively large size of the VA system compared to other hospitals such as UMKC. The system that led to the UMKC-Pathology Scandal is no different than that of the VA. In addition, the Medical Board attempted to reprimand the whistleblower documenting months of poor cancer care for women who had lumpectomy specimens. They did not make preliminary investigations to show that the DIO was lying about the documentation of "Ischemic Time." Which they will not often find in the surgical pathology reports from Nov 2010 to June 2011 because as I told the ACGME, the breast specimens often sat on the counter for a couple to a few hours. After one hour, the receptor status starts to change and these women with hormone receptor positive breast cancer likely did not get the correct treatment. Taking a group of physicians to court and claiming that numerous highly-respected physicians are violating antitrust laws takes courage. Read more from this brave attorney here. http://www.theantitrustattorney.com/2014/03/30/virginia-board-medicine-violated-antitrust-laws/
The above excerpt was selected under my understanding of the fair-use of copyright law, if copyright concern please contact firstname.lastname@example.org
Many physicians will claim he is unethical, or out for money. However, what the medical boards typically do not advertise, is that they commit crimes worse than those they reprimand.
Medical Board Fraud
Peer Review Fails Repeatedly
1. Dr. Antoine Adem -2012 -2014+: reprimanded for providing good medical care by the Missouri Medical Board who committed six counts of fraud against him.
2. VAScandal: Peer review also failed in the VA. This probably came to more attention because the GOP has used it for their political campaign againnst the ACA. Regardless of your political affiliation, you are welcome to share your comments here.
3. UMKC Pathology Department 2010 - 2014+ - DIO lied to Amy Beane of the ACGME and claimed they documented the ischemic time of patient's tumors. No investigation was made to review the reports from that time period to verify this claim. Dr. Snodgrass was later reprimanded by the medical board for filing this claim, which they, without investigation, asserted to be false. If the ACGME or the Missouri Medical Board were to review the lumpectomy reports from November 2010 to June 2011, they would realize that the reports do not contain the claimed "ischemic time," also known as the "time to formalin fixation," as the DIO from UMKC in Kansas City claimed that they often did.
4. Missouri Medical Board Reprimanded Doctor for Providing FDA-approved Excellent Medical Care - 1990's - see below for more details.
5. Medical Board bullied the woman in this video: and cost her many thousands of dollars, which they did not pay her. The Medical Boards claim patient safety, while committing fraud, repeatedly reprimanding good care, and want more of the States Money and absolutely no accountability for their decisions.
6. Texas Medical Board: Bullied Dr. Buryzinski for performing medical research with the FDAs approval. They have conflated standard clinical practice with clinical research. Their conduct suggests that it may be beneficial if someone with clinical trial experience serves on medical boards.
7. RoboRob a case of slander by his peers: Prominent UA doctor taunted as 'Robo Rob' says settlement clears him. http://tucson.com/news/science/health-med-fit/prominent-ua-doctor-taunted-as-robo-rob-says-settlement-clears/article_028b3388-b753-57f5-acf8-cc0a1c266b2e.html
8. Texas Medical Board: Potential conflicts of interest in filing reprimands, and apparently the medical board reprimanded a radiologist without first reviewing the x-rays to determine whether or not they exhibited metastatic cancer. http://www.houstonpress.com/2014-03-27/news/steven-hotze-texas-medical-board/ in defense of the President of the Texas Medical Board: I would commend her on (1) making decisions outside her ABMS specialty, as I once taught a night float radiologist how to examine CT Scans of the Head for midline shift after trauma; and then (2) claiming that she trained at Johns Hopkins. Some people have maligned her stating that she trained at a clinic outside of Johns Hopkins and thus it doesn't count. Such statements are petty, and completely miss the issues of medical regulation and patient safety. In my humble opinion, if her hospital states that it was affiliated with Johns Hopkins University, as the hospital I trained at for a year in North Carolina, Carolinas Medical Center claimed it was affiliated with University of North Carolina Chapel Hill, then it should be reported as such.
9. Oklahoma University Medical School, Pediatrics Department: Altered the score of one of the medical students that they did not like and dismissed him from the residency. In addition, the Oklahoma University Medical School had to pay him in court.
10. Missouri Medical Board: Reprimanded a cardiothoracic surgeon for a terrible error that the nurse caused one week after the surgery. (link pending)=____
11. Report from Maryland: Maryland stole this man's medical license based on politics. http://mdreport.blogspot.com/2012/08/stealing-medical-license-maryland-style.html
With the advent of the internet, patient safety advocates are getting a closer look into the details of medical regulation. That they do a great job many times. In addition, they have a side that harms patients. More reports are continually surfacing and being obtained from the archives detailing how medical boards harass doctors for "by the books," "excellent," "FDA-approved medical care," and don't follow the American Medical Association Code of Medical Ethics. With an upcoming supreme court decision, it is important that we are ***Transparent*** for appropriate decision making.
Medical Boards committing Fraud & Harassing Doctors for Good Care reported in #TX #SD #VA #MO. #VAScandal #SCOTUS
Reading the Medical Board Court Cases is more action packed than most reality TV Shows. So pull up a chair, and get cozy.
Bringing you the real world of medical regulation,
from (1) fraud to (2) inappropriate sexual conduct, to (3) patient harm, to (4) reprimanding excellent patient care.
Drama fans, medical educators, and policy regulators will likely find this a useful resource. Furthermore, with the current physician shortage, it will be upon patients to advocate for reform in medical regulation. If they cannot afford to see a doctor, it isn't necessarily because of Obama Care. It may be secondary to a medical board reprimanding a doctor for providing good medical care, or for them determining that a doctor does not have good moral character.
Surely there is no one perfect, but if that is the standard which physicians must be at for their entire life (past and future), then we will likely see patients die without care. Personally, I find saving lives through appropriate medical care to be incredibly rewarding, but there are a number of factors that determine medical regulation. Furthermore, these factors are continually in flux, and it is up to patients and patient-advocates to ensure that the policies favor patient safety and not merely provide absolute immunity to physicians.
An excellent reference with many medical ethics cases is the American Medical Association's Virtual Mentor. However, the ethics cases do not cover how the system can redress and stop fraud by medical boards. The aim would not be to punish people for serving on medical boards, except in cases where they commit fraud and reprimand good medical care. Patients who are harmed want justice, and society needs to discuss if malpractice is the means to that, or whether actions by medical boards is the means. Many times poor outcome is not related to the quality of the provided patient care and society needs to be made aware of this. Medical Boards, patient advocate societies, and lawyers probably should work collaboratively to establish and equitable and fair system.
An article that I enjoyed reading is found here. It asks numerous prudent questions, questions that may never be answered.
VM -- Professional Self-Regulation in Medicine, Apr 14 ... Virtual Mentor http://virtualmentor.ama-assn.org/2014/04/hlaw1-1404.html#.U3k9SxEbaEI.twitter …#meded
Attached are my comments from the case of "RoboRob," a derogatory term, not uncommonly used by those on peer review bodies to insult someone they do not like.
Thank you for sharing. I am collecting cases of failed peer-review from around the country. Topics include blatant fraud committed by medical boards, reprimanding physicians for FDA-approved, "by the books," "excellent medical care." There was a case in Missouri where Dr. Antoine Adem was brought to court for providing appropriate patient care. The Medical Board could have spent one hour reviewing the cardiac stent guidelines to realize he had been providing good medical care. Instead of doing that the Medical Board committed six counts of fraud v. him. I will be adding a link to this story to the collection. http://drsocial.org/forums/topic/276/-/view/post_id/430
Your report from Arizona, the Missouri Medical board Fraud, and several other cases provide detail into an organization that has not had, and does not want accountability. Scandal rocks the V.A. and peer review repeatedly failed . There have been over 100,000 view of the article written by Yinka Vidal on the lack of accountability of peer-review groups and administrative bodies within healthcare.
Vidal's work predated the Institute of Medicine's report on medical error by several years, and he was initially ridiculed for his observations of systematic patient harm in healthcare. The lack of accountability of medical boards and hospital administration have silence front-line workers, permitted pockets of corruption. After the Medical Board committed six counts of fraud v. the cardiologist Dr. Antoine Adem for good medical care. They went home without reprimand and received payment for their unprofessional, unethical, and unfathomable conduct. Do not take my word for it, read what the Judge wrote. Court excerpts and links to court cases along with commentary demonstrating a shocking lack of medical knowledge, in addition to fraud, by those on peer-review committees might be a concern to many.
If you or someone you know has witnessed sham peer review, patient harm accepted by the medical board based on academic title, or the reprimanding of whistleblowing without investigating, then please share your comments.
The #VA article is found at http://bit.ly/VAScandaL
JAMA, Journal of the American Medical Association American Medical Association (AMA) #PtSafety Joint Commission Resources Federal Trade Commission SCOTUSblog #SCOTUS #FTC #hcsm
Something that many physicians are not trained in during medical school are the ethics of professional regulation. They are naively led along that if they do the right thing, they will remain out of trouble with regulatory agencies. No one is perfect and always does the right thing. For example,a speeding ticket is breaking the law, is unethical for a physician, and unprofessional, but doing it once is probably not related to patient care.
More importantly doctors in-training are taught that if they provide good care of patients, and follow ethical and regulatory guidelines they will not encounter troubles with the medical boards.
This is not necessarily due, and in my review of medical board cases I wanted to share the good and the bad so that people will have a better idea, and a medical analysis regarding the ethics of professional regulation. I state a medical analysis, because not many physiciains read medical board actions and discussions for years. Most physicians are afraid of the medical board, possibly because they have absolute immunity. Some lawyers are defending physicians against the medical boards and suing them for anti-trust. Well, I will add more commentary with potential policy implications related to medical boards. Through the internet, physicians and patients now have the opportunity to be heard. This is something that medical boards were not traditionally familiar with. However, we must remember to put patient care first, and when medical boards reprimand good care, and prevent patient care through their regulation, patient advocates need to investigate and work with state representatives and senators.
Most people have some form of accountability for their decisions. An exception is those persons who "serve," on medical boards. As several case examples will show, medical boards reprimand good care in addition to bad care. Furthermore, the care that they have occasionally reprimanded as "bad," is not abstruse and any physician should be able to determine whether it is appropriate.
Everything for the patient.
This doctor may have lost their medical license, but, in my opinion, their odious behavior warrants criminal prosecution.
However, due to the odious nature of this offense, it doesn't require a medical degree to reprimand this person. The MD or DO on a medical board would presumably be used to give insight into cases of whether the doctor was following current guidelines, excetra.
Here is a case where the Medical Board ruled in favor of patient safety. One need not have a doctorate degree to reprimand this physician. Having physicians on a licensing board should be used in cases where "common sense," may not be enough.
There is more from the FSMB here.
Here is a case where the medical board attempted to reprimand this physician for excellent medical care.
If medical boards are reprimanding, or trying to reprimand "by the books," "simple," "non-abstruse," "FDA-approved," medical care, then one might ask the following questions
1. Do we need doctors to serve on the medical board
2. Why don't the doctors on the medical board perform their due diligence
3. Is absolute immunity of medical board members helping board members, or patients?
We also rank very high in rates of fraud and misconduct committed by medical boards. We need legislative advocacy. According to the medical board, every medical student in the state is practicing medicine without a license when they form a "diagnosis," after seeing the patient.
Laws need to state that clinical diagnosis of practicing without a license is when the diagnosis of another physician is rendered not as an opinion, but as a the diagnosis that is informed to the patient and presented as such, and without commentary by the physician who is the patients provider.
These are the things that medical boards are engaging in and you never know when an administrator will give you bad evals for asking them a single question, and when they will equivocate an honest reply with blaming.
Would it surprise you that the medical board in MO (and they probably aren't alone,) committed six counts of fraud trying to reprimand Doctor Antoine Adem for GOOD medical care.
These physicians on the medical board didn't spend one hour looking up the stent guidelines, not did they simply call Dr. Adem and say, "hey, can you explain the case to me." The Unaccountable medical board attorneys are encouraged by tv unaccountable medical board members to win, apparently to ignore patient harm, even if it occurred repeatedly.
The VA Scandal is not limited to the VA, but could occur in any hospital in the USA.
We need to reform medical boards somewhat. You may mock, but MO isn't alone, TX appears* to be engaged in abuse of discretion. In MO. The judge said that the Board of Registration for the Healing Arts conduct was "unfathomable and deeply disturbing,"
The AMA currently opposes the FTC in their effort v the NC dental board.
They say that patient safety is the reason, but it appears to be to abuse discretion. Yes, patient harm is significant, but boards capriciously evaluate physicians moral character. For example, a resident beat the sh!+ out of someone, was arrested, and taken to jail, has a mug shot online. The resident is of good moral character with the board because the resident claimed exactly what the Chair wanted. Nonetheless, if the Board investigated, they would find that the claim of "documenting fixation time often in lumpectomy specimens (told to the ACGME)" is false.
So never being arrested is considered more unethical than beating the sh!t out of someone.
Do you think Medical Board Members should be held accountable and financially liable when they reprimand "by the books," "FDA-approved care."
They are destroying another physicians life because they didn't spend an hour looking up the clinical guidelines.
My aim is that they are held accountable and have some risk, some personal need to render just and equitable decisions when evaluating their peers. Instead, as it stands, board members committ fraud, reprimand good medical care, and refuse to investigate (to even check), potential patient harm that was ongoing for months.
This is not about me, but this is an issue of patient safety. For example, reprimanding good medical care and committing fraud doesn't help anyone, yet it costs hundreds of thousands of dollars in litigation, and it could be prevented by 1 board member spending 1 hour reviewing the guidelines. Furthermore, they do not permit cross-examination of their claims prior to litigation, an essential feature of peer-review groups according to the AMA Code of Medical Ethics.
Please pardon the language that may resemble an expletive.
There is more here
Thank you kindly,
No one will probably touch this topic, but we need physician leaders to step up and identify fraud and reprimanding simple, by-the-books, excellent care in the hospital administration, peer review groups and medical boards.
It isn't asking that much if medical board members: "don't reprimand excellent, by the books care, or you might be held liable."
If a medical student can figure out the case in an hour, then board members of another specialty should
1. Identify the concern, decide &/or if not certain
2. Call the physician and say, would you please explain the therapeutic rationale for your medical decision making. Or perhaps they could ask the doctor to write a letter with the rationale. If the judge can figure out the medical board is committing fraud & misrepresenting Medical information, then medical board members can monitor their rubber stamp more closely.
If you were the medical doctor who provided by the books, "FDA-approved," "excellent medical care." To this patient, would you want to spend ten hours and two thousand dollars teaching the medical board's attorney, in front of the judge, why your medical care was ~perfect?
The medical board walks away unscathed and they used the government's money to reprimand excellent medical care.
State medical boards that work diligently to keep people from practicing medicine based on a personal conflict, for which resulted in a electronic communication disturbance, was not even a misdemeanor, are probably harming patients.
The idea that physicians must provide evidence of "good moral character," to be a physician is drastically flawed.
Consider if the Depaetment leader lied to the ACGME about the department. Stating that the care they provided was "by the books" and excellent.
The Board would likely assume what they say is true based on academic title. By the way, writing that you are compliant with safe patient practices, is NOT the same as doing it.
For example, if you tell the ACGME that they don't need to investigate, ~"we are documenting the ischemic time," no need to review our actual surgical pathology lumpectomy reports, they won't investigate.
So who has good moral character, the one who lied and covered up patient harm, or the person who reported the harm. Patients could be receiving the wrong cancer treatment (w/out trastuzumab), and possibly dying early,
Would you be silent about this?
If many patients were potentially harmed and then a physician lied saying "oh no, we provide good care, and write the ischemic time down," but the reports from that time do not have the ischemic time, then should you speak up or be silent?
ndercover agents from the California Medical Board allegedly expose a pediatrician committing insurance fraud and providing illegal prescriptions. Why is the medical board running errands for the police?
I'm sure that running a medical board isn't easy, thus I offer this information for a necessary and prudent discourse that is essential in order to figure out how to fix the system.
Here is a claim that a lawyer made against a doctor. Why do we have doctors on the medical board if they don't review the clinical validity of these claims before they are filed in court.
Reprimanding "by the books," "FDA-approved," Medical care is probably not helping people.
Here is from reports of Fraud by the Maryland Medical Board,
There are many more to come, and physicians are becoming upset with medical regulation that favors academic title to patient safety, that consider too many letters in the mail more important than people dying.
MDreport: Stealing a medical license: Maryland style http://mdreport.blogspot.com/2012/08/stealing-medical-license-maryland-style.html?spref=tw
Don't worry, I am not trying to pick on Missouri, but they are far from the only state medical board acting worse than many of those they reprimand
As long as Administration is completley immune from their decicisions, we can anticipate more VA-like conduct http://www.ncbi.nlm.nih.gov/pubmed/2783210
Interesting that some think that Medical Boards should have no accountability for their actions, in spite of the Board's actions actions
1. Committed fraud, six times versus one cardiologist Dr. Antoine Adem. Court case at the length. The judge said the medical board's conduct was "unfathomable," "perverse," and more. There is nothing protecting patients about this. These physicians are sending their lawyers off to commit fraud, are not doing their job by reprimanding good medical care. Anyone can reprimand a physician for raping a patient. If doctors are not going to apply their medical knowledge to their job serving the medical board, then why do we need them, or doctors for that matter on the medical board.
2. After trying to reprimand Dr. Adem for providing good medical care, and committing fraud against him six times, and then depriving patients of care so they could try and reprimand Dr. Adem in court, they ultimately went home both paid and without reprimand.
They reprimanded a cardiologist who they committed fraud against six times for forging a letter x1, and then did not reprimand themselves. The Medical Board wasted 100,000 dollars wasting 100,000 dollars of tax-payer dollars prosecuting Dr. Adem for providing "by the guidelines," medical care. Thus, the medical board both
2a. Harassed Dr. Adem,
2b. Committed Fraud six times
2c. was negligent and did not use their medical knowledge to do their job.
2d. Deprived patients of medical care amidst the shortage of physicians
2e. Wasted $100,000 of tax-payer dollars
2f. Received payment for their unethical, unprofessional nefarious conduct
2g Made no reparation to Dr. Adem for acting like senseless gorillas trying to clobber him with fraudulent information.
2h. Did not reprimand themselves for a more serious offense than that committed by Dr. Adem.
3. No physician on the medical board bothered to spend a single hour reviewing the cardiac stent guidelines, and instead tossed the case to their attorney. Why do we need physicians on medical boards if they cannot read the stent guidelines and need the judge to do it for them?
4. Poor communication on behalf of the medical board. A physician on the medical board could have easily picked up the phone. called Dr. Adem at a n agreed-to time and said
"Dr. Adem would you please explain to me your therapeutic rationale. I cannot give you an answer today, but I would like to speak with you about your medical reasoning before the Board makes any further decisions."
Instead the Monkeys on the Medical Board tossed the case to the attorneys who ran at him mindlessly.
5. The following website contains 12 cases of unethical medical board conduct and more is being added daily. THere are 13 cases if you consider North Carolina's recent harassment of a physician for lying about having sex with her husband. There is a physician shortage, and people will likely die without preventive medical care, especially the poor. Given that, the medical board members are despicable and without moral compass as they would rather let patients die
than permit a physician who lied about having sex provide patient care.
Furthermore, the Medical Boards do NOTHING proactively to help physicians be complaint with the broad and selectively interpreted laws. This is in stark contrast to the FDA, CMS, who gives physicians a year to get in complaince. It is disgusting that the medical board would pressure some nervous woman to where she is feared for her life and her career, pressing her about having sex, not even harming anyone, and then reprimand her. Medical boards are becoming about as intelligent and professional as a drunken fraternity club. There is nothing respectable about their harassment of doctors for providing good medical care.
If you would like to share your comments on Medical Board fraud, harassment, bullying of doctors, reprimanding FDA-approved care, then please see the following website: VA Scandal-2: Medical Board Fraud and Antitrust http://ow.ly/zfmHT
Why is the Medical Board Committing Fraud?
Why is the Missouri Medical Board committing fraud? Is a lack of legal liability responsible for the Medical Board's negligence and repeated acts of reprimanding good medical care? If the medical board members could be personally sued through antitrust litigation, would they spend an extra hour a year contemplating not committing fraud, and thus saving the government at least one hundred thousand dollars per year? This post presents a root cause analysis of the errors that led the Missouri Medical Board to commit six acts of fraud versus Dr. Antoine Adem for having provided patients with good medical care.
The likely reason that the board committed fraud six times against Dr. Antoine Adem is due to prejudice. The Missouri Medical Board thought that they knew the stent guidelines. I suggest this root cause analysis of the medical board's error because it is very pertinent to the practice of medicine, medical regulation, and my own aims to resume "clinic." The Medical Board did not review the literature during their decision making process but relied on the following:
1. A negative evaluation of Dr. Adem written by his ignorant boss;
2. The Board's experience with a similar case of coronary stenting that was characterized by the placement of stents in a vessel with less than 50% occlusion, was malpractice, and not indicated. The cardiovascular doctor placed merely to make money.
The board incorrectly presumed that Dr. Aden's case was identical to the aforementioned malpractice.
The Medical Board did not review the medical literature, did not review the stent guidelines, nor did they ask/listen-to Dr. Adem's therapeutic rationale.
Due to the failure of the medical board to have their physicians exercise evidence-based decision making, they wasted $100,000 of tax-payer dollars, committed fraud six times, were paid and not reprimanded for their unethical and unprofessional conduct, and likely harmed patients through the deprivation of care and stressing an already stressed healthcare system.
Summary: The Missouri Board of Registration for the Healing Arts did not appreciate the key difference between the two cases, which was the size of the coronary arteries. If the coronary artery diameter is less than 4 mm, then a stent may be indicated, even if the degree of luminal obstruction is less than 50%. However, the case of malpractice occurred when stents were placed in vessels larger than 4 mm with less than 50% luminal obstruction.
Will medical boards continue to committ fraud, harass doctors for providing good medical care, and refuse to investigate patient harm, the United States Supreme Court will soon decide. Comments and suggestions are welcome.
Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards - Kindle edition by David A. Johnson, Humayun J. Chaudhry. Professional & Technical Kindle eBooks
http://www.amazon.com/Medical-Licensing-Discipline-America-Federation-ebook/dp/B00ABCNZBI/ref=cm_rdp_product Only 25.99
Medical Licensing and Discipline in America: A History of the Federation of State Medical Boards by David A. Johnson
This post is related to antitrust and is from the NEJM archives. Development of Medical Ethics MEDICAL ethics, so-called, had very earthy origins. It stemmed not from theorists who speculated airily on the nature of the good, but from hardheaded, practical men who faced ugly, concrete situations. The framework of medical ethics lay not in philosophy but in sociologie phenomena, especially those leading to guild organization. A guild was an association of workers banded together to protect their common interests and to destroy competition. The technic was to obtain a strict monopoly enforced by the powers of the state. The guild in return for this monopolistic position guaranteed the competence of the workmen, established standards of . http://www.nejm.org/doi/full/10.1056/NEJM195803062581006 ---- Is the monopoly still as necessary today? What do you think? -BrettMD
Brett Snodgrass to #FTC Greetings, I would like to speak with someone at the #FTC about my complaint. I have had my identify stolen so many times. sigh. We need to bring the State Medical Boards to justice for their crimes. They are entity of the state to uphold the statutes and protect the public. They have absolutely no oversight, and they are not held accountable for patient safety. If they were held accountable for patient safety they would be fired when the error rate in hospitals increases. The Medical Boards have failed the people of every state and ths occurs at least a million times per year. State Medical Boards are one of the most, if not the most incompetent government agency. Few other agencies commit fraud and are paid for it.
#MedEd #hcsm #PtSAfety #Fraud #incompetence #RefusalToInvestigate#UMKC #Pathology #Lumpectomy #Specimens #Fraud #gossip #PtSafety
They are a state agency to protect patients and do you think they are doing a good job. 12 million deaths due to errors per year and the Medical Board reprimands the reporting of patient harm at UMKC? The UMKC DIO lied to Amy Beane of the ACGME and the medical board could have verified this in three hours. Instead of doing their job Missouri Division of Professional Registration
they reprimanded me for reporting patient harm. This is without investigating.#Telemedicine #Telehealth
Adding to the competition and cost in our health care system is the recent rapid increase in the number of practicing physicians, most of whom are specialists. In 1970 there were 153 active physicians per 100,000 members of the population; in 1980 there were 192; and the number for 1990 was estimated to exceed 220.9 Among these new practitioners, the number of specialists is increasing more rapidly than that of primary care physicians. When doctors were in relatively short supply two or three decades ago, they worried less about their livelihood. Now, as the economists would say, we are in a buyer's market, in which not only underused hospitals but also specialists — available in increasing, sometimes even excessive, numbers — are forced to compete for the diminishing number of paying patients who are not already part of the managed care network.
How have all these developments affected the practice of medicine? In the first place, they have resulted in more regulation of the private practice of medicine by third-party payers, who are trying to control costs. There is more interference with clinical practice decisions, more second-guessing and paperwork, and more administrative delays in billing and collecting than ever before, as third-party payers attempt to slow down cost increases through micromanagement of the medical care system.
Second, doctors are increasingly threatened by malpractice litigation as a strictly business relationship begins to replace the trust and mutual confidence that traditionally characterized the doctor–patient relationship.
Third, the courts, which formerly kept the practice of medicine out of the reach of antitrust law, now regard the physician as just another person doing business, no longer immune from antitrust regulation. In 1975 the Supreme Court handed down a landmark decision that found that the business activities of professionals were properly subject to antitrust law.10 As a consequence, physicians can no longer act collectively on matters affecting the economics of practice, whether their intent is to protect the public or simply to defend the interests of the profession. Advertising and marketing by individual physicians, groups of physicians, or medical facilities, which used to be regarded as unethical and were proscribed by organized medicine, are now protected — indeed, encouraged —by the Federal Trade Commission.
Advertisements now commonly extol the services of individual physicians or of hospital and ambulatory facilities staffed by physicians. Most of them go far beyond simply informing the public about the availability of medical services. Using the slick marketing techniques more appropriate for consumer goods, they lure, coax, and sometimes even frighten the public into using the services advertised.
I recently saw a particularly egregious example of this kind of advertising in the Los Angeles Times.A freestanding imaging center in southern California was urging the public to come for magnetic resonance imaging (MRI) studies in its new "open air" imager, without even suggesting the need for previous examination or referral by a physician. The advertisement listed a wide variety of common ailments about which the MRI scan might provide useful information — a stratagem calculated to attract large numbers of worried patients whose insurance coverage would pay the substantial fee for a test that was probably not indicated.
Before it was placed under the protection of antitrust law, such advertising would have been discouraged by the American Medical Association (AMA) and viewed with disfavor by the vast majority of physicians. Now it is ubiquitous, on television and radio, on billboards, and in the popular print media. Of course, not all medical advertising is as sleazy. Many respectable institutions and reputable practitioners advertise in order to bring their services to the public's attention. But in medical advertising there is a fine line between informing and promoting; as competition grows, this line blurs. Increasingly, physicians and hospitals are using marketing and public relations techniques that can only be described as crassly commercial in appearance and intent.
Advertising and marketing are just a part of the varied entrepreneurial activities in which practicing physicians are now engaged. Perceiving the trend toward the industrialization of medicine, sensing the threat to their access to paying patients from hospitals, HMOs, and other closed-panel insurance plans, and feeling the pressures of competition from the growing army of medical practitioners, doctors have begun to think of themselves as beleaguered businesspersons, and they act accordingly. I occasionally hear from physicians expressing this view. For example, a doctor from Texas recently sent me a letter saying: "Medicine is a service business, despite the fact that it deals with human beings and their health problems.... Physicians are an economic entity, just like the corner service station." Although I suspect many of his colleagues would not appreciate the analogy, I am afraid that too many would agree with the writer's opinion about the primacy of economic considerations in medical practice. In that respect, they would support the oft-expressed views of the leaders of the for-profit hospital industry. For example, the executive director of the Federation of American Hospitals (the trade association of the investor-owned chains) wrote in a letter published in the Journal 10 years ago: "I fail to see a difference between health services and other basic necessities of life — food, housing, and fuel — all of which are more oriented to the profit motive than is health care."11
Of course, the private practice of medicine has always had businesslike characteristics, in that practicing physicians earn their livelihood through their professional efforts. For the vast majority of physicians, however, professional commitments have dominated business concerns. There was always more than enough work for any physician to do, and few physicians had to worry about competition or earning a livelihood. Furthermore, it had long been generally accepted that a physician's income should derive exclusively from direct services to patients or the supervision of such services, not from any entrepreneurial activities.
All that seems to be changing now in this new era of medical entrepreneurialism and health care marketing. Increasing numbers of physicians have economic interests in health care that go beyond direct services to patients or the supervision of such services. The AMA, which formerly proscribed entrepreneurialism by physicians, now expressly allows it, with some caveats, apparently recognizing that a very substantial fraction of practitioners supplement their income by financial interests in all sorts of health care goods, services, and facilities.
The arrangements are too numerous and varied to describe in full here, so I shall simply cite some of them, a few of which I have already alluded to: (1) practitioners hold limited partnerships in for-profit diagnostic-laboratory facilities, to which they refer their patients but over which they exercise no professional supervision; (2) surgeons hold limited partnerships in for-profit ambulatory surgery facilities to which they refer their own patients; (3) office-based practitioners make deals with prescription-drug wholesalers, who supply them with drugs that the physicians prescribe for their patients and for which they charge retail prices; (4) physicians purchase prostheses at reduced rates from manufacturers and make a profit in addition to the professional fees they receive for implanting the prostheses; and (5) practitioners own interests in imaging units to which they refer their patients. Most of the free-standing imaging units are owned by investor-owned businesses, but some were originally owned by radiologists in private practice who have told me that they were persuaded to form joint partnerships with their referring physicians because these physicians threatened to refer their patients elsewhere.
Such arrangements create conflicts of interest that undermine the traditional role of the doctor.12 In the minds of some physicians, the old Samaritan tradition of our profession has now given way to the concept of a strict business contract between doctor and patient. According to this view, good physicians are simply honest and competent vendors of medical services who are free to contract for whatever services they are willing to provide and patients or their insurers are willing to pay for. Society has no more stake in the practice of medicine than in the conduct of any other business activity, and therefore no right to interfere with the terms of the private contract between doctor and patient."
Medical Board Fraud reported in California. The prosecuting attorney committed fraud in a manner similar to the Missouri Medical Board. What we need for patient safety, is better monitoring of physicians, earlier monitoring, gather more data, before repeatedly ignorantly reprimanding good medical care. Medical Board fraud isn't secondary to the attorney, or the incompetence of the Board Members, the current system is unaccountable, harmful to patients, and not helpful as they claim. Assign Board Members that will be accountable for their decisions. NOt those that want to be able to commit six acts of fraud and not pay a single penny to those that they harmed.
Medical Board Brutality - The Plot Thickens...
Opinion by Consumer Advocate Tim Bolen
Thursday, August 25th, 2005
Last Friday, August 19th, 2005 I sent out a newsletter called "Medical Board Brutality." It was about the newest antics of the California Medical Board Staff - an organization, I believe, to be completely corrupt - and not worth saving. Like the story about Hercules and the Aegean stables, the best thing that could happen is for someone to re-route the Sacramento river right through 1426 Howe Avenue (the medical board offices) - and for the same reason....
The responses were startling. In short, my disdain for the Administrative Law System, and the way it is abused against licensed health professionals, is SHARED worldwide.
I want to thank all of those who responded with a letter to the Presiding Judge of the Appeals Court. If you haven't yet sent yours in, please do so. You can get the details about what to do by clicking here.
In short, my earlier newsletter details an assault against a "lay representative" helping people through the Administrative law process. Charles Benninghoff had complained to an Administrative Law Judge that the Medical Board, and the prosecutor in the case, had "biased" the State's witness - a violation of the agency's own rules of conduct - and the State retaliated against Benninghoff, claiming he was "practicing law without a license..."
The Medical board went to a "friendly" Superior Court Judge and got an order seizing Benninghoff's office, leaving his clients in the lurch. Benninghoff filed an Appeal to the Fourth District Court of Appeals - and here we are.
So, how is the plot thickening?
Well, the situation is WORSE than I originally indicated. The corruption is far deeper, and far more extensive, than I thought. It extends deep into the bowels of the California Attorney General's (AG) office. Sit back, and read this...
It turns out that the whole case against Charles Benninghoff centers around two letters, so-called "legal opinions" of two employees of the Attorney General's office, one named Alfredo Terrazas, and the other, Robert McKim Bell...
So, who are these people?
First I'll tell you who Alfredo Terrazas is.
Those of you who have been long time readers of my newsletter will remember the series about the infamous "California Medical Board v. Sinaiko" case - and the huge cost, and embarrassment, it caused the California Medical Board over the seven years it took to complete. It was the "Sinaiko" case that first brought the wrath of the California Legislature on the staff, in the form of an official "Enforcement Monitor."
The "star" of the show, on the Medical Board's side, during the "Sinaiko" case, the man that lost the biggest case in the medical board's history, was prosecutor Alfredo Terrazas. It was his "legal opinions" and his grasp of the law (or lack of it), that was so contemptuously shot down by the California Court of Appeals. Terrazas's case, and his concept of what constituted health care, and his concept of the the law surrounding health care, brought together the largest, angriest, and most diverse, group of opposition I've ever seen anywhere. And, it was deserved.
The hallmark of the "Sinaiko" case was Terrazas's flagrant prosecutorial misconduct laid out in a fifty-one page document I'm going to give you access to right here. But the keynote was Terrazas's continued use of a "fake" witness (Samantha Simons), with a "fake" complaint. You can read about it, and view the documents , by clicking here.
Like in the situation Benninghoff complained about, Terrazas not only sought to "influence" the State's witnesses in the case, but he, against the orders of a Judge, slipped the"fake" document, by the "fake" witness, into the presentation to the appointed Medical Board members as "Exhibit #21."
In other words, there is a long history of abuse of the system, and misconduct on the part of the Medical Board staff and the AGs assigned to that function. And, Mrs. Terrazas's little boy Freddy is right in the forefront.
Why is this important? Read on...
As you may remember, the support network for "Sinaiko" ended up including not just the North American Health Freedom Movement, and the Progress in Medicine Foundation, but the Center for Public Interest Law (the group that actually WROTE the California Medical Practices Act), the California Medical Association (CMA), The American Association of Physicians and Surgeons (AAPS), the Union of American Physicians & Surgeons (UAPD), and many others - just too many to name here.
Unlikely bed-fellows - on most days.
The "Sinaiko" case brought factors together, in California, which significantly changed the way medicine is regulated. For, the general feeling was that the whole situation surrounding the "Sinaiko" case was just plain wrong. The finger pointing was, for the most part, ALL at Alfredo Terrazas.
The cause of all of the "Sinaiko" commotion was the misconduct, and decidedly "bigoted," and clearly "anti-due process" legal opinions, and maneuvering, of Alfredo Terrazas. Simply, (1) Terrazas felt that it was improper for a defendant (in this case, Sinaiko) to be able to defend himself/herself. He convinced an Administrative Law Judge, named Ruth Astle (who slept through much of the hearings) to disallow any of Sinaiko's top-of-the-line "expert witnesses," basically, because they DISAGREED with his witnesses, and he, Terrazas, claimed that (go ahead and laugh), that "only medicine that was generally accepted in the mainstream was allowed in California - everything else was health fraud."
The California Appeals Court, in the "Sinaiko" case, I think, must have thought that they'd run across a total nut case when they read Terrazas's arguments - for their reaction, and their ruling, was appropriate to that finding.
With Terrazas, it's not about justice, or disciplining bad doctors, its about "winning."
Terrazas bragged to Sinaiko's first attorney that "I never lose a case. I use the 'death of a thousand cuts' attack. I make as many accusations as possible so that even if you win on 999, I still win on one. And, I'm going to take your client's license to practice medicine away from him."
Shula Edelkind, the Executive Director of the Progress in Medicine Foundation, the group that raised the money for the "Sinaiko" defense, also gathered information to help Sinaiko. One of the most interesting documents (fifty-one pages long) I've seen come out of the case is called:
"Request for a Formal Investigation of: Mr. Alfredo Terrazas, State Bar # 78403, Deputy Atty Gen of CA, 2101 Webster Street, 12th Floor, Oakland, CA 94612-3049, (510) 622-2220, for misconduct in his prosecution of the case of Medical Board of California v. Robert Sinaiko, MD"
In that Terrazas did the following: False Statement of Fact, Concealed Material Information, Misquoted Scientific Materials, Misquoted the Testimony, Produced Inappropriate “Experts”, Misquoted and Misread the Medical Charts of Patients, Betrayed the Confidentiality of the Patients, Made Inappropriate Assumptions as to the Aim of Therapy, Cited as Authority a Decision that had been Overruled, Introduced into Evidence Materials Barred from Consideration, Colluded with Another to Deceive the Court, Used Slander, violated the ABA Code of Professional Responsibility, EC 7-13, Attempted to Show “Guilt by Association,” Took Advantage of Defense Naiveté ....
State Medical Board regulation should be more similar to this.'https://plus.google.com/101622158432432263442/posts/CVwVzhevbeg
Instead the Medical Board Members in Missouri Pre-judge or predetermine what data to gather, what to investigate, and what to reprimand. For example:
The State Medical Board committed six counts of fraud v. Dr. Adem for providing good medical care. The Medical Board Members commit crimes more heinous, than those they reprimand. In addition, a clinic has loaned me many thousand dollars to sue the medical board. The State Medical Boards desperately need federal oversight. Whoever said that it was a "good idea," to give a group of physicians absolute immunity and no oversight was probably narcissistic. Kind regards
#Fraud #FraudWatch +American Medical Association (AMA)
+American College of Cardiology
Greetings, as Telemedicine moves forward, we need to do something effective about Medical Boards such as Missouri. They commit fraud and then reprimand other doctors, such as Dr. Antoine Adem for lesser moral wrongs. They have completely lost sight of the purpose of physicians. They have no accountability for public health, for overall patient safety. They ignorantly and incompletely reprimand doctors for
both good medical care and numerous other incompetently documented claims.
Consider the case of Dr. Antoine Adem, who was helping patients, providing good medical care, healing the sick. The Missouri Medical Board, ignorantly, and probably somewhat maliciously refused to spend one hour to review the cardiac stent guidelines and reprimanded Dr. Adem six times in court. In addition the Missouri Medical Board caused patients in the State to go without medical care while they spent $100,000 plus of the States Money committing fraud. Eventually he was reprimanded for forging a signature. Okay, it is wrong. He did provide good patient care though. What is most perverse. Is that the Medical Board Members demonstrated incompetence, unethical, and unprofessional conduct when they commissioned the act of fraud against him x6. Whatever physician thinks that Medical Boards should be immune to commit fraud and repeatedly reprimand good medical care as they have repeatedly done should be evaluated for being a sociopath, and undergo a series of personality inventories, on various days. The lawyer on the medical board did not even know what PubMed is, and he was trying to say that I was not competent. The Medical Board staff is only paid $50 dollars per day, and the lawyer is paid 110 per hour. The Medical Board Members should be expected to use their medical training to prevent, and not enable the harassment of multiple doctors who were providing good medical care. Furthermore, if the physicians who "serve," on the State Medical Board were interested in the affairs of the State and did not co-opt their position of authority for their own interests, they would reprimand themselves for fraud x 6.
Medical Board Members are still forgoing their medical training and reprimanding doctors for providing by-the-books, FDA-approved, Medical care.
State Medical Boards need to be limited in their authority. Per the Judge, the Missouri Board of Registration for the Healing Arts committed six counts of fraud v. Dr. Antoine Adem and they did not reprimand themselves or their own medical licenses for either fraud or incompetence.
This is the link to the Burzynski case and the related fraud. Would any reasonable person file a claim of inappropriate advertising? These crooks on the Texas Medical Board have no active state oversight and no regard for the law.
#news #SCOTUS #antitrust #law #NC #dental #ABMS #MOC #MOL
Had enough medical board fraud yet