Wednesday, March 11, 2009
Editorial: Dealing with dangerous doctors
A decade after a state study found disciplinary action inadequate and tardy, there are signs that problems continue to exist in Virginia.
From the RoundTable blog
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It's been a decade since the last comprehensive assessment of Virginia's disciplinary system for doctors and six years since the reforms that followed that dismal assessment took effect.
It is time for another look.
A 1999 report by the Joint Legislative Audit and Review Commission faulted the state Board of Medicine for allowing physicians to continue to practice even in cases where license suspension or revocation seemed warranted. The board also set too high a threshold for determining negligence and took too little heed of medical-malpractice claims.
The General Assembly passed reforms in 2003 meant to deal with some of those issues, but there are some reasons to believe the discipline of dangerous doctors remains lax in the commonwealth.
Public Citizen's Health Research Group issues an annual ranking of serious disciplinary actions taken by every state. The latest survey shows that Virginia has fallen from 30th to 39th since the 2003 reform.
In 2007, the Virginia Board of Medicine took serious disciplinary action against 70 doctors, or 2.6 per 1,000 doctors practicing in the state.
The national average was 3.46 per 1,000 doctors.
While that could be a sign that fewer dangerous doctors are practicing in Virginia, there's little reason to believe that.
The Board of Medicine receives about 2,000 complaints a year, according to President Stephen Heretick.
Not all of those complaints are valid, of course, and judging physician competency is notoriously difficult. But the sheer number of complaints makes it harder to determine which are most egregious, Heretick said.
In an interview with The (Norfolk) Virginian-Pilot, Heretick also said the board could use some help from doctors themselves.
"I can tell you after almost seven years of doing this that it is very rare that a doctor will report another doctor," he said. "For example, I have to wonder aloud why, in these particular cases, there was no complaint ever made by a single medical examiner."
The "particular cases" he referred to dealt with Dr. Stephen Plotnick, whose license the board recently suspended after a number of serious complaints dating back to at least 2003.
A pain management specialist, Plotnik has been accused of contributing to the deaths of many patients during the last five years. The Virginian-Pilot documented the deaths of at least 10 of his patients since 2004.
Many family members have filed complaints saying Plotnik overprescribed pain killers, leaving patients lethargic and, in some cases, semi-comatose. Many of his patients died of narcotic overdoses.
Heretick heard from fellow practitioners only after action was taken against Plotnick, he said. "One, an emergency room physician, told me that 'Plotnick' is a verb in their practice," he said. "They'll say, 'Oh, yeah, this patient was Plotnicked.' Apparently, his issues have been recognized in the medical profession for quite some time."
By law, doctors are required to report suspected cases of malpractice. That law appears to be regularly ignored.
The General Assembly should direct JLARC to conduct a follow-up study to its 1999 report with a specific emphasis on doctors who fail to report dangerous colleagues.
