ProPublica

Journalism in the Public Interest

Cancel

As Side Effect of Fiscal Constraints, Dangerous Docs Go Undisciplined in California

More than 700 doctors in California sanctioned for wrongdoing by hospitals and other health care organizations haven’t faced any disciplinary action from the California medical board. And according to consumer advocacy group Public Citizen, which compiled the numbers, the medical board’s inaction puts public safety on the line.

The group sent a letter this week to California Gov. Jerry Brown, urging him to take action to protect patients. Most of the physicians had been identified by other health organizations as “unable to practice safely,” having “substandard or inadequate skill level,” or giving “substandard or inadequate care.” More than 100 were identified by peer reviewers as posing an “immediate threat to health or safety” of patients.

California’s medical board isn’t the first of the state’s regulators to be flagged for giving dangerous caregivers a pass.

Following a series of ProPublica reports in 2009 about the failure of the state nursing board to discipline nurses convicted of serious misconduct, then-Gov. Arnold Schwarzenegger replaced most of the members on the California Board of Registered Nursing and began issuing sanctions against some of the nurses we identified.

What’s unclear is whether the stepped-up enforcement by the nursing board has continued in light of the state’s budget problems. Records from a Board of Registered Nursing meeting in May showed members discussing the need for more enforcement staff—a challenge, given the state’s hiring freeze: “We lack the ability to fill the necessary, approved positions, or to backfill our existing vacancies,” the meeting minutes noted.

Vacancies are also a factor for the Medical Board of California, which is responsible for licensing doctors and suspending or revoking licenses for serious violations. A Medical Board spokeswoman told the Los Angeles Times, “We have a 20 percent vacancy rate and we’re trying to focus on our core functions.”

Meantime, the board is taking an average of more than 400 days to complete an investigation into a doctor, even though state law sets a deadline of 180 days, reported the Times.

California isn’t the only state with a troubled record of disciplining doctors. An earlier report by Public Citizen found that, across the country, more than half of the doctors listed in the National Practitioner Data Bank as having had their clinical privileges either restricted or revoked by their health care organizations did not face any state licensing action. That percentage was as high as 70 percent to 77 percent in eight states—Delaware, Hawaii, Indiana, New Mexico, Nevada, Pennsylvania, South Dakota and Tennessee.  

To see how your state compares, you can check the full report [PDF] or take a look at Public Citizen’s ranking of disciplinary rates [PDF] for doctors. 

Barry Schmittou

Aug. 11, 2011, 2:17 p.m.

DOL and DOJ did nothing after seeing Judges’ quotes that prove MetLife and their paid consultant Dr. Gary Greenhood ignore life threatening medical conditions including Multiple Sclerosis and a foot a new mother broke in five places !!!!

The Judges quotes include :

(1)  In the case of Ms. Jacquelyn Addis U.S. District Judge Honorable Timothy J. Savage wrote that MetLife and Dr. Greenhood ignored :

“MRI reports evidencing Multiple Sclerosis”

“nerve damage consistent with Ms. Addis’s complaints of stumbling and falling”

“pain in the lower extremities, fatigue, weakness and shaking in lower and upper extremities, poor coordination, bladder and bowel problems, blurred vision, and other physical problems”

(2) In the case of new mother Joanne Vick, U.S. District Judge Robert Cleland wrote that Metlife and Dr. Greenhood ignored a foot that Ms. Vick broke in 5 Places after she developed diabetic kytoacedosis following childbirth.

Please remember the patients may die during the years it takes their case to get to Court !! That almost happened to me and may happen soon !!

In the case of Brenda Zanny, U.S. District Judge Richard Enslen wrote :

“Metlife and its henchmen should appreciate that such conduct may itself precipitate the suicide death of a person who has placed implicit trust in their organization. This record is an open indictment of MetLife’s practices and treatment of the mentally-ill and long-term disability benefits.”

Marian, because of respect for your article I will not post a link here but you can Google search the following words and see how multiple insurance companies are endangering lives but the Obama and Bush administrations will not lift a finger to stop them

Treason Evidence Presented to President Obama as Mandated By U.S. Title 18 § 2382

In his Eulogy sermon/speech Obama said we should :

“expand our moral imaginations”
“sharpen our instincts for empathy”

I’m in shock because I cannot even get the Obama administration to ask MetLife and Dr. Greenhood to stop ignoring brain lesions and a foot a new mother broke in five places !!

My Psychologist wrote :

“Mr. Schmittou is in desperate situation”

“His intense emotional misery is a daily struggle. His concentration and sleep are impaired. His thoughts and emotions are so troubled he describes feeling “like my brain is on fire. I think he struggles to express the fullness of his distress.”

“I have conceptualized the severe and cumulative stress as traumatizing”

It is my impression that three medical doctors paid by Metlife appeared to have ignored medical evidence. For example, Metlife’s paid consultant, Dr. Yanik, “evaluated” Mr. Schmittou without ever having seen him or his medical record from 2004 through 2008. In fact, from the time he filed the claims in 2002 until the Court ordered a review in 2008, Metlife ignored both his claims for long-term disability based on vision impairments and on psychological impairments. In treatment, I have observed that the impact of such actions by Metlife has resulted in exacerbation of Mr. Schmititou’s psychological symptoms and periods of significant destabilization.

While being diagnosed with cancer was itself traumatizing, the subsequent nine-year struggle with Metlife has proved even more devastating to Mr. Schmittou. His COBRA insurance expired. He had no money for food, housing, insurance, medical treatment, or medication for four years until he received Social Security Disability benefits. His credit has been ruined. He has had to move in with his parents. He has developed desperate fears about homelessness. Understandably, his mental health deteriorated, traumatized by this threat to his life, his well-being, his sense of wholeness. Now, in addition to his impaired vision, he has intense psychological distress, impaired concentration, impaired frustration tolerance, fitful sleep, irritability, and hypervigilance, all hallmarks of Post-traumatic Stress Disorder (PTSD). As a result, he is at greater risk for impulsive acts against himself or others.

At various times, Mr. Schmittou has informed Metlife how desperate he has become. He has begged Metlife to stop the delays and obfuscations, because they added to his stress and depression, even to the point he often wished he were dead. Currently, he is so demoralized he is not seeking treatment for suspicious skin lesions or disturbing GI symptoms.

In light of the violations Metlife has committed against Mr. Schmittou and Metlife’s awareness of the additional harm caused him, Metlife’s actions seem irresponsible, inhumane, dangerous, and reckless.

(end of Psychologists quotes)

There is extensive medical evidence that excess stress had devastating affects physically.

Google has 17,300,000 search results and here is a brief quote from Womans Day :

“Researchers at Ohio State University have found that stress can accelerate the progression of malignant melanoma, a particularly aggressive form of skin cancer. According to TheMedGuru.com, researchers discovered that the stress hormone norepinephrine produces enzymes that stimulate blood vessels to grow in melanoma tumors, speeding up the progression and spread of the tumors”

(end of quote)

I have had multiple melanomas and cancer, but Obama’s DOL will not lift a finger to stop MetLife !!

MetLife’s Executive VP James Sullivan gave Obama $30,000 for his victory party, and then Sullivan signed MetLife’s third Non Prosecution agreement for committing multiple frauds in the sales of the policies like mine, but MetLIfe and doctors they pay are still destroying lives by ignoring medical consitions !!

Multiple insurance companies including MetLife also rigged bids and paid illegal kickbacks to promote sales of life, disability, and health insurance policies but no one was prosecuted.

Prudential, MetLife and Unum insurance all received Non Prosecution agreements for illegal kick backs !!

I have just found where AIG Insurance Company rigged so many bids in Workers Comp cases they were fined 1.6 billion dollars but no one was prosecuted !!!!

In 2006 the Securities Exchange Commission wrote :

“AIG will pay in excess of $1.6 billion to resolve claims related to improper accounting, bid rigging and practices involving workers’ compensation funds.”

(end of quote)

WFAA-TV in Dallas wrote :

“a remarkable number of Texans committed suicide because they could no longer endure the pain caused by their injuries and they had been repeatedly turned down for worker’s comp care.”

“The WFAA-TV series has revealed how some insurance companies send peer review doctors medical files “stripped” of records important to the possible approval of workers’ comp claims. Those peer review doctors who routinely deny care receive lucrative contracts, while those who approve care fail to be rehired.”

(end of quotes)

I feel like I’m in Obama/Bush Hell Marian. I pray God will help and ProPublica will do what they can !!

This article strikes me as a bit disingenuous, for some reason.  I mean, what, exactly, is the process, here?

If the doctors are already classified as dangerous (“immediate threat to health or safety”), then I would think that the work involved would be limited to suspending their licenses and sending notification.  The AMA—possibly the most powerful union you’re likely to find other than Congress—should be highly motivated to pitch in, since the presence of bad doctors only discredits them.  And I’m sure there’s a volunteer programmer somewhere who can automate the letter-writing, if not.  We’re not talking about landing on the Moon.

It’s not like they need to mount a door-to-door manhunt or imprison them in stockades (though they probably should), so where’s the problem, exactly?

More to the point, since you mention that there were similar problems under the Schwarzenegger administration, isn’t it more likely that this is the institutional culture in California rather than a budget issue?

Since perspective is always good, and our intrepid Mrs Wang seems to think the state = god, I decided to provide a list of all California state agencies.

California Academic Performance Index (API) * California Access for Infants and Mothers * California Acupuncture Board * California Administrative Office of the Courts * California Adoptions Branch * California African American Museum * California Agricultural Export Program * California Agricultural Labor Relations Board * California Agricultural Statistics Service * California Air Resources Board (CARB) * California Allocation Board * California Alternative Energy and Advanced Transportation Financing Authority * California Animal Health and Food Safety Services * California Anti-Terrorism Information Center * California Apprenticeship Council * California Arbitration Certification Program * California Architects Board * California Area VI Developmental Disabilities Board * California Arts Council * California Asian Pacific Islander Legislative Caucus * California Assembly Democratic Caucus * California Assembly Republican Caucus * California Athletic Commission * California Attorney General * California Bay Conservation and Development Commission * California Bay-Delta Authority * California Bay-Delta Office * California Biodiversity Council * California Board for Geologists and Geophysicists * California Board for Professional Engineers and Land Surveyors * California Board of Accountancy * California Board of Barbering and Cosmetology * California Board of Behavioral Sciences * California Board of Chiropractic Examiners * California Board of Equalization (BOE) * California Board of Forestry and Fire Protection * California Board of Guide Dogs for the Blind * California Board of Occupational Therapy * California Board of Optometry * California Board of Pharmacy * California Board of Podiatric Medicine * California Board of Prison Terms * California Board of Psychology * California Board of Registered Nursing * California Board of Trustees * California Board of Vocational Nursing and Psychiatric Technicians *

Well, the Propublica filters seem to think the list is spam, so google “California’s Unsustainable Existence, By Larry” and take a look at the hundreds of agencies and think about how much it costs to fund them.

No wonder everyone from Cali is packing thier bags for Texas.

So what are you trying to say, “Mike H”?  Eliminate all government services and regulatory agencies, and transform all of California into the Los Angeles depicted in Escape from L.A.?

lolll…that surely would make life more interesting; you see something you want, you just go take it using any method you please.

The right never stops to think how the growth in regulatory agencies was driven by they themselves when they inflicted the lie of “flood-up/trickle-down” economics upon the American people.

When the penalty for excessive greed became only more wealth, of course those individuals whose character flaws include a lack of ethics and morality began taking shortcuts and abusing the public trust - thus driving the growth of regulatory agencies in order to provide them with a reason to act in a civilized manner in spite of their greed.

Put another way, it is very hard to identify a regulatory agency that was created when no need existed - although the right would have you believe that just because their behavior resulted in financial loss, disease, injury, or death to other Americans doesn’t mean that they themselves created a need to regulate their behavior.

Or put another way yet, the right would have all behavior that might result in their suffering financial loss, disease, injury, or death regulated - with the caveat that their behavior be exempted from those regulations.

Is like dealing with two-year-olds; the right is nothing but “self”.  Pick anything that they do and consider it in the context of the behavior of a two-year-old and I think you will see what I mean.

the bureaucracy expands to meet the needs of the expanding bureaucracy

The state of California employs more than 350,000 directly and who knows how many more via contract and every single one of them (minus the contractors) is eligible for a big fat pension for life. Agencies like the Lieutenant Governor’s Commission for One California, charged with “exploring ways in which the media and our schools can foster tolerance” suck up finite and precious monies that should be going to police/fire/sanitation/education. The function of state government is to provide services to keep people safe, protect property, encourage economic activity and the like, and do it for the minium expenditure possible. Liberals tend to think that state government (and all levels for that matter) exists to provide good middle class jobs to its employees.

If you believe this is sustainable and its not a drag on both the public coffers then you are part of the problem.

As a dentist who was severely “disciplined” by the Maine dental board for no legitimate reason, I think it’s imperative to make sure all practitioners in licensed professions receive due process.  That often doesn’t happen, as in my case.  I lost my license because I had a business setback which was caused when one of the seven board members reneged on an agreement over office space, leaving me without a facility temporarily.  But the board claimed I’d abandoned a patient, grounds for discipline.  What the board member did was ignored completely.  Many other dentists in that state have received unjust sanctions.  I also know there is a big problem with sham peer review in hospitals.  The public also loses good providers.  Certainly there needs to be a way to protect the public from harm, but it must be remembered that providers make major sacrifices over many years of hard work to get their educations and it’s absurd to label them as incompetent, etc. without adequate and objective substantiating proof.    It now costs $350,000 or so to go to four years of dental school (not including college before that).  Public Citizen also has a bias in favor of discipline and doesn’t seem to care whether it’s fair to the practitioner.  As health care professionals, we’re expected to put the welfare of patients first and most of us do, but who looks out for our welfare?  Bad docs need to be dealt with, but so do bad licensing boards.

There needs to be a free, public access, website for every state that lists the names of doctors who have been reprimanded and sanctioned for malpractice and negligence.  Included should be an open forum for all to comment and post regarding the conduct and proficiency of any licensed physician.  Get the information into the open and let the public take care of the problem.

First of all, we’ve cut back on so many departments under the guise of saving money, but in the end, it’s going to bite us in the butt.  When you cut back on some of these departments, you lose the very people necessary to root our fraud and malpractice; which, in turn, causes more people to suffer the consequences.

Secondly, there are so many departments that duplicate jobs….I think we need to go through each department line by line and either consolidate, get rid of, or streamline so that we don’t have several departments doing the same job and not communicating.  Work would get done a lot quicker if things were streamlined and departments consolidated and working together to get jobs done.  This way, we would not only save money, but we would be able to have the staff needed to handle the problems that are coming up.

Could I become “property” if corporations are “person”??? 

If Corporations can sue over stuff – patents – why can’t Americans become property too?

Barry Schmittou

Aug. 13, 2011, 8:45 a.m.

Maybe you could become Proper T   : )

Thanks for the laughs !!

Stephanie Palmer

Aug. 13, 2011, 5:11 p.m.

Why can’t the names of these physicians and nurses be published in the local newspapers?  Sounds like a solution that wouldn’t require a lot of money. And how about putting their names on a national registry available over the internet?

Private Citizen

Aug. 14, 2011, 6:37 p.m.

I filed a complaint against a surgeon in CA.  I had abundant evidence and documents to prove my doctor’s intentional negligence.  The Medical Board of California completely ignored all my evidence and documents and my medical records.  The medical board just listened to the doctor’s attorney’s lies and the doctor’s lies.  I asked why?  I was told that the medical board was understaffed, so they made the decision by listening only to the doctor’s attorney and the doctor who brazenly lied under oath. The facts and evidence be damned!!  The public policy here is that when doctors are not held accountable, more patients’ lives are ruined.  Med Mal insurance companies do not pay anything to repair the injured patients.  Thus, it falls to the taxpayers, who pay via medicare, medi-cal, and social security disability.  What needs to happen is that doctors must be held accountable, their names and misdeeds should be noted by the Medical Board on a public web site, and they should face appropraite punishment.  Especially if they concealed facts and were grossly negligent and dishonest.  Med Mal Insurance companies, like The Doctor’s Company, should be forced to pay legitimate, provable claims, just like auto insurers.  The system in California is broken.

Barry Schmittou,

I actually agree with your comments on the lack of action by our judiciaries. They are supposed to be the guardians of the law.  Unfortunately, they have become politicians and are more concerned about protecting the rights of big business rather then individual rights as mandated by the Constitution. Where in the Constitution does it give any rights to business or corporations?  Our forefathers were business men and the specifically excluded any language to protect the interests of business.  You an only assume that lacking that language can only mean that the Constitution was meant for individual rights, ONLY.

With regard to the lack of federal government involvement, you must understand that the McCarran-Ferguson Act removed all limitations on interstate commerce and so long as the states regulated insurance.  The McCarran-Ferguson Act was passed in the wake of United States v. South-Eastern Underwriters Assn., 322 U. S. 533 (1944), which held that insurance is “commerce” within the meaning of the Commerce Clause. Prior to South-Eastern 654*654 Underwriters, insurance was not considered to be commerce within the meaning of the Commerce Clause, New York Life Ins. Co. v. Deer Lodge County, 231 U. S. 495 (1913); Paul v. Virginia, 8 Wall. 168 (1869), and thus “negative implication from the commerce clause was held not to place any limitation upon state power over the [insurance] business.” Prudential Ins. Co. v. Benjamin, 328 U. S. 408, 414 (1946) (emphasis added). Believing that the business of insurance is “a local matter, to be subject to and regulated by the laws of the several States,” H. R. Rep. No. 143, 79th Cong., 1st Sess., 2 (1945), Congress explicitly intended the McCarran-Ferguson Act to restore state taxing and regulatory powers over the insurance business to their pre-South-Eastern Underwriters scope. H. R. Rep. No. 143, supra, at 3; see SEC v. National Securities, Inc., 393 U. S. 453, 459 (1969); Maryland Casualty Co. v. Cushing, 347 U. S. 409, 412-413 (1954).

It’s up to the states to prosecute.

The worst worst ruling US District Court Judge Mariana R. Pfaelzer ever made with regard to states rights, was to rule Proposition 187 as unconstitutional.  Why should we have to pay for illegal immigrants?  Now look at the state of the mess California is in.  $323 billion, yes, billion dollars a year is spent on illegal immigrants. We would never had to raise the debt ceiling if we just cut off all the entitlement programs to illegal immigrants. 

I hear what you are saying and I actually agree with you on the issues of virtually no regulation.  Insurance companies keep getting court rulings that blatantly favor them, and hurt consumers. Consumer laws are being eroded, and we are letting it happen.

Add a comment

Email me when someone responds to this article.

Get Updates

Stay on top of what we’re working on by subscribing to our email digest.

optional

Our Hottest Stories

  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •  
  •