EVANS: Public Must Be Informed In Medical Discipline Cases | Columns


The Iowa Legislature’s to-do list is expected to get a little longer after last week.

And people should contact their Senators and Legislative Assembly representatives to make sure they understand their duty is to protect the health and safety of the Iowans.

The reason? The Iowa Supreme Court on Friday released a ruling that will virtually keep the public in the dark when a doctor is accused by state regulators of malpractice.

For decades, the Iowa Board of Medicine has published the facts and legal basis for the disciplinary charges the board has filed against doctors. This base could include a physician who is impaired by alcohol or other drugs. The doctor can be accused of sexually assaulting a patient in the examination room. Perhaps the doctor is accused of using inappropriate, unnecessary or unqualified treatment.

All of these things happened in Iowa. Each time, the board shared basic details of the case with the public after the charges were laid, although the names of the patients were never released.

But under the Supreme Court’s unanimous decision last week, these basic facts and circumstances must remain confidential until the medical board makes its final decision. This process often takes a few years. Meanwhile, the people of Iowa are deprived of vital information they should have when choosing a doctor.

The court’s decision was based on the judges’ interpretation of the language in Iowa’s licensing laws and disciplinary laws for physicians and other professions, including dentists, nurses, chiropractors and pharmacists.

The law states that “investigative information” gathered in connection with a complaint against a licensee must be kept confidential until the board makes its final, written decision – which is a public record.

Lawmakers long ago wrestled with a similar conundrum of what is public and what is private involving criminal charges. They decided that the facts and circumstances forming the legal basis for these charges must be made public when a person is charged with a crime.

With its ruling last week, the Supreme Court appears to be embracing the idea that the disciplinary charges filed by the medical board involve raw and unproven allegations.

The board doesn’t just type and file unverified charges after receiving allegations about a doctor. Commission investigators dig into the charges. They interview people. They study medical and scientific evidence with the help of experts.

Then the staff appear before the members of the Medical Council and ask them to decide whether there is an adequate legal basis and justification to justify disciplinary charges. Board members are appointed by the governor, subject to confirmation by the Iowa Senate. Seven of the 10 members must be physicians.

Staff and board members do not take their responsibilities lightly. They know they are making decisions that could affect a doctor’s livelihood, as well as the health and safety of the patients they treat.

Kent Nebel, the executive director of the Board of Medicine, told reporters the implications of the court’s decision were concerning.

The council receives about 600 complaints each year against the 6,600 active physicians in Iowa. These complaints remain confidential. It is only when the board concludes that there is a factual and legal basis for filing disciplinary charges that a physician is identified.

Only 25 to 30 of those 600 complaints result in charges, Nebel said.

The medical board has the power to order an emergency suspension of a doctor’s license if the person presents an immediate danger to the public. But this power is rarely used.

The Supreme Court case involved cardiac surgeon Dr. Domenico Calcaterra, who worked at the University of Iowa hospitals when he lived in Iowa. The medical board accused him of “disruptive and / or unethical or unprofessional behavior”.

The 2013 statement of charges indicated that he pushed another doctor during the operation. The allegations were not the first against him. He was charged with disruptive behavior in hospital in 2003-2004 and again in 2007-2008.

Calcaterra eventually agreed to pay a fine of $ 5,000 to settle the remaining charges.

He objected to the earlier allegations being made public because he said he did not admit them. These earlier allegations unfairly limited his employment opportunities, he said.

The dispute boils down to this: Does the Board of Medicine properly balance a physician’s desire for privacy with the public’s desire to know when a physician may have endangered health, safety and security? well-being of patients?

It is the position of the Iowa Freedom of Information Council, the nonprofit organization that I lead, that the facts and circumstances of such cases should be disclosed immediately when the Board of Medicine lays disciplinary charges against a physician. . Otherwise, if secrecy surrounds the basis of medical board fees, consumers cannot make informed decisions when they need a doctor.

That is why the legislature must step in and resolve this public-private dispute.

It would be troubling if lawmakers decide that public safety is less of a concern than ensuring that doctors accused of misconduct can keep their patients and potential patients in the dark while these cases are decided.

Randy Evans is executive director of the Iowa Freedom of Information Council, a 43-year-old nonprofit education and advocacy organization that works to improve government transparency and civic responsibility. He can be contacted at [email protected]

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