BAD MEDICINE | The Board's Reaction and its Future

BALTIMORE - Abusing drugs and alcohol, trading sex for medication, even playing a role in the deaths of patients.  Those are some of the serious claims we found inside the discipline files of Maryland doctors.  But an ABC2 News investigation uncovered that even in those disturbing cases justice isn't always swift.

Maryland Delegate Wade Kach was shocked to hear about lengthy delays in discipline carried out by the Maryland Board of Physicians, "When I found out, I was absolutely shocked."

Of the 49 doctors whose records we examined, discipline took an average of 21 months, although we saw some cases drag on as long as seven years.  But we're not the only ones looking at the board.  State legislators are also reviewing how the board operates and saw the results of an audit last fall.  Board Chairman Doctor Paul Elder says, "The Sunset Review sort of hit the board like a tsunami."

Elder sat down for a one-on-one interview with ABC2 to discuss the audit as well as the findings of our investigation.  He says, "It's my impression we were doing a pretty good job."

But that's not how auditors felt.  They issued harsh criticisms of the board, citing backlog of complaints and increasing delays in resolving them, with hundreds of cases left open.  Doctor Joshua Sharfstein, Maryland's Health Secretary says, "I think the most concerning part of the audit was that overall things are just moving in the wrong direction."

While Sharfstein's agency is separate from the independent Board of Physicians, he says the serious issues brought to light in the audit left him no choice but to step in and offer guidance.  He explains, "I think it can be very hard for organizations that are generally out there on their own, like a board is, to change significant.  I think it requires outside intervention."

That intervention will likely come from three sources.  Sharfstein has appointed a new Executive Director, Carole Catalfo, and an outside consultant, Dr. Jay Perman.  Lawmakers are also putting the board under a microscope.  Delegate Kach, who sits on the committee that will determine whether the board survives in its current form, says, "We need to know why they can't do the job."

For his part, Chairman Elder says the board is doing its job despite funding and staffing challenges.  He touts their success in prosecution, noting that through thorough investigation, once charges are brought against bad doctors they typically stick, even at the highest levels of appeal.  Elder says, "There's something noteworthy about the quality of our work product, when we're able to identify somebody who really needs to be sanctioned."

But those sanctions can be months or years in the making as our investigation exposed.  Some believe patients are potentially put at risk while cases are examined.  Elder says, "That is unfortunate, extraordinarily unfortunate and I wish that it did not happen but we are bound by certain rules and regulations as to how to deal with these cases."

Elder says the appearance of staleness in some cases is also often misunderstood.  He says the board often receives complaints that are investigated and later have to be closed without action for various reasons.  But in many instances, additional evidence or complainants are offered and the case is reactivated, using both the older and more recent information.

But state leaders would like to see those cases move more quickly.  They hope new leadership and changes in the board's processes will help.  Sharfstein, in addition to appointing those new leaders, has also asked the board to start tracking and posting the time it takes to resolve complaints.  Elder says the board is open to improvement, "The board knows, like any human endeavor, things can be done better and we are working to do that."

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