Wednesday, May 24, 2006

Are state medical boards becoming draconian?

Perhaps so, opines Chris Rangel. State boards, suffering from an image of being too lax, are under public pressure to police the medical profession more aggressively. And, according to Dr. Rangel, at least in the state of Texas, an increasing frequency of complaints to medical boards, often frivolous, may be an unintended consequence of successful tort reform in that state. He writes that physicians in Texas fear the board is getting out of control and notes the case of one doctor who was “fined $500, ordered to take classes on documentation, publicly reprimanded, and all for forgetting to time and date an addendum note in a chart.” (Though I have no hard data I’ve heard of instances of this sort of thing).

Rangel writes that board investigators tend to take the attitude that the doctor is guilty until proven innocent. If that’s not already true one influential consumer activist group wants the standard to move in that direction. The Public Citizen Health Research Group wants “A reasonable statutory framework for disciplining doctors (preponderance of the evidence rather than beyond reasonable doubt or clear and convincing evidence).” And just how “reasonable” is preponderance of evidence as a standard for disciplinary hearings? I had that standard of explained to me by a plaintiff attorney when I was on jury duty a few years ago. He asked prospective jurors to imagine preponderance as analogous to “one thousand and one grains of sand” balanced on the scales of justice against “one thousand grains of sand.” Wow. Two grains of sand shy of guilty until proven innocent.

Related post here.

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