MSDC Testifies at Hearing on Board of Medicine

Highlights Work of Professional Standards Committee and Physician Health Program

WASHINGTON, DC--The Medical Society of the District Columbia presented testimony at today's oversight hearing on the DC Board of Medicine. The hearing was called by DC Councilmember David Catania, chair of the Council's Committee on Health.  MSDC Executive Vice President K. Edward Shanbacker, MPA, introduced President Victor G. Freeman, MD, MPP, who presented the Medical Society's testimony.

As part of the testimony, MSDC highlighted the work of its Professional Standards Committee and Physician Health Program.  Howard Hoffman, MD, chair of the Professional Standards Committee and Peter Cohen, MD, chair of the Physician Health Committee, which administers the Physician Health Program, were also in attendance.

Introduction by Mr. Shanbacker:

Thank you Chairman Catania and members of the Committee.  I am K. Edward Shanbacker, Executive Vice President of the Medical Society of the District of Columbia, representing nearly 2000 District physicians and the thousands of patients they serve each day.  With me today is the Medical Society's President, Dr. Victor Freeman, who will provide the Medical Society’s comments.  Also with me, to respond to questions, are Dr. Howard Hoffman, Co-chair of the Society's Professional Standards Committee and Dr. Peter Cohen, Chair of the Society's Physician Health Committee.

Chairman Catania, we applaud you for holding this hearing.  One "bad doctor" is one too many. And while no system of oversight and discipline of physicians—or for that matter of attorneys, accountants, nurses, or other professionals – can be absolutely perfect, we will all benefit from a much stronger and better-funded Board of Medicine which can and will license physicians efficiently and, more importantly, can and will identify and remove from practice any physician who poses a threat to patients.  We remain committed to working with the Council, the Mayor, the Board of Medicine and other stakeholders to improve physician licensure and discipline to foster greater patient safety throughout the District of Columbia’s entire health care delivery system.  One clear step toward that goal is that the Health Care Reform Act of 2005 recently introduced into the Council on behalf of Mayor Williams contains important provisions to enhance patient safety in the District of Columbia.  We fully support this legislation.

Statement by Dr. Freeman: 

As President of the Medical Society of the District of Columbia, I want first to underscore Mr. Shanbacker’s statement that the Medical Society of the District of Columbia supports – and in fact has long supported – a stronger and more effective Board of Medicine.  Over the years we have testified before Council committees and met with the Board of Medicine and other officials to urge the City to make the licensing process more timely and efficient and also to provide sufficient funding so that the Board could hire more investigators and attorneys to address concerns about quality and patient safety.  Our position on this is a matter is long-standing. Therefore, in the few minutes I have today, I will discuss the medical community’s response to the recent Washington Post series and tell you about physician-led programs aimed at enhancing the quality of medical care delivered by the over 3,000 physicians who on a daily basis provide compassionate, high quality care to thousands of patients in the District of Columbia.

I want to make it very clear to you and to everyone listening:  the behavior of the troubled physicians profiled in the Post series is completely unacceptable.  Patients were clearly and tragically at risk.  This is intolerable and antithetical to all that physicians are trained to be.  The Medical Society and our members remain disturbed that such actions apparently went undetected by the Board of Medicine for too long and then, when identified, were not addressed promptly and aggressively.  Clearly, one important element of the medical peer review system in this City broke down.  We must act promptly and aggressively to fix it.  The Medical Society remains committed to working with you and other stakeholders toward that goal.

It is important, however, to point out that the Board of Medicine is only one element of the District of Columbia medical peer review system.  There are other extensive safeguards for patients and the public that function effectively every day.  For example, in hospitals throughout the city, physicians volunteer their time to serve on peer review, disciplinary, quality improvement, and patient safety committees which closely monitor care, identify areas of possible concern and intervene where appropriate.  Also, health plan peer review committees work to ensure that care provided by physicians in the plans’ networks deliver high quality care to the patients those plans insure.  In addition, medical liability insurance companies’ underwriting and peer review committees monitor the care provided by physicians to determine whether – and if so, to what extent - the companies will insure those physicians.  These many peer review groups throughout this city have prevented impaired physicians from practicing and have identified, educated and closely monitored other aberrant physicians.   These peer review groups are, in short, part of the reason why patients from all over the world come to Washington, DC to receive their medical care.

Hospital, health plan and liability insurance company peer review programs are only part of the peer review system in this community.  The Medical Society of DC maintains two peer review committees for whom patient safety is the highest priority.  These are our Professional Standards Committee and the Physician Health Committee.  In the interest of time, I have attached to our testimony, a fact sheet regarding these committees.  I will briefly describe the programs to you now and encourage you to ask questions of the committees’ leaders who sit here today.

Our Professional Standards Committee addresses allegations of inappropriate conduct by a physician toward an individual patient, non-compliance with the accepted standards of medical ethics, or of failure to provide quality medical care.  The Committee investigates allegations thoroughly, evaluates each complaint and then renders a decision.  In some cases, we direct the physician’s attention to inappropriate conduct or care and strongly recommend that the physician change the behavior or method that gave rise to the complaint.  In other cases, we request that the physician and/or patient accept a settlement of the issue or disagreement.  In still other cases, we explain to the patient that the physician acted appropriately. 

One important note:  The deliberations of the Professional Standards Committee are not legal proceedings.  In fact we are not empowered to revoke or even restrict a medical license.  If the subject of the complaint refuses to comply with the Committee’s decision, the only sanctions we can impose include suspension of the physician’s Medical Society membership or expulsion from the Society.  If the non-compliant physician is not a member – and we accept complaints against both members and non-members - our decisions can be only advisory.  With serious cases where a physician is non-compliant and/or non-responsive and patient safety is in jeopardy, we can and do refer the matter to the Board of Medicine.

No physician’s behavior or medical judgment should be compromised by alcoholism or other drug dependencies, mental illness or disabilities associated with aging.  And so, approximately 25 years ago, the Medical Society of DC created our Physician Health program to protect patients and save the careers and sometimes even lives of physicians and medical students.  We receive expressions of concern from impaired physicians’ medical colleagues, practice staff, family members, friends, and sometimes from the physicians themselves.  The name of the concerned caller and the nature of the report are held in confidence while we conduct a prompt and discreet investigation to confirm the accuracy of this information.  If necessary, the Committee will initiate an intervention and work with the impaired physician and trained professionals to develop a strict, rigorous and uncompromising treatment program.  The impaired physician signs an agreement with the Committee, a Treatment Program Agreement, through which we absolutely do not coddle the physician.  We do, however, help him or her obtain and stay in treatment and recovery.  We closely monitor that process and if the physician refuses to seek therapy, interrupts therapy prematurely or violates any terms of the treatment agreement that he or she signed with the Committee, the Society may refer the physician to the Board of Medicine at which point the Committee’s advocacy for the physicians will terminate.

I want to emphasize that we encourage those who suspect that a physician or medical students might be impaired to contact the Medical Society’s Professional Standards Department at 202-466-1800, ext. 103.  We also welcome calls from physicians themselves.

In closing, I want to emphasize again that the Medical Society of the District of Columbia has long supported efforts to strengthen the District of Columbia Board of Medicine.  However, for this to happen, the Board must be given adequate resources not only to license physicians efficiently and effectively but also – and more importantly – to provide the oversight and discipline that are integral to the delivery of high quality health care in the nation’s capital.   To reach these goals, the District must be willing to provide additional funding to the Board of Medicine, especially funding earmarked for the hiring and training of investigators and attorneys who are equal to the challenges faced by the Board of Medicine.

I and my colleagues here would welcome any questions you may have.  Thank you.