Article archive / November 1, 2015
Originally published: . Volume 6, No. 11. Source pages: 3, 4.
In what appears to be a years-long effort by the Louisiana Medical Society to make key changes in the way the state medical board manages investigations, supporters of Act 441 are pushing for the Rules changes, including a limit on preliminary investigations to one, rather than three years. The public hearing was to have taken place October 28.
The behind the scenes negotiation over time limits could become an issue, government affairs consultant and spokesperson for the Louisiana State Medical Society, Ms. Jennifer Marusak explained to the Times.
Marusak said that the changes in Act 441, some of which are major, came after years of complaints about how physicians were treated by the investigations staff at the state medical board.
“There were no limits, no structures, no definitions,” Marusak said. “A complaint of having a poor bedside manner could open up the door so that the investigators could go in and investigate everything in that physician’s office.”
Marusak also explained that there were problems because investigations would look at the complaint out of context, and not in light of the standard of care that was related to that specific complaint.
Currently, Rules are being developed to go with Act 441, which passed this spring. Marusak explained that while the original bill was changed during the legislative process, the main elements were retained and negotiated to be included in the rules.
“We might have a sticking point in the rule making because they would like the preliminary investigation to be three years, But, we mandated the changes go into the rules [instead of the law] and so this should be a one- year limit,” she said.
Marusak explained that other problems had emerged with the investigations process over the years. These included reports of retaliation and bullying. “Some were told not to bring an attorney,” she said. “And, you could have a piece of paper shoved across the desk at you and told to ‘Sign this consent order,’” she said.
“Cases would be opened and never closed.” But, Marusak said, “The board members never knew what was going on.”
At the Senate Commerce meeting on June 3, 2015, Ms. Marusak told committee members that the bill “simply put some due process steps in place, so that when a complaint is filed against the physician, there is complete transparency in the process, they know what to expect, and that they’re able to navigate the process at all.”
“Absolutely no way is the state Medical Society even attempting to hinder the investigation or prosecuting of bad doctors.”
President of the Louisiana State Board of Medical Examiners (LSBME), Dr. Mark Dawson spoke in what appeared to be opposition. He objected to the proposed changes in the law for incompetent practice and unprofessionalism, and asked that those changes be placed in the Rules, rather than coded into the statutes.
Senator Martiny cautioned Dr. Dawson that he was not to
lobby, but only to present information, represented by filling out the “white card.”
Senator Martiny paused in hearing testimony and said, “This is the problem I have with some of the boards, as it exists now. Because you’re going to end up being the judge. You have no say so as to whether or not an investigation takes place.”
“Instead, what happens is, your staff codes the investigations. Okay. And what it comes down to is that, when they present the information to you…these are people that work for you and you have to be an unbiased person to make that determination. And I think, the point I’d make to you is, I work with these people [points to other Senators] every day. If there was a credibility call between one of my staff members and you, and it’s whether I believe you or I believe them, […] Whether you want to admit it or not, its what I refer to as ‘two friends and a stranger.’ It’s the board, the board’s investigator, and a doctor.”
Martiny said that he has watched a board take the advice of their advisor and the person representing the doctor, and “any objection was over-ruled.”
Dr. Cecila Mouton, current Executive Director of the LSBME also testified. “There is no lack of due process in any of our proceedings,” she said. And, “In no case do physicians, not know what’s going on. They are encouraged to bring an attorney, and they are, again, afforded all due process.”
She said that because of the low number of incidences of discipline, “There is no reason for a physician to be frightened of the board.”
She asked that instead of a change in the law, that the changes be in the Rules, or to have a study group. She also said “The medical society is not being honest when they say they’ve been asking for this Rule change.”
In a follow-up testimony, Marusak responded that she was insulted by the suggestion that the Medical Society had in any way mislead the committee. She said that three years ago, Representative Nick Lorusso had worked with the society on this topic and the medical board had promised to write Rules to address the issue. However, no rules had been written, she said.
“Physicians fear speaking out,” Marusak said.
Executive Director of the state medical board, Dr. Cecila Mouton (seated L), and Dr. Mark Dawson, president of the medical board, speak about their concerns regarding a bill to change investigations. Senator Martiny in frame.
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