Report raises concerns over effectiveness of CT scan medical advice

The state medical review board ranked 37th in the country for the annual rate of serious disciplinary action taken against doctors accused of wrongdoing from 2017 to 2019, according to a Public citizen report released earlier this year.

The Connecticut board averages about 13 serious disciplinary actions per year in 2017, 2018 and 2019, according to Public Citizen. Rankings were based on the number of serious disciplinary actions taken by states per 1,000 physicians. Connecticut’s rate was 0.65 per 1,000 physicians – Kentucky had the highest rate of serious disciplinary action at 2.29 per 1,000 physicians, according to the report. Public Citizen defines “serious disciplinary action” as one that has a clear effect on a physician’s ability to practice.

Medical Boards, which oversee the discipline of physicians in all 50 states and the District of Columbia, are largely unfunded or underfunded, insufficiently staffed, respond to complaints rather than initiate investigations proactive and receive little oversight from government officials or legislators. , according to the report.


“They don’t do what they’re commissioned to do,” said Dr Sidney Wolfe, founder and senior advisor of the Public Citizen’s Health Research Group and one of the report’s authors. “So what’s happening is they’re leaving tens of thousands of patients exposed to doctors who shouldn’t be exercising.”

Complaints against doctors in Connecticut can take months and sometimes years to investigate and decide. In a recent case, a psychiatrist was cleared to practice while a 2018 complaint was investigated and disciplinary action was being negotiated over allegations that he had failed to monitor a patient on Lithium and did not keep patient records during the reporting period. His case was settled in June with a fine of $ 10,000 and 18 months probation.

Lawyer Kathryn Emmett, President of the Connecticut Board of Directorssaid the Public Citizen report did not reveal the whole picture. Emmett said she couldn’t speak for the entire board, but noted that comparing states based on the number of disciplines issued was not the best way to gauge their effectiveness.

“I think the idea that as many serious disciplines as possible can be used is wrong,” Emmett said. “I don’t think it shows whether the board is achieving its goal of protecting the public.”

But at least two public council members share the concerns of the national rights group. Jean Rexford, who has been a member of the board of directors for over a decade and founded the Connecticut Center for Patient Safety, told the board at its May meeting that it wanted to determine whether it was doing enough to keep the public safe.

“I think the legislation that chartered us goes back many years,” Rexford said. “Is it time to take a look at this and wear it until 2021?” Do we need greater consideration of transparency? I feel incredibly helpless on Zoom [where the meetings are now conducted] but also helpless in our role of protecting the public, ”Rexford said before suggesting that a committee of board members consider“ how we could keep up to date and do a better job ”.

Rexford’s comments prompted the creation of a task force, which met privately for the first time on September 28. The state Department of Public Health maintains that the meetings are administrative and not open to the public. Connecticut Health Investigation Team has filed a complaint with the state Freedom of Information Commission on the denial of access to the meetings of the working group.

Composition and role of the Med Council

The composition of the medical council – which includes doctors, lawyers and members of the public – and its functions are set out in decades-old law that has been periodically updated. The board of directors has no funding and no staff of its own. All fines collected from disciplined doctors go into state coffers. All staff are DPH employees who also handle complaints against other professions. The Board of Directors does not have independent investigative or policy-making powers, as required by law.

The DPH practitioner authorization and investigation section examines complaints against doctors. The same investigators are handling complaints against dozens of other professions, including nurses, hair and nail salons, and veterinarians.

There are 18 full-time investigators within the unit who work on 1,200 to 1,500 complaints per year, said section chief Christian Andresen. There is also a hearing process for physicians who dispute the charges. The agency receives about 450 complaints about doctors each year, resulting in an average of 43 disciplines per year, DPH officials said.

The DPH hires medical consultants to determine whether a doctor faced with a complaint has met the standard of care or been involved in activities that could be harmful to patients, Andresen said. The range of complaints submitted to the Medical Review Board includes physicians practicing under the influence of alcohol or drugs, physicians who do not accurately diagnose serious illness, physicians practicing with severe mental illness, or physicians prescribing to patients without adequate supervision and control.

Michele Jacklin, a public member of the medical council, said the council was “powerless and toothless” compared to medical advice from other states. “Other councils have budgets, publish newsletters and run seminars,” Jacklin said in an interview. “The Connecticut Medical Examination Board is fully responsive.”

Jacklin’s concerns range from the lack of an orientation process for new board members to the range of fines that can be imposed as a discipline, she said.

“Other states regularly impose fines of up to $ 50,000,” Jacklin said. “In Connecticut, the penalties are often $ 1,000 to $ 5,000, which is a slap on the wrist for a doctor. “

State law limits fines for medical discipline to $ 25,000.

No staff member can monitor state or national medical issues that may arise, including checking social media for state doctors who are spreading misinformation about COVID-19 vaccines, officials said.

Although a spokesperson for the DPH said the agency would investigate all complaints related to misinformation about COVID-19, it took more than five weeks for Andresen to follow up on an anonymous report that a doctor in the Durham retreat was issuing fraudulent exemptions for COVID-19 vaccines and masks. anyone who sent him a stamped envelope to his address, according to the documents.

Since the complaint against Sue McIntosh was filed anonymously, it took five weeks to “sort” it out before it was presented to Andresen for investigation, DPH officials said.

The board of directors unanimously voted to suspend McIntosh’s medical license on September 24. Days later, the DPH alerted all long-term care facilities in the state, which require staff to be vaccinated, to review their employees’ COVID-19 vaccine exemptions to see if McIntosh had signed any.

The DPH declined to provide information on whether McIntosh had granted exemptions to long-term care workers or state employees, who are also required to be vaccinated against COVID-19. The board unanimously agreed to drop the charges against McIntosh last week after she voluntarily relinquished her medical license.

Under the current system, board members have no idea how many complaints are filed, the substance of complaints, or how many complaints are dismissed, Jacklin said. “Discipline is negotiated by DPH lawyers, and then what happens to us is a consent order,” she said. “Basically, we can’t ask questions or get any information other than what is in the consent order. All we can do is reject the consent order or approve it automatically. “

In general, the council focuses on endorsing the disciplines that educate and monitor physicians to improve and provide better care, said Emmett, president of the medical council. “I don’t think there is good data to support that greater discipline translates into better care for the community,” Emmett added.

But the board could do more to protect the public by providing direction to all board members and being kept abreast of state legislative events and national policy changes, Rexford and Jacklin said.

Rexford said other state councils decided to pass legislation based on a report from a national task force on physician sexual misconduct. “I just feel like we’re missing the boat when I hear that and when I see what the other bands are doing,” Rexford said. “At the very least, I would like Chris [Andresen] attending meetings, I would like everyone to attend an orientation session and I would like to feel that we are all working as a team.

This story was reported in partnership with the Connecticut Health I-Team (c-hit.org), a non-profit news organization dedicated to health reporting.


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Sara H. Byrd

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