Complaints warrant checkups on doctors

The Nevada Board of Medical Examiners had a backlog of 525 complaints at the start of 2015. An additional 1,078 complaints were filed last year — about three per day. By the end of the year, 570 complaints were pending.

But only 19 medical doctors and physician assistants were publicly disciplined last year.

How can a board that's falling behind ever erase that backlog and fulfill its duty to discipline bad medical doctors?

Executive Director Edward Cousineau said Wednesday that the office is making headway and that the situation not as bleak as the numbers suggest.

Since taking over the board's top job in January, Cousineau has added investigators. But there are so many cases, the investigative committees of three board members have trouble handling all the complaints — the committees meet just four times a year.

Despite that, he said most cases are resolved within six to nine months. "The oldest might be 18 months," said Cousineau, an attorney who has worked for the board in various capacities since 2000.

Sixteen medical doctors were disciplined last year: Cesar Estela, Peter Philander, Arlyn Valencia, Emmanuel Acosta, Steven Holper, Arnold Klein, Michelle Stacey, Irina Volkova, Timothy Beckett, Susan Boyd, Ara Keshishian, Henry Landsman, Rita Starritt, Jan Thompson, Binh Chung and Ascar Egtedar. Three physician assistants were disciplined: David Armitage, Douglas Lynch and Heather Rohrer.

The Nevada Board of Osteopathic Medicine disciplined three doctors last year: Daniel Royal, David Moon and Jacqueline Leventhal. The DO board oversees fewer physicians, about 1,000 compared with 7,210 active MDs. Only 19 complaints were pending before the DO board at the end of 2015; 85 complaints were dismissed and 23 were dismissed with a letter of caution last year.

The DO board is able to stay on top of complaints because it gets far fewer complaints than the Board of Medical Examiners.

If any of these people are your medical providers, I want to teach you how to research the specifics of their cases, because it's all online and you need to know.

Let's start with the Board of Medical Examiners. The website is: http://medboard.nv.gov/

There are three links to search.

First, click on "Licensee Lookup" and put in the name of the medical doctor or physician assistant. Up pops their educational background. Scroll down to see if there's a record of discipline or restrictions placed on a license. Malpractice settlements are listed here.

A second option is to look down the alphabetical list under "Disciplinary Actions." If a doctor's name is there, you can click on the name and find printable documents regarding his or her discipline. However, the list only dates back to 2008, so it won't have previous discipline cases.

The third way is to click on "Public Filings by Year." That's where you find cases where an investigatory board has found cause to file a complaint, but no final decision has been made. Other public filings, such as the termination of a probation, are also on this list.

The newsletters online also disclose doctors who have been disciplined.

Or one can call the toll-free, in-state number at 888-890-8210 and ask whether a doctor has been disciplined.

The Board of Medical Examiners has added a wealth of information for the public and deserves much praise for its openness.

But how many of you have ever bothered to check out your doctor, much less your PA?

For the osteopathic board, go to http://www.osteo.state.nv.us/

Go to "Licensee Verification" and it will direct you to "Disciplinary Action." From there, all kinds of information can be downloaded and printed out.

If you don't have access to a computer, you can call the board at 702-732-2147 and ask if your DO has been subject to any formal disciplinary action or if malpractice has been reported.

"What we absolutely do not do is verbally summarize the complaint or the malpractice case because that leaves too much to interpretation and can be misstated," said Executive Director Barbara Longo, who provided the disciplinary statistics for 2015.

The websites of the boards also explain that malpractice settlements don't necessarily reflect a doctor's competence or indicate that malpractice occurred.

I looked at the 22 people disciplined by the two Nevada boards last year. Some complaints involved substance abuse. Several were disciplined because they failed to notify the Nevada board they had been disciplined in other states.

The most serious complaints involve patient care or sexual abuse. Binh Chung's license has been suspended indefinitely for having sex with a minor patient.

Hand surgeon Ascar Egtedar has had insurance companies pay out three malpractice settlements, and last year he had a neuropsychological assessment and was deemed a risk to patients. His license also was suspended indefinitely.

Many medical providers reach settlements with the board and their licenses are returned to active status. For example, pain management specialist Steven Holper's license is active again, although he has had two settlements since 2013. Malpractice charges were dropped, and he pleaded guilty to keeping poor records regarding his diagnosis, treatment and care of certain patients. He's been publicly reprimanded.

The Board of Medical Examiners' records also show that since 1993, his insurance companies have paid out three settlements. The highest was $500,000 in 1999 and involved a misdiagnosis that led to a woman's death, and in 2006, his insurance carrier paid $250,000 because one of his patients overdosed on prescription drugs.

Just saying, if these were my doctors, I'd want to know. And I'd want to see the documents if my doctor were disciplined. Sometimes I wouldn't care. Other times it would matter, particularly if there were a pattern.

The New England Journal of Medicine released a study in January that found "approximately 1 percent of all physicians accounted for 32 percent of paid [malpractice] claims." They looked at more than 66,000 claims paid out against more than 54,000 physicians from 2005 through 2014, using the National Practitioner Data Bank.

I wouldn't want to go to one of the 1 percent of bad doctors who cause most of the insurance settlements when there are so many fine doctors out there.

Jane Ann Morrison's column runs Thursdays. Leave messages for her at 702-383-0275 or email jmorrison@reviewjournal.com. Find her on Twitter: @janeannmorrison