Bad handwriting could cost doctor his license

The Nevada State Medical Board has formally threatened to revoke the medical license of Dr. James Gabroy, a 69-year-old Henderson internist who has never had malpractice or professional incompetence problems, nor has he ever had sexual misconduct, patient abandonment or fraudulent billing issues.

He even takes care of patients who become unemployed and lose their insurance.

“He’s an unsung hero,” said Daniel Stango, a limousine driver. “Four years ago I was out of work with no means to pay and he helped me and my son get our health back. I’m a single dad and I don’t know what I would have done without him.”

In other words, he’s what most people look for in a primary care doctor — a physician with an unblemished record and a big heart.

“I’ve handled 1 million office visits and never missed a diagnosis,” said Gabroy on a recent weekend as he handled paperwork in his office for the 50 patients he sees each day.

So why is the board taking action against Gabroy — punishment ranges from a $5,000 fine to license revocation — with a Sept. 28 hearing scheduled in Reno?

His handwriting.

No, there aren’t claims that his alleged poor penmanship ever hurt patients in any way.

Not even a claim that his writing caused a prescription to be redone.

So what gives?

Citing confidentiality, Ed Cousineau, the board’s executive director, won’t stray far from the Oct. 23, 2015, board complaint that alleges the medical records of three unnamed patients were illegible, inaccurate and incomplete.

While Cousineau says he can’t reveal how Gabroy’s alleged poor penmanship came to the board’s attention, Gabroy argues that UMR, a third party administrator hired by employers to ensure employee insurance claims are paid correctly, made a complaint to the board.

In an email, Trevor Hayes, a spokesman for UMR’s owner United Healthcare, wrote: “We will not have a response to this column.”

Carrie Parker, an attorney for Gabroy, said the fax number used to send copies of some of Gabroy’s draft notes to the medical board turned out to be UMR’s.

“All three patients’ records were UMR’s, ” Gabroy said. “UMR owes me $100,000. This is a stall tactic for not paying, but I haven’t dropped their patients.”

Cousineau said the board takes complaints from insurance companies against physicians.

What is mystifying is why Gabroy’s case got to the formal action level. Even if his handwriting was illegible — three local doctors dispute that — the board could have sent him a warning letter, suggesting that if he didn’t learn how to write clearly, action could be taken in the future.

Drs. Leo J. Spaccavento, Russell Gollard and Michael Fishell say they can read Gabroy’s writing. They say it followed standard medical note format for ease of information access to his patient assessments and treatment plans.

Cousineau said he found a doctor who’ll argue she can’t understand what Gabroy wrote.

Attorney Parker said “it is inexplicable” the board would spend thousands of taxpayer dollars on a case that has cost Gabroy $70,000 to defend.

“It makes no sense,” she said.

Could it be Gabroy came across as too abrasive when first asked by the board to communicate about his handwriting?

Gabroy, who calls Cousineau “psychotic,” concedes the board may have detected his antagonism against what he sees as a ridiculous situation.

Parker says Gabroy “has a way of speaking his mind.”

But is lack of tact reason to revoke a doctor’s license, or put him on probation, or suspend him?

Keep in mind Gabroy is a proud man. Even though he never works less than 12 hours day and must work Saturday and Sunday to do the paperwork necessary to ensure his patients get the care they deserve, he refuses to stop working as a solo practitioner and enter a group as most doctors do.

“I want to do what’s best for my patients, not do what’s best for a medical group,” he said.

And he plans to continue to help patients as long as he can.

“Unfortunately, I know what happens now — more and more harassment,” he said. “What the medical board should be doing is supporting good doctors, not trying to run them out of business.”

Paul Harasim’s column runs Sunday, Tuesday and Friday in the Nevada section and Thursday in the Life section.Contact him at pharasim@reviewjournal.com or 702-387-5273. Follow @paulharasim on Twitter.