...and that's why they wear masks!

Interested Blogger, or “IB,” makes some interesting observations about professional ethics enforcement generally and medical ethics in particular in the Comment of the Day, responding to the post, The Legal Profession’s Muddled Standard For “Fitness To Practice.” Her insight regarding the reasons why professionals are so reluctant to pull the licenses of misbehaving colleagues is astute, I think.  Lawyers and doctors are hesitant to punish individuals for doing something they could imagine themselves doing, though the Golden Rule is  being misapplied. It’s a disturbing thought, but an illuminating one: perhaps John Edwards keeps his law license because other male lawyers think, “Boy, that could happen to me: get smitten by some hot babe in the office, we fool around, she sandbags me on birth control…heck, I might panic. I might try a crazy scheme to cover it up, especially if it was all going to be played up in the tabloids. Poor guy! How can we disbar him?”

Here is IB’s “Comment of the Day”:

“I think the problem with the legal profession, much like the medical profession, is that it’s lawyers and doctors who make the ultimate disciplinary decisions about other lawyers and doctors. And after all the years of schooling and the personal ego identification that goes along with the titles and professions, there’s a (misguided) reluctance to judge one’s own too harshly. “There but for the grace of God go I …” or “It was wrong, but that doesn’t mean we should take away his/her right to make a living,” or “A written reprimand should be a wake-up call to deter this individual to not behave this way again” is too often the standard applied. Never mind that we’re talking about highly educated, presumably intelligent people (after all, they did go to college and graduate school and pass medical/legal boards) and they could, therefore, presumably get, I don’t know, SOME other kind of job.

If you really want to scream, look into how long it takes BORIM (the Board of Registration in Medicine) in Massachusetts to take action against physicians in cases where the physicians don’t accept the recommendation of the Board and it goes to litigation. It takes years, many years. After all – when we’re talking about slapping a physician’s wrist and ruining his or her reputation or, God forbid, taking away a hard-earned medical license, let’s err on the side of caution for the physician  rather than on the side of caution for the hundreds of patients who may be put in harm’s way. (Unless they don’t pay taxes or child support on time…then we can yank their license straight away. Of course – I’d rather be treated by someone who’s a little bit delinquent to Uncle Sam than someone who killed a patient by over-prescribing narcotics, but that’s just me.)

Meanwhile – these physicians can still practice medicine in all but the most egregious cases. And the list of complaints against some (I know of one case where a physician has several cases pending against him/her, composed of several dozens of serious complaints dating back to 2008 or earlier) include charges involving inappropriate sexual relations with patients, writing prescriptions for narcotics to patients he/she has never met or treated, etc. – and for this particular physician the cases are not expected to be resolved for at least several more years. Meanwhile – the physician has not been reprimanded, has not had his/her license suspended, still holds a valid Massachusetts physician’s license. Patient beware! But – how would the patient know?

If you look up the physician’s profile on the Commonwealth of Massachusetts official website – you can see it for yourself – this physician has no record of any disciplinary action by the Board for the last ten years!   The State of Mass website indicates this is a physician with a clean record. And if you know enough to dig deeper and ask BORIM to send you all closed cases against this doctor, they will – but the open cases (the ones tied up in litigation) are not a matter of public record yet, and BORIM isn’t allowed to tell you if there are any open cases. Only if you know enough to know this doctor. is under investigation and know that he/she has cases in litigation with DALA (Division of Administrative Law Appeals) and also know that you can ask to see what they have in a public records request can you find out that maybe this is not a doctor you want to have treating you.

How is the public being protected and served during the years this is all being litigated? It isn’t! And did I mention – the physicians who sit on the BORIM review board are all paid by the State of Massachusetts – that’s right – tax-payer dollars (not) being used to protect the welfare of taxpayer’s health. Scary, indeed.

Frankly – I think this is FAR worse than the situation with lawyers not properly policing their own. With lawyers, public trust is at stake and (unfortunately) slimy lawyers cost some innocent people a lot of time, money and, on rare occasion, their freedom and lives. But physicians who are not appropriately policed have the potential to do much more damage to a much larger group of people on a daily basis.