State law restrains medical board from doing better

In reading the recent three-part series, “Ailing Oversight,” regarding Hawaii’s Board of Medical Examiners, it rapidly became apparent the direction the writers were taking.

Unfortunately, they chose sensationalism in favor of objective analysis. Criticism was overwhelmingly directed at the medical licensing boards — more specifically, to its physicians as opposed to public members.

The articles, which ran in the Star-Advertiser Sunday through Tuesday, implied that if there were more public members on the board, these lapses in discipline would not be occurring. The obvious sensationalism is the suggestion of a “good ol’ boy” network of doctors who look out for each other, like the priesthood.

The articles only vaguely skirted at the overweighing factor in the cause of the problems cited, that being the administrative and bureaucratic lag of Hawaii’s system of discipline in its regulated industries.

Furthermore, this is not unique to the medical board whatsoever. The role of the state Regulated Industry Complaints Office (RICO) pervades this issue for all licensing boards.

Making the insinuations more egregious, the writers seemed to be well aware of the underlying process of disciplinary actions the board must follow.

The Board of Medical Examiners is made up of physicians who volunteer their time and efforts. Yet, beyond mere time, it would be difficult to convey the extent of emotion and soul searching that goes into making the difficult judgments they are presented with. In my 16 years of experience as a member of a medical board in Hawaii, I can guarantee that the physician members are as tough or tougher on complaints that come before them as any other medical board in the country.

What the writers did not bring out is that the medical board is specifically barred against doing its own investigations. The entire investigative process is done by RICO, and that is the entire reason for the delays the writers cited.

The board cannot do anything until RICO brings a case to it and suggests a specific action. In fact, board members are admonished strongly against looking into potential complaints in any way before RICO has brought it to them. Once it has, the board cannot consider any other facts but those that RICO presents.

We live in a small state where physicians interact more closely than in most others. One might only imagine the frustration this creates among board members.

Compounding the problem, when RICO brings a complaint to the board, it does so with a suggestion for action that it has arrived at by interacting with the accused physician (and often his or her lawyer).

Statutorily, the board cannot act on the matter in the way they see fit and must either accept or reject RICO’s suggested course of action.

In my years on the board, we were all too often faced with the dilemma of feeling strongly that a more severe sanction was due than that suggested by RICO. In these cases, all we could do was reject RICO’s suggestions and send the case back to them, hoping that they would come up with a more severe sanction.

The perversion of this system is that no action is then taken for perhaps months more while RICO goes over the case. All the while, the offending physician remains unsanctioned. The second in the series of articles vaguely alluded to this Catch-22, but again, made it sound that it is the fault of the board. This represents nothing more than sensationalistic journalism that obscures the facts.